WorldWideScience

Sample records for care teams operating

  1. Developing a Multidisciplinary Team for Disorders of Sex Development: Planning, Implementation, and Operation Tools for Care Providers

    Directory of Open Access Journals (Sweden)

    Mary Elizabeth Moran

    2012-01-01

    Full Text Available In the treatment of patients with disorders of sex development (DSD, multidisciplinary teams (MDTs represent a new standard of care. While DSDs are too complex for care to be delivered effectively without specialized team management, these conditions are often considered to be too rare for their medical management to be a hospital priority. Many specialists involved in DSD care want to create a clinic or team, but there is no available guidance that bridges the gap between a group of like-minded DSD providers who want to improve care and the formation of a functional MDT. This is an important dilemma, and one with serious implications for the future of DSD care. If a network of multidisciplinary DSD teams is to be a reality, those directly involved in DSD care must be given the necessary program planning and team implementation tools. This paper offers a protocol and set of tools to meet this need. We present a 6-step process to team formation, and a sample set of tools that can be used to guide, develop, and evaluate a team throughout the course of its operation.

  2. Interdisciplinary diabetes care teams operating on the interface between primary and specialty care are associated with improved outcomes of care: findings from the Leuven Diabetes Project.

    NARCIS (Netherlands)

    Borgermans, L.D.A.; Goderis, G.; Broeke, C. Van Den; Verbeke, G.; Carbonez, A.; Ivanova, A.; Mathieu, C.; Aertgeerts, B.; Heyrman, J.; Grol, R.P.T.M.

    2009-01-01

    BACKGROUND: Type 2 diabetes mellitus is a complex, progressive disease which requires a variety of quality improvement strategies. Limited information is available on the feasibility and effectiveness of interdisciplinary diabetes care teams (IDCT) operating on the interface between primary and spec

  3. Better team management--better team care?

    Science.gov (United States)

    Shelley, P; Powney, B

    1994-01-01

    Team building should not be a 'bolt-on' extra, it should be a well planned, integrated part of developing teams and assisting their leaders. When asked to facilitate team building by a group of NHS managers we developed a framework which enabled individual members of staff to become more effective in the way they communicated with each other, their teams and in turn within the organization. Facing the challenge posed by complex organizational changes, staff were able to use 3 training days to increase and develop their awareness of the principles of teamwork, better team management, and how a process of leadership and team building could help yield better patient care.

  4. Interdisciplinary diabetes care teams operating on the interface between primary and specialty care are associated with improved outcomes of care: findings from the Leuven Diabetes Project

    Directory of Open Access Journals (Sweden)

    Mathieu Chantal

    2009-10-01

    Full Text Available Abstract Background Type 2 diabetes mellitus is a complex, progressive disease which requires a variety of quality improvement strategies. Limited information is available on the feasibility and effectiveness of interdisciplinary diabetes care teams (IDCT operating on the interface between primary and specialty care. A first study hypothesis was that the implementation of an IDCT is feasible in a health care setting with limited tradition in shared care. A second hypothesis was that patients who make use of an IDCT would have significantly better outcomes compared to non-users of the IDCT after an 18-month intervention period. A third hypothesis was that patients who used the IDCT in an Advanced quality Improvement Program (AQIP would have significantly better outcomes compared to users of a Usual Quality Improvement Program (UQIP. Methods This investigation comprised a two-arm cluster randomized trial conducted in a primary care setting in Belgium. Primary care physicians (PCPs, n = 120 and their patients with type 2 diabetes mellitus (n = 2495 were included and subjects were randomly assigned to the intervention arms. The IDCT acted as a cornerstone to both the intervention arms, but the number, type and intensity of IDCT related interventions varied depending upon the intervention arm. Results Final registration included 67 PCPs and 1577 patients in the AQIP and 53 PCPs and 918 patients in the UQIP. 84% of the PCPs made use of the IDCT. The expected participation rate in patients (30% was not attained, with 12,5% of the patients using the IDCT. When comparing users and non-users of the IDCT (irrespective of the intervention arm and after 18 months of intervention the use of the IDCT was significantly associated with improvements in HbA1c, LDL-cholesterol, an increase in statins and anti-platelet therapy as well as the number of targets that were reached. When comparing users of the IDCT in the two intervention arms no significant differences

  5. Innovation Teams: Operating Principles.

    Science.gov (United States)

    Thomas, George B.; Jones, James M.

    This examination of the operation of teams in the Pilot Communities Program is chiefly historical in character. Based on intensive examination of proposals, evaluation studies, reports, memoranda, and interviews with personnel involved in the program, it was written by two university professors who had not been involved in the actual program. The…

  6. Improving Palliative Care Team Meetings: Structure, Inclusion, and "Team Care".

    Science.gov (United States)

    Brennan, Caitlin W; Kelly, Brittany; Skarf, Lara Michal; Tellem, Rotem; Dunn, Kathleen M; Poswolsky, Sheila

    2016-07-01

    Increasing demands on palliative care teams point to the need for continuous improvement to ensure teams are working collaboratively and efficiently. This quality improvement initiative focused on improving interprofessional team meeting efficiency and subsequently patient care. Meeting start and end times improved from a mean of approximately 9 and 6 minutes late in the baseline period, respectively, to a mean of 4.4 minutes late (start time) and ending early in our sustainability phase. Mean team satisfaction improved from 2.4 to 4.5 on a 5-point Likert-type scale. The improvement initiative clarified communication about patients' plans of care, thus positively impacting team members' ability to articulate goals to other professionals, patients, and families. We propose several recommendations in the form of a team meeting "toolkit." PMID:25794871

  7. Team networking in palliative care

    Directory of Open Access Journals (Sweden)

    Odette Spruyt

    2011-01-01

    Full Text Available "If you want to travel quickly, go alone. But if you want to travel far, you must go together". African proverb. The delivery of palliative care is often complex and always involves a group of people, the team, gathered around the patient and those who are close to them. Effective communication and functional responsive systems of care are essential if palliative care is to be delivered in a timely and competent way. Creating and fostering an effective team is one of the greatest challenges for providers of palliative care. Teams are organic and can be life giving or life sapping for their members.

  8. Critical Care Team

    Science.gov (United States)

    ... of these areas: Surgery Internal medicine Pediatrics Anesthesiology Critical care nurse: A highly skilled nurse who provides all aspects ... and can often uphold the patient's wishes. The critical care nurse becomes an important part of decision-making with ...

  9. Building the eye care team

    Directory of Open Access Journals (Sweden)

    Thulasiraj Ravilla

    2014-07-01

    Full Text Available Eye care services are people intensive. They require the right people (competence, in the right numbers (capacity, in the right mix (team with the right resources and processes (enabling conditions to ensure effective and sustainable delivery of patient care.

  10. Team Interactions in Specialized Palliative Care Teams: A Qualitative Study

    OpenAIRE

    Klarare, Anna; Hagelin, Carina Lundh; Fürst, Carl Johan; Fossum, Bjoorn

    2013-01-01

    Background: Teamwork is a standard of care in palliative care and that is emphasized by leading organizations. When interdisciplinary teams communicate their varied assessments, outcomes may be more than additive due to the synthesis of information. Interprofessionality does not guarantee multidimensionality in health care interventions, however, and that interprofessional teams promote collaboration may be questioned. Aim: The aim was to explore team interaction among team members in special...

  11. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette; Rasmussen, Jens Ole; Nielsen, Claus Vinther;

    2012-01-01

    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... people with hip fracture, homeless people with mental illness, adults with multiple sclerosis, stroke, aquired brain injury, chronic arthropathy, chronic pain, low back pain, and fibromyalgia. Whereas evidence was not found for adults with amyetrophic lateral schlerosis, and neck and shoulder pain....... Conclusion: Although these studies included heterogeneous patient groups the overall conclusion was that multidisciplinary rehabilitation team care effectively improves rehabilitation intervention. However, further research in this area is needed. © 2012 The Authors....

  12. Understanding Cleft and Craniofacial Team Care

    Science.gov (United States)

    ... Selecting a Team Now that you understand how team care works and have seen the approved listing of teams ... so make sure you are comfortable communicating and working with the members of the team. Treatment recommendations should be communicated to you in ...

  13. Exploring primary care activities in ACT teams.

    Science.gov (United States)

    Vanderlip, Erik R; Williams, Nancy A; Fiedorowicz, Jess G; Katon, Wayne

    2014-05-01

    People with serious mental illness often receive inadequate primary and preventive care services. Federal healthcare reform endorses team-based care that provides high quality primary and preventive care to at risk populations. Assertive community treatment (ACT) teams offer a proven, standardized treatment approach effective in improving mental health outcomes for the seriously mentally ill. Much is known about the effectiveness of ACT teams in improving mental health outcomes, but the degree to which medical care needs are addressed is not established. The purpose of this study was to explore the extent to which ACT teams address the physical health of the population they serve. ACT team leaders were invited to complete an anonymous, web-based survey to explore attitudes and activities involving the primary care needs of their clients. Information was collected regarding the use of health screening tools, physical health assessments, provision of medical care and collaboration with primary care systems. Data was analyzed from 127 team leaders across the country, of which 55 completed the entire survey. Nearly every ACT team leader believed ACT teams have a role in identifying and managing the medical co-morbidities of their clientele. ACT teams report participation in many primary care activities. ACT teams are providing a substantial amount of primary and preventive services to their population. The survey suggests standardization of physical health identification, management or referral processes within ACT teams may result in improved quality of medical care. ACT teams are in a unique position to improve physical health care by virtue of having medically trained staff and frequent, close contact with their clients.

  14. Health care operations management

    OpenAIRE

    Carter, M W; Hans, E.W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully selected papers dealing with optimization and decision analysis problems in the field of health care operations management.

  15. Working with a palliative care team.

    Science.gov (United States)

    Wiebe, Lauren A; Von Roenn, Jamie H

    2010-01-01

    The interdisciplinary team is fundamental to the successful delivery of quality palliative care. Ideally, the oncologist is an integral part of either the palliative care or hospice team and serves to maintain continuity of care through the end of life. In the United States, barriers can complicate the oncologist's easy integration into the hospice team as patients often remain at home. Also, there may be philosophical or clinical practice differences between oncology and palliative care at first glance. This article focuses on ways to overcome these potential obstacles and use differences in training to strengthen the team's impact. A significant part of oncology practice includes managing difficult symptoms, mitigating suffering, and discussing priorities of care--all elements of palliative medicine that oncologists perform daily. Participating on a palliative care team may be natural for oncologists, and some might elect to provide integrated palliative cancer care for patients throughout the course of their disease and at the end of life. Thus, there is a need to enrich the general oncologist's knowledge of specialized palliative medicine, as recommended by the major cancer organizations, including the American Society of Clinical Oncology and the European Society of Medical Oncology.It is important to know when to incorporate a palliative or hospice care team into the routine management of a cancer patient and what benefits these referrals can provide. Oncologists have an obligation to provide high-quality palliative care to all patients in an integrated fashion, including patients with advanced cancer enrolled in clinical trials for early therapeutics.

  16. The Mangle of Interprofessional Health Care Teams

    Directory of Open Access Journals (Sweden)

    Susan C. Sommerfeldt

    2015-01-01

    Full Text Available The aim of this study was to explore dimensions of relational work in interprofessional health care teams. Practitioners from a variety of disciplines came together to examine teamwork and cocreate knowledge about interprofessionalism using forum theater. Interviews held prior to the workshop to explore teamwork were foundational to structuring the workshop. The forum theater processes offered participants the opportunity to enact and challenge behaviors and attitudes they experienced in health care teams. Throughout the workshop, aspects of professional identity, power, trust, communication, system structures, and motivation were explored. The activities of the workshop were analyzed using Pickering’s theory, identifying three mangle strands found in being a team: organizational influences, accomplishing tasks, and an orientation to care. Performativity was identified as having a bearing on how teams perform and how teamwork is enacted. Practice components were seen as strands within a mangling of human and nonhuman forces that shape team performativity.

  17. Primary health care team workshop: team members' perspectives.

    Science.gov (United States)

    Long, S

    1996-05-01

    This study explored members' perceptions of teamwork in two primary health care teams (PHCTs). It also examined the effect of a team-building intervention on members' perceptions centred around five topics: the PHCT, role perception, communication, leadership and conflict. The study used a qualitative approach with semistructured interviews before and after the intervention. It was found that members perceived each other's roles only in the light of their interactions with each other. Issues of hierarchy in leadership and interpersonal conflicts were raised. It is concluded that the team-building intervention had some positive effects on team members' perceptions and behaviour. However, further research is needed into management structures and conflict resolution in the PHCT. PMID:8732520

  18. Predictors of Cooperation in Health Care Teams.

    Science.gov (United States)

    Stahelski, Anthony J.; Tsukuda, Ruth Ann

    1990-01-01

    Investigated assumption that positive group process results from cooperation among group members by analyzing specific components of cooperation involved in teamwork and relating them to group input variables in interdisciplinary health care team members (N=72). Found cooperation was significantly related to size of team and whether an individual…

  19. Medical Operations Support for ISS Operations - The Role of the BME Operations Team Leads

    Science.gov (United States)

    Janney, Rob; Sabatier, Veronica

    2010-01-01

    This slide presentation reviews the role of the biomedical flight controllers (BMEs), and BME Operations Team Leads (OTLs) in providing medical support for personnel on the International Space Station. This presentation will concentrate on role of the BME OTLs, who provide the integration function across the integration function across all Crew Health Care System (CHeCS) disciplines for operational products and medical procedures.

  20. Pharmacists belong in accountable care organizations and integrated care teams.

    Science.gov (United States)

    Smith, Marie; Bates, David W; Bodenheimer, Thomas S

    2013-11-01

    Effective health care workforce development requires the adoption of team-based care delivery models, in which participating professionals practice at the full extent of their training in pursuit of care quality and cost goals. The proliferation of such new models as medical homes, accountable care organizations, and community-based care teams is creating new opportunities for pharmacists to assume roles and responsibilities commensurate with their capabilities. Some challenges to including pharmacists in team-based care delivery models, including the lack of payment mechanisms that explicitly provide for pharmacist services, have yet to be fully addressed by policy makers and others. Nevertheless, evolving models and strategies reveal a variety of ways to draw on pharmacists' expertise in such critical areas as medication management for high-risk patients. As Affordable Care Act provisions are implemented, health care workforce projections need to consider the growing number of pharmacists expected to play an increasing role in delivering primary care services.

  1. Palliative care teams: effective through moral reflection.

    NARCIS (Netherlands)

    Hermsen, M.A.; Have, H.A.M.J. ten

    2005-01-01

    Working as a multidisciplinary or interdisciplinary team is an essential condition to provide good palliative care. This widespread assumption is based on the idea that teamwork makes it possible to address the various needs of the patient and family more effectively. This article is about teamwork

  2. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    Science.gov (United States)

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338

  3. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    Science.gov (United States)

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.

  4. Building collaborative teams in neonatal intensive care.

    Science.gov (United States)

    Brodsky, Dara; Gupta, Munish; Quinn, Mary; Smallcomb, Jane; Mao, Wenyang; Koyama, Nina; May, Virginia; Waldo, Karen; Young, Susan; Pursley, DeWayne M

    2013-05-01

    The complex multidisciplinary nature of neonatal intensive care combined with the numerous hand-offs occurring in this shift-based environment, requires efficient and clear communication and collaboration among staff to provide optimal care. However, the skills required to function as a team are not typically assessed, discussed, or even taught on a regular basis among neonatal personnel. We developed a multidisciplinary, small group, interactive workshop based on Team STEPPS to provide staff with formal teamwork skills, and to introduce new team-based practices; 129 (95%) of the eligible 136 staff were trained. We then compared the results of the pretraining survey (completed by 114 (84%) of staff) with the post-training survey (completed by 104 (81%) of participants) 2 years later. We found an improvement in the overall teamwork score from 7.37 to 8.08 (p=job fulfilment (p=<0.0001), believed that their abilities were being utilised properly (p=0.003), and felt more respected (p=0.0037). 90% of staff found the new practice of team meetings to help increase awareness of unit acuity, and 77% of staff noted that they had asked for help or offered assistance because of information shared during these meetings. In addition to summarising the results of our training programme, this paper also provides practical tools that may be of use in developing team training programmes in other neonatal units. PMID:23396854

  5. Team work of care workers in residential care institutions

    OpenAIRE

    Mišković, Svjetlana

    2014-01-01

    In my diploma thesis special attention is given to care workers that work with a group of youth in extrafamilial residential institutions. They are defined as a team or work group, depending on the work structure. I am aware of the difficulty of educational team work and that is why I want to define and research their experiencing team or group work. At the beginning of the theoretical part I define educational work in educational institutions and youth homes, then continue with the definitio...

  6. The IAEA operational safety review team programme

    International Nuclear Information System (INIS)

    In 1982, the IAEA set up the Operational Safety Review Team (OSART) programme, under which international expert teams make in-depth three week reviews of operational safety practices at nuclear power plants (NPPs). The OSART reviews offer excellent opportunities for the exchange of experience between expert team members and operating organization staff on how to improve safety performance. The missions deal with important areas of operational safety, including plant management, personnel training, operation, technical support, radiation protection and emergency planning. OSART does not advocate a single proven approach, but supports alternative approaches that can contribute to a plant's drive for enhanced operational safety. An OSART mission comprises 10 to 12 experts, external consultants recruited from NPPs, utilities and regulatory authorities for reactor specific expertise, and IAEA staff to ensure consistency between reviews. OSART Guidelines have been developed, based on IAEA Safety Series publications, applicable national rules and experience from OSARTs. A technical document on the major results of the first 18 OSART reviews (1983-1987) has been published. As of April 1988, a total of 25 OSART missions had been carried out. All NPPs visited were being operated without causing undue risk to the health and safety of plant personnel or the general public. However, room for further improvements was discovered, particularly in those areas where human factors play a major role. The most important recommendations made concerned advanced management methods, preparedness to cope with emergencies and the comprehensive feedback of operating experience. All plants visited were responsive to the teams' proposals and actions were often initiated while the teams were still present at the site. (author). 3 refs, 3 tabs

  7. Team performance measures for abnormal plant operations

    International Nuclear Information System (INIS)

    In order to work effectively, control room crews need to possess well-developed team skills. Extensive research supports the notion that improved quality and effectiveness are possible when a group works together, rather than as individuals. The Nuclear Regulatory Commission (NRC) has recognized the role of team performance in plant safety and has attempted to evaluate licensee performance as part of audits, inspections, and reviews. However, reliable and valid criteria for team performance have not yet been adequately developed. The purpose of the present research was to develop such reliable and valid measures of team skills. Seven dimensions of team skill performance were developed on the basis of input from NRC operator licensing examiners and from the results of previous research and experience in the area. These dimensions included two-way communications, resource management, inquiry, advocacy, conflict resolution/decision-making, stress management, and team spirit. Several different types of rating formats were developed for use with these dimensions, including a modified Behaviorally Anchored Rating Scale (BARS) format and a Behavioral Frequency format. Following pilot-testing and revision, observer and control room crew ratings of team performance were obtained using 14 control room crews responding to simulator scenarios at a BWR and a PWR reactor. It is concluded, overall, that the Behavioral Frequency ratings appeared quite promising as a measure of team skills but that additional statistical analyses and other follow-up research are needed to refine several of the team skills dimensions and to make the scales fully functional in an applied setting

  8. What Can Primary Care Learn From Sports Teams?

    Science.gov (United States)

    Fiscella, Kevin; Fogarty, Colleen; Salas, Eduardo

    2016-01-01

    Teams are familiar to sports but relatively new to primary care. In this perspective, we use sports teams to illustrate key principles from team science and extract practical lessons for primary care teams. The most notable lessons include the need for continuous team learning based on presession planning and postsession debriefing, real-world team training focused on identified teamwork needs, and on-site team coaching. Implementation of these principles requires organizational commitment coupled with alignment of continuing medical education and recertification requirements with primary care teamwork competencies. PMID:27232689

  9. Guidance for Structuring Team-Based Incentives in Health Care

    OpenAIRE

    Blumenthal, Daniel M.; Song, Zirui; Jena, Anupam B.; Ferris, Timothy

    2013-01-01

    New payment methods designed to incentivize more efficient care delivery are accelerating the movement of health care providers into organized provider groups. More efficient health care delivery requires explicit structuring of care delivery processes around teams of clinicians working toward common patient care goals. Provider organizations accepting new payment methods will need to design and implement compensation systems that provide incentives for team-based care. While lessons from stu...

  10. Cooperating with a palliative home-care team

    DEFF Research Database (Denmark)

    Goldschmidt, Dorthe; Groenvold, Mogens; Johnsen, Anna Thit;

    2005-01-01

    BACKGROUND: Palliative home-care teams often cooperate with general practitioners (GPs) and district nurses. Our aim was to evaluate a palliative home-care team from the viewpoint of GPs and district nurses. METHODS: GPs and district nurses received questionnaires at the start of home-care and one...... by 91 %, mainly due to improvement in symptom management, 'security', and accessibility of specialists in palliative care. After one month, 57% of the participants reported to have learnt aspects of palliative care, primarily symptom control, and 89% of them found cooperation satisfactory....... Dissatisfaction was caused mainly by lack of information from the home-care team to primary-care professionals. CONCLUSION: GPs and district nurses welcomed the palliative home-care team and most experienced benefits to patients. Strengthened communication, initiated by the home-care team would enhance...

  11. Diagnosing and improving functioning in interdisciplinary health care teams.

    Science.gov (United States)

    Blackmore, Gail; Persaud, D David

    2012-01-01

    Interdisciplinary teams play a key role in the delivery of health care. Team functioning can positively or negatively impact the effective and efficient delivery of health care services as well as the personal well-being of group members. Additionally, teams must be able and willing to work together to achieve team goals within a climate that reflects commitment to team goals, accountability, respect, and trust. Not surprisingly, dysfunctional team functioning can limit the success of interdisciplinary health care teams. The first step in improving dysfunctional team function is to conduct an analysis based on criteria necessary for team success, and this article provides meaningful criteria for doing such an analysis. These are the following: a common team goal, the ability and willingness to work together to achieve team goals, decision making, communication, and team member relationships. High-functioning interdisciplinary teams must exhibit features of good team function in all key domains. If a team functions well in some domains and needs to improve in others, targeted strategies are described that can be used to improve team functioning.

  12. Does team training work? Principles for health care.

    Science.gov (United States)

    Salas, Eduardo; DiazGranados, Deborah; Weaver, Sallie J; King, Heidi

    2008-11-01

    Teamwork is integral to a working environment conducive to patient safety and care. Team training is one methodology designed to equip team members with the competencies necessary for optimizing teamwork. There is evidence of team training's effectiveness in highly complex and dynamic work environments, such as aviation and health care. However, most quantitative evaluations of training do not offer any insight into the actual reasons why, how, and when team training is effective. To address this gap in understanding, and to provide guidance for members of the health care community interested in implementing team training programs, this article presents both quantitative results and a specific qualitative review and content analysis of team training implemented in health care. Based on this review, we offer eight evidence-based principles for effective planning, implementation, and evaluation of team training programs specific to health care.

  13. Organizational Leadership For Building Effective Health Care Teams

    OpenAIRE

    Taplin, Stephen H.; Foster, Mary K.; Shortell, Stephen M.

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they al...

  14. Training the Eye Care Team: Principles and Practice

    OpenAIRE

    Prashant Garg; Snigdha Reddy; Chaitanya Nelluri

    2014-01-01

    One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. Bu...

  15. Community nurses working in piloted primary care teams: Irish Republic.

    LENUS (Irish Health Repository)

    Burke, Triona

    2010-08-01

    Primary care health services in the Irish Republic have undergone fundamental transformation with the establishment of multidisciplinary primary care teams nationwide. Primary care teams provide a community-based health service delivered through a range of health professionals in an integrated way. As part of this initiative ten pilot teams were established in 2003. This research was undertaken in order to gain an understanding of nurse\\'s experiences of working in a piloted primary care team. The methodology used was a focus group approach. The findings from this study illustrated how community nurse\\'s roles and responsibilities have expanded within the team. The findings also highlighted the benefits and challenges of working as a team with various other community-based health-care disciplines.

  16. The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams.

    Science.gov (United States)

    Dimas, Isabel Dórdio; Renato Lourenço, Paulo; Rebelo, Teresa

    2016-07-01

    The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes. PMID:27135137

  17. The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams.

    Science.gov (United States)

    Dimas, Isabel Dórdio; Renato Lourenço, Paulo; Rebelo, Teresa

    2016-07-01

    The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.

  18. Integrated Primary Care Teams (IPCT) pilot project in Quebec: a protocol paper

    OpenAIRE

    Contandriopoulos, Damien; Duhoux, Arnaud; Roy, Bernard; Amar, Maxime; Bonin, Jean-Pierre; Borges Da Silva, Roxane; Brault, Isabelle; Dallaire, Clémence; Dubois, Carl-Ardy; Girard, Francine; Jean, Emmanuelle; Larue, Caroline; Lessard, Lily; Mathieu, Luc; Pépin, Jacinthe

    2015-01-01

    Introduction The overall aim of this project is to help develop knowledge about primary care delivery models likely to improve the accessibility, quality and efficiency of care. Operationally, this objective will be achieved through supporting and evaluating 8 primary care team pilot sites that rely on an expanded nursing role within a more intensive team-based, interdisciplinary setting. Methods and analysis The first research component is aimed at supporting the development and implementati...

  19. For Better Heart Care, Get a Pharmacist on Your Team

    Science.gov (United States)

    ... 159384.html For Better Heart Care, Get a Pharmacist on Your Team Canadian study highlights a potential ... cut their chances of future trouble by having pharmacists help manage their care, new Canadian research suggests. ...

  20. From Practice Culture to Patient Outcomes: Improving Primary Care Through Interdisciplinary Health Care Teams

    OpenAIRE

    Grace, Sherry M.

    2013-01-01

    Background: In 2011, a large integrated healthcare organization implemented a primary care team redesign in five pilot practices to improve the delivery of patient-centered chronic illness care and augment the physician-medical assistant dyads by adding two new primary care team roles for each practice - a nurse care manager (NCM) and a patient health coach (PHC). This work examines three aspects of implementing the care team redesign: 1) The facilitators and barriers of implementation, 2) Th...

  1. The roles of health care teams in care of the elderly.

    Science.gov (United States)

    Robertson, D

    1992-02-01

    In this brief overview of the issues relating to health care teams in geriatric care, some advantages of multidisciplinary team care versus care by an individual practitioner are outlined. An examination of barriers to teamwork and strategies to overcome them follows. Finally, a Canadian program in which medical students and family practice residents participated in interdisciplinary teamwork is described. PMID:1537446

  2. Organizational leadership for building effective health care teams.

    Science.gov (United States)

    Taplin, Stephen H; Foster, Mary K; Shortell, Stephen M

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they all need support from leadership to succeed. Teams have been invoked as a necessary tool to address the needs of patients with multiple chronic conditions and to address medical workforce shortages. Invoking teams, however, is much easier than making them function effectively, so we need to consider the implications of the growing emphasis on teams. Although the ACA will spur team development, organizational leadership must use what we know now to train, support, and incentivize team function. Meanwhile, we must also advance research regarding teams in health care to give those leaders more evidence to guide their work.

  3. Organizational leadership for building effective health care teams.

    Science.gov (United States)

    Taplin, Stephen H; Foster, Mary K; Shortell, Stephen M

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they all need support from leadership to succeed. Teams have been invoked as a necessary tool to address the needs of patients with multiple chronic conditions and to address medical workforce shortages. Invoking teams, however, is much easier than making them function effectively, so we need to consider the implications of the growing emphasis on teams. Although the ACA will spur team development, organizational leadership must use what we know now to train, support, and incentivize team function. Meanwhile, we must also advance research regarding teams in health care to give those leaders more evidence to guide their work. PMID:23690329

  4. Integrated Care and the Evolution of the Multidisciplinary Team.

    Science.gov (United States)

    Dobbins, Mary Iftner; Thomas, Sheila A; Melton, Stacy L Stokes; Lee, Stacy

    2016-06-01

    The primary care medical home continues to adapt by applying new research to population health approaches to care. With the discovery that life experiences trigger a chain of biologic events linked to chronic illnesses, the role of patient-centered multidisciplinary care teams becomes of paramount importance. Subsequently, mental health professionals are being incorporated into the primary care setting, using their skills in nontraditional models to customize care for each patient. This "integration" of primary care and unique mental health services engenders opportunity for enhanced clinical care, professional workforce development and support, more effective population health initiatives, and informed health care policy. PMID:27262000

  5. Leadership practice as interaction in primary care emergency team training

    OpenAIRE

    Brandstorp, Helen; Kirkengen, Anna Luise; Sterud, Birgitte; Haugland, Bjørgun; Halvorsen, Peder Andreas

    2015-01-01

    The present study, framed as critical action research, aimed at contributing to the improvement of training emergency teams in primary care. The first author was a participating observer in local simulation sessions performed by 10 different teams. Leadership practice as interaction was analysed in three types of communicative spaces: in the review and debriefing sessions; in the author group; and in focus groups involving local stakeholders. The teams practiced both designated and distribute...

  6. Health care professionals in a heart failure team

    NARCIS (Netherlands)

    Jaarsma, T

    2005-01-01

    A heart failure team that treats heart failure patients often faces the challenge of managing multiple conditions requiring multiple medications and life style changes in an older patient group. A multidisciplinary team approach can optimally diagnose, carefully review and prescribe treatment, and e

  7. Developing a team performance framework for the intensive care unit

    OpenAIRE

    Reader, Tom W; Flin, Rhona; Mearns, Kathryn; Cuthbertson, Brian H

    2009-01-01

    Objective: There is a growing literature on the relationship between teamwork and patient outcomes in intensive care, providing new insights into the skills required for effective team performance. The purpose of this review is to consolidate the most robust findings from this research into an intensive care unit (ICU) team performance framework. Data Sources: Studies investigating teamwork within the ICU using PubMed, Science Direct, and Web of Knowledge databases. Study Selection: Studies i...

  8. Supporting collaboration in multidisciplinary home care teams.

    OpenAIRE

    Pinelle, David; Gutwin, Carl

    2002-01-01

    Collaboration is an important part of healthcare delivery. However, in home care, collaboration is difficult due to the mobility and schedule variability of the workers. In this paper, we investigate the difficulties inherent in home care collaboration. We present the results of a study carried out with home care clinicians in Saskatoon District Health, and identify five areas of collaboration that are difficult for home care workers: scheduling, information dissemination, information retriev...

  9. Primary care team composition in 34 countries.

    NARCIS (Netherlands)

    Groenewegen, P.; Heinemann, S.; Greß, S.; Schäfer, W.

    2015-01-01

    Health care needs in the population change through ageing and increasing multimorbidity. Primary health care might accommodate to this through the composition of practices in terms of the professionals working in them. The aim of this article is to describe the composition of primary care practices

  10. Measuring Effectiveness of Teams and Multi-team Systems in Operation

    NARCIS (Netherlands)

    Hof, T.; Koning, L. de; Essens, P.

    2010-01-01

    Military operations have evidently become more complex. The development toward multi-service, multi-national operations with teams often functioning in larger systems of teams is one of the complexities commanders have to deal with. Therefore commanders need not only to gain and maintain insight in

  11. Training the eye care team: principles and practice.

    Science.gov (United States)

    Garg, Prashant; Reddy, Snigdha; Nelluri, Chaitanya

    2014-01-01

    One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. But for it to be effective, a team must possess four attributes - availability, competency, productivity, and responsiveness. Therefore, training of all team members and training the team to work together as a unit are crucial components in the success of this concept. Some of the critical attributes include: Training across the health spectrum through quality and responsive curricula administered by motivated teachers; accreditation of programs or institutions by national or international bodies; certification and recertification of team members; and training in working together as a team through inter- and intra- disciplinary workshops both during training and as a part of the job activity.

  12. Training the eye care team: Principles and practice

    Directory of Open Access Journals (Sweden)

    Prashant Garg

    2014-01-01

    Full Text Available One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. But for it to be effective, a team must possess four attributes - availability, competency, productivity, and responsiveness. Therefore, training of all team members and training the team to work together as a unit are crucial components in the success of this concept. Some of the critical attributes include: Training across the health spectrum through quality and responsive curricula administered by motivated teachers; accreditation of programs or institutions by national or international bodies; certification and recertification of team members; and training in working together as a team through inter- and intra- disciplinary workshops both during training and as a part of the job activity.

  13. Team Sports: A Place for Primary Care

    OpenAIRE

    Hancock, Larry

    1985-01-01

    Physicians' role in team sports goes beyond the traditional ‘Doc’ who attends the game for stitching and primary injury management. Injury and illness prevention, ongoing supervision of rehabilitation, education, fitness evaluation, and training prescription are roles which have often fallen, by default, to paramedicals. The author recounts his experience in medical supervision of major junior hockey in the Western Hockey League.

  14. Developing leadership in rural interprofessional palliative care teams.

    Science.gov (United States)

    Hall, Pippa; Weaver, Lynda; Handfield-Jones, Richard; Bouvette, Maryse

    2008-01-01

    This project brought together community-based practitioners and academics to develop and deliver interventions designed to enhance the leadership abilities of the designated leaders of seven rural/small town-based palliative care teams. Members of these community-based teams have already gained recognition for their teams' leadership and service delivery in their communities. All of the teams had worked closely with most members of the academic team prior to this project. The team members participated in a needs assessment exercise developed by the Sisters of Charity of Ottawa Health Service and University of Ottawa academic team. Results of the needs assessment identified leadership qualities that had contributed to their success, as well as their needs to further enhance their individual leadership qualities. The team effort, however, was the most important factor contributing to the success of their work. The interventions developed to address the identified needs had to be adapted creatively through the collaborative efforts of both the community and academic teams. The educational interventions facilitated the integration of learning at the individual and community level into the busy work schedules of primary health care providers.

  15. Developing leadership in rural interprofessional palliative care teams.

    Science.gov (United States)

    Hall, Pippa; Weaver, Lynda; Handfield-Jones, Richard; Bouvette, Maryse

    2008-01-01

    This project brought together community-based practitioners and academics to develop and deliver interventions designed to enhance the leadership abilities of the designated leaders of seven rural/small town-based palliative care teams. Members of these community-based teams have already gained recognition for their teams' leadership and service delivery in their communities. All of the teams had worked closely with most members of the academic team prior to this project. The team members participated in a needs assessment exercise developed by the Sisters of Charity of Ottawa Health Service and University of Ottawa academic team. Results of the needs assessment identified leadership qualities that had contributed to their success, as well as their needs to further enhance their individual leadership qualities. The team effort, however, was the most important factor contributing to the success of their work. The interventions developed to address the identified needs had to be adapted creatively through the collaborative efforts of both the community and academic teams. The educational interventions facilitated the integration of learning at the individual and community level into the busy work schedules of primary health care providers. PMID:19005956

  16. Maritime operations centers with integrated and isolated planning teams

    OpenAIRE

    Hutchins, Susan G.; Kemple, William G.; David L. Kleinman; Miller, Scot; Pfeiffer, Karl; Horn, Zachary; Weil, Shawn; Entin, Elliot

    2010-01-01

    The Maritime Operations Center (MOC) was designed to effectively utilize the planning elements of Future Operations (FOPS) to provide more rapid, accurate resource allocations consistent with the vision of the Commander. MOC staff simultaneously participate in the planning effort, while executing the current operation, and supporting headquarters during planning and execution. Frequently, an operational planning team (OPT) – a task-organized team formed to conduct integrated planning for a sp...

  17. Art Therapy with an Oncology Care Team

    Science.gov (United States)

    Nainis, Nancy A.

    2005-01-01

    Oncology nurses are particularly vulnerable to "burnout" syndrome due to the intensity of their work and the ongoing losses they experience while providing oncology care to their patients. High levels of stress in the workplace left untended lead to high job turnover, poor productivity, and diminished quality of care for patients. Attention to…

  18. O trabalho de equipe no programa de saúde da família: reflexões a partir de conceitos do processo grupal e de grupos operativos El trabajo del equipo en el programa de salud de la familia: reflexión a partir de conceptos del proceso grupal y de grupos operativos Team work in a family health care program: the team process concept and operational teams

    Directory of Open Access Journals (Sweden)

    Cinira Magali Fortuna

    2005-04-01

    theoretical revision of team work in a family Health Care Program. We define team work in the health care field as a relationship network among people, power, knowledge, affection, and wishes, when there is a possibility of identifying group processes. We deal with concepts of Operational Group from the Argentinean School, which might help health professionals to get training in team work. We have visible (spoken and invisible (unspoken tasks within teams, which are modified and need to be combined and known. Communication, learning, the feeling of belonging, the atmosphere, the actions' pertinence for the team's purpose and power relations may help the team to get to know and analyze each other and to build a team. External supervision may help the team to turn itself into an operational team, working towards a life care project.

  19. Supporting collaboration in multidisciplinary home care teams.

    Science.gov (United States)

    Pinelle, David; Gutwin, Carl

    2002-01-01

    Collaboration is an important part of healthcare delivery. However, in home care, collaboration is difficult due to the mobility and schedule variability of the workers. In this paper, we investigate the difficulties inherent in home care collaboration. We present the results of a study carried out with home care clinicians in Saskatoon District Health, and identify five areas of collaboration that are difficult for home care workers: scheduling, information dissemination, information retrieval, short-term treatment coordination, and long-term treatment planning. We present recommendations for incorporating support for each of these areas into point-of-care clinical information systems that provide access to shared patient records. Finally, we discuss general design approaches for incorporating this type of support, including the need for workers to maintain awareness of the activities of others, and the need to integrate communication with the presentation of the health record. PMID:12463897

  20. The impact of fear on the operation of virtual teams

    OpenAIRE

    Casey, Valentine; Richardson, Ita

    2008-01-01

    peer-reviewed Distributed software development has become the norm for the software industry today. As a result many organizations are leveraging the expertise of their existing staff by establishing virtual teams. Here we outline the results from three independent case studies undertaken over a period of eight years. The first study considered the operation of virtual teams whose members were situated in two locations in the same country. The second investigated why U.S. and Irish team me...

  1. Understanding Physiotherapists' Roles in Ontario Primary Health Care Teams

    OpenAIRE

    Dufour, Sinéad Patricia; Lucy, S. Deborah; Brown, Judith Belle

    2014-01-01

    Purpose: To understand physiotherapists' roles and how they are enacted within Ontario primary health care (PHC) teams. Methods: Following a pragmatic grounded theory approach, 12 physiotherapists practising within Ontario PHC teams participated in 18 semi-structured in-depth in-person interviews. All interviews were audiotaped and transcribed verbatim, then entered into NVIVO-8. Coding followed three progressive analytic stages and was iterative in nature, guided by grounded theory. An expla...

  2. Team Learning: Through the Relational Dynamics of Co-operation and Rivalry in Team Communities

    OpenAIRE

    Lotz, Maja

    2008-01-01

    In this paper I explore the constructive links between co-operation, rivalry, and learning within the structure of team communities. Drawing upon social learning theory, the main purpose of this paper is to argue that both co-operation and rivalry are important triggers for mobilizing learning processes within and between teams. However, social learning theory tends to disregard the positive aspects of rivalry. Consequently, this paper will argue for the need to extend social learning theory ...

  3. The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality.

    Science.gov (United States)

    Fennell, Mary L; Das, Irene Prabhu; Clauser, Steven; Petrelli, Nicholas; Salner, Andrew

    2010-01-01

    Quality cancer treatment depends upon careful coordination between multiple treatments and treatment providers, the exchange of technical information, and regular communication between all providers and physician disciplines involved in treatment. This article will examine a particular type of organizational structure purported to regularize and streamline the communication between multiple specialists and support services involved in cancer treatment: the multidisciplinary treatment care (MDC) team. We present a targeted review of what is known about various types of MDC team structures and their impact on the quality of treatment care, and we outline a conceptual model of the connections between team context, structure, process, and performance and their subsequent effects on cancer treatment care processes and patient outcomes. Finally, we will discuss future research directions to understand how MDC teams improve patient outcomes and how characteristics of team structure, culture, leadership, and context (organizational setting and local environment) contribute to optimal multidisciplinary cancer care.

  4. Informal carers and the primary care team.

    OpenAIRE

    Simon, C.

    2001-01-01

    The number of carers in the community is rising, and the importance of general practice in providing supportfor them has been highlighted. Caring for a disabled friend or relative has been shown to be harmful to the health of the caregiver and changes in social and family structure have led carers to become isolated and more reliant on the formal support services. However, many carersfeel that GPs do not understand their needs, and in turn many GPs and nursesfeel that they lack the relevant r...

  5. Culture, leaders, and operator team training

    International Nuclear Information System (INIS)

    Every nuclear utility has a culture which either drives or becomes a barrier to the vision of high performance and accountability of its personnel. This paper discusses two very powerful cultures at work in the nuclear power industry that may have very different values or ways of doing things. Employees from fossil plants have moved over to the nuclear plants where they meet with personnel who have been raised in the US Navy Nuclear Power Program. If these two cultures collide, as many plants have experienced, no one wins. Left alone, the two cultures may merge naturally, but if not, no amount of technical or procedural training will bridge the gulf. A second powerful influence within nuclear utilities is leadership. While culture explains how we do things around here, leadership has to do with the example people follow. This example may be set by a top executive in the corporate office or by a supervisor in the control room. The influence of leaders, whether positive or negative, can be seen at all levels of the utility. Team training, at any level, begins with a thorough understanding of the parent utility's culture, followed closely by an efficient method of implanting a culture suited to the company's strategy

  6. [A determined team caring for an elderly detainee].

    Science.gov (United States)

    Sifaoui, Brigitte

    2011-01-01

    The arrival of an elderly person in a remand centre reveals the extent to which the prison system is ill-equipped to deal with this type of detainee. The cooperation between the prison, nursing and social care teams however compensates for the many difficulties his case presents.

  7. The care and feeding of a psychotherapy research team.

    OpenAIRE

    Mahrer, A R; Gagnon, R.

    1991-01-01

    Although psychotherapy research teams have been in existence since the 1940s, one of the reasons they are not more popular is the absence of literature on how they operate. There is essentially no literature on the organization and administration of psychotherapy research teams, on the management of their everyday practical issues, decisions, and problems. In order to open the way for a dialogue on these matters, an inside view is provided of one relatively productive psychotherapy research t...

  8. Prevention of insufficient team monitoring among nuclear power plant operators

    International Nuclear Information System (INIS)

    Earlier studies showed that the most common human errors involving operators at overseas nuclear power plants were those due to insufficient team monitoring, namely errors subsequently committed by superiors or fellow workers rather than an initial error committed by an operator. Although cases of insufficient team monitoring have rarely been reported in Japan, such faults could occur judging from the results of simulator training for operators. We therefore examined possible solutions to this problem. Using Rasmussen's model of human behavior, we analyzed the cases of insufficient team monitoring identified by instructors based on their experience in training. Analyses revealed that errors occur when an operator as a member of a team has gained a wrong situation awareness and this wrong situation awareness has not been corrected in the subsequent team action. The cases of insufficient team monitoring that were found during training can be classified into five types: the intuition type, the labyrinth type, the underestimation type, the dependence-on-experienced-operators type, and the complacency type. Problems identified in these five types of insufficient team monitoring have been analyzed using a newly developed team monitoring behavior model. Common factors that have been identified as the causes of errors committed during busy hours such as an emergency are: (1) the procedures are difficult to use; (2) necessary information cannot be retrieved easily; and (3) the procedure places as undue burden on a shift supervisor. These factors must be improved. Accordingly, we propose adopting a set of remedial measures: (1) the preparation of an easy-to-use procedure that sets forth instructions to be given by a shift supervisor; (2) the preparation of educational materials that are effective in assessing the progress of an event and gaining a broad overview of the situation; and (3) the sharing of responsibility and the delegation of authority to alleviate the burden on

  9. 42 CFR 456.604 - Physician team member inspecting care of recipients.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Physician team member inspecting care of recipients... Intermediate Care Facilities and Institutions for Mental Diseases § 456.604 Physician team member inspecting care of recipients. No physician member of a team may inspect the care of a recipient for whom he...

  10. Health care professional development: Working as a team to improve patient care.

    Science.gov (United States)

    Babiker, Amir; El Husseini, Maha; Al Nemri, Abdurrahman; Al Frayh, Abdurrahman; Al Juryyan, Nasir; Faki, Mohamed O; Assiri, Asaad; Al Saadi, Muslim; Shaikh, Farheen; Al Zamil, Fahad

    2014-01-01

    In delivering health care, an effective teamwork can immediately and positively affect patient safety and outcome. The need for effective teams is increasing due to increasing co-morbidities and increasing complexity of specialization of care. Time has gone when a doctor or a dentist or any other health practitioner in whatsoever health organization would be able to solely deliver a quality care that satisfies his or her patients. The evolution in health care and a global demand for quality patient care necessitate a parallel health care professional development with a great focus on patient centred teamwork approach. This can only be achieved by placing the patient in the centre of care and through sharing a wide based culture of values and principles. This will help forming and developing an effective team able to deliver exceptional care to the patients. Aiming towards this goal, motivation of team members should be backed by strategies and practical skills in order to achieve goals and overcome challenges. This article highlights values and principles of working as a team and principles and provides team players with a practical approach to deliver quality patient care.

  11. Burn Teams and Burn Centers: The Importance of a Comprehensive Team Approach to Burn Care

    OpenAIRE

    Al-Mousawi, Ahmed M.; Mecott-Rivera, Gabriel A.; Jeschke, Marc G.; Herndon, David N

    2009-01-01

    Advances in burn care have been colossal, but while extra work is needed, it is clear that the organized effort of burn teams can continue making improvements in survival rates and quality of life possible for patients. Burn patients are unique, representing the most severe model of trauma,33 and hence this necessitates treatment in the best facilities available for that endeavor. Burn centers have developed to meet these intricate needs but can only function productively and most efficiently...

  12. Simulation of operator team behavior. Introduction of emotional function

    International Nuclear Information System (INIS)

    Operator's behavior may be influenced by the atmosphere in a control room. Therefore, it is important to consider operator's emotions especially when abnormal situations occur in a plant. SYBORG (Simulation System for the Behavior of an Operating Group) is a system for simulating the behavior of an operator team. Based on 1) Investigations of how operators feel the situations in a control room and 2) biological and psychological similarities between emotion and immunity, an emotional function was tried to be incorporated into SYBORG using immune algorithm. (author)

  13. Joint working in community mental health teams: implementation of an integrated care pathway.

    Science.gov (United States)

    Rees, Gwyneth; Huby, Guro; McDade, Lian; McKechnie, L

    2004-11-01

    Abstract Integration of community mental health services is a key policy objective that aims to increase quality and efficiency of care. Integrated care pathways (ICPs) are a mechanism designed to formalise multi-agency working at an operational level and are currently being applied to mental health services. Evidence regarding the impact of this tool to support joint working is mixed, and there is limited evidence regarding the suitability of ICPs for complex, community-based services. The present study was set in one primary care trust (PCT) in Scotland that is currently implementing an ICP for community mental health teams (CMHTs) across the region. The aim of the study was to investigate professionals' experiences and views on the implementation of an ICP within adult CMHTs in order to generate learning points for other organisations which are considering developing and implementing such systems. The study used qualitative methods which comprised of individual interviews with three CMHT leaders and two service development managers, as well as group interviews with members of four adult CMHTs. Data was analysed using the constant comparison method. Participants reported positive views regarding joint working and the role of an ICP in theory. However, in practice, teams were not implementing the ICP. Lack of integration at higher organisational levels was found to create conflicts within the teams which became explicit in response to the ICP. Implementation was also hindered by lack of resources for ongoing support, team development and change management. In conclusion, the study suggests that operational systems such as ICPs do not address and cannot overcome wider organisational barriers to integration of mental health services. Integrated care pathways need to be developed with strategic input as well as practitioner involvement and ownership. Team development, education about integration and change management are essential if ICPs are to foster and support

  14. Applying the guidelines for pharmacists integrating into primary care teams

    Science.gov (United States)

    Barry, Arden R.; Pammett, Robert T.

    2016-01-01

    Background: In 2013, Jorgenson et al. published guidelines for pharmacists integrating into primary care teams. These guidelines outlined 10 evidence-based recommendations designed to support pharmacists in successfully establishing practices in primary care environments. The aim of this review is to provide a detailed, practical approach to implementing these recommendations in real life, thereby aiding to validate their effectiveness. Methods: Both authors reviewed the guidelines independently and ranked the importance of each recommendation respective to their practice. Each author then provided feedback for each recommendation regarding the successes and challenges they encountered through implementation. This feedback was then consolidated into agreed upon statements for each recommendation. Results and Discussion: Focusing on building relationships (with an emphasis on face time) and demonstrating value to both primary care providers and patients were identified as key aspects in developing these new roles. Ensuring that the environment supports the practice, along with strategic positioning within the clinic, improves uptake and can maximize the usefulness of a pharmacist in primary care. Demonstrating consistent and competent clinical and documentation skills builds on the foundation of the other recommendations to allow for the effective provision of clinical pharmacy services. Additional recommendations include developing efficient ways (potentially provider specific) to communicate with primary care providers and addressing potential preconceived notions about the role of the pharmacist in primary care. Conclusion: We believe these guidelines hold up to real-life integration and emphatically recommend their use for new and existing primary care pharmacists.

  15. Primary care teams: New Zealand's experience with community-governed non-profit primary care.

    Science.gov (United States)

    Crampton, Peter; Davis, Peter; Lay-Yee, Roy

    2005-05-01

    Community-governed non-profit primary care organisations started developing in New Zealand in the late 1980s with the aim to reduce financial, cultural and geographical barriers to access. New Zealand's new primary health care strategy aims to co-ordinate primary care and public health strategies with the overall objective of improving population health and reducing health inequalities. The purpose of this study is to carry out a detailed examination of the composition and characteristics of primary care teams in community-governed non-profit practices and compare them with more traditional primary care organisations, with the aim of drawing conclusions about the capacity of the different structures to carry out population-based primary care. The study used data from a representative national cross-sectional survey of general practitioners in New Zealand (2001/2002). Primary care teams were largest and most heterogeneous in community-governed non-profit practices, which employed about 3% of the county's general practitioners. Next most heterogeneous in terms of their primary care teams were practices that belonged to an Independent Practitioner Association, which employed the majority of the country's general practitioners (71.7%). Even though in absolute and relative terms the community-governed non-profit primary care sector is small, by providing a much needed element of professional and organisational pluralism and by experimenting with more diverse staffing arrangements, it is likely to continue to have an influence on primary care policy development in New Zealand.

  16. Transforming care teams to provide the best possible patient-centered, collaborative care.

    Science.gov (United States)

    Sevin, Cory; Moore, Gordon; Shepherd, John; Jacobs, Tracy; Hupke, Cindy

    2009-01-01

    Patient experience of care is now a crucial parameter in assessing the quality of healthcare delivered in the United States. Continuity, patient-driven access to care, and being "known" by a provider or practice, particularly for patients with chronic diseases, have been shown to enhance patient satisfaction with care and health outcomes. Healthcare systems are challenged to effectively meet the wants and needs of patients by tailoring interventions based on each person's unique set factors-his or her strengths, preferences, and personal and social context. Creating care teams, a coordinated multidisciplinary group of healthcare professionals, enables a practice to take advantage of the skill sets represented and redesign care delivery with the patient and community as the focal point. This article describes the attributes of highly functioning care teams, how to measure them, and guidance on creating them. A case example illustrates how these ideas work in practice.

  17. Factors predicting team climate, and its relationship with quality of care in general practice

    OpenAIRE

    Eccles Martin P; Goh Teik T; Steen Nick

    2009-01-01

    Abstract Background Quality of care in general practice may be affected by the team climate perceived by its health and non-health professionals. Better team working is thought to lead to higher effectiveness and quality of care. However, there is limited evidence available on what affects team functioning and its relationship with quality of care in general practice. This study aimed to explore individual and practice factors that were associated with team climate, and to explore the relatio...

  18. What do we know about health care team effectiveness? A review of the literature.

    Science.gov (United States)

    Lemieux-Charles, Louise; McGuire, Wendy L

    2006-06-01

    This review of health care team effectiveness literature from 1985 to 2004 distinguishes among intervention studies that compare team with usual (nonteam) care; intervention studies that examine the impact of team redesign on team effectiveness; and field studies that explore relationships between team context, structure, processes, and outcomes. The authors use an Integrated Team Effectiveness Model (ITEM) to summarize research findings and to identify gaps in the literature. Their analysis suggests that the type and diversity of clinical expertise involved in team decision making largely accounts for improvements in patient care and organizational effectiveness. Collaboration, conflict resolution, participation, and cohesion are most likely to influence staff satisfaction and perceived team effectiveness. The studies examined here underscore the importance of considering the contexts in which teams are embedded. The ITEM provides a useful framework for conceptualizing relationships between multiple dimensions of team context, structure, processes, and outcomes. PMID:16651394

  19. Cooperating with a palliative home-care team: expectations and evaluations of GPs and district nurses

    DEFF Research Database (Denmark)

    Goldschmidt, Dorthe; Groenvold, Mogens; Johnsen, Anna Thit;

    2005-01-01

    BACKGROUND: Palliative home-care teams often cooperate with general practitioners (GPs) and district nurses. Our aim was to evaluate a palliative home-care team from the viewpoint of GPs and district nurses. METHODS: GPs and district nurses received questionnaires at the start of home-care and one...... month later. Questions focussed on benefits to patients, training issues for professionals and cooperation between the home-care team and the GP/ district nurse. A combination of closed- and open-ended questions was used. RESULTS: Response rate was 84% (467/553). Benefits to patients were experienced....... Dissatisfaction was caused mainly by lack of information from the home-care team to primary-care professionals. CONCLUSION: GPs and district nurses welcomed the palliative home-care team and most experienced benefits to patients. Strengthened communication, initiated by the home-care team would enhance...

  20. Pediatric Liver Transplantation: Unique Concerns for the Critical Care Team.

    Science.gov (United States)

    Bilhartz, Jacob L; Shieck, Victoria L

    2016-01-01

    Liver transplantation originated in children more than 50 years ago, and these youngest patients, while comprising the minority of liver transplant recipients nationwide, can have some of the best and most rewarding outcomes. The indications for liver transplantation in children are generally more diverse than those seen in adult patients. This diversity in underlying cause of disease brings with it increased complexity for all who care for these patients. Children, still being completely dependent on others for survival, also require a care team that is able and ready to work with parents and family in addition to the patient at the center of the process. In this review, we aim to discuss diagnoses of particular uniqueness or importance to pediatric liver transplantation. We also discuss the evaluation of a pediatric patient for liver transplant, the system for allocating them a new liver, and also touch on postoperative concerns that are unique to the pediatric population. PMID:27254643

  1. [The concept of mental care of a family health team from a historical-cultural perspective].

    Science.gov (United States)

    Vecchia, Marcelo Dalla; Martins, Sueli Terezinha Ferreira

    2009-01-01

    The present study aims at analyzing the individual senses and social meanings of mental care actions carried out by professionals working in a Family Health Care Team. The study is based on Vigotsky's (1896-1934) theoretical perspective of a historical and cultural psychology. The work is part of a participant research and as such conducted in the context of a field research. It was observed that the team took into consideration the relevance of social determinants for the disease of the target population, the need for making use of diversified care strategies reaching beyond the clinical setting, the importance of taking care of their own mental health, as well as difficulties related to approaching the families of the patients. We emphasize the importance of overcoming the exclusiveness of the biomedical determination of the health-disease process as pointed out in the operational principles of the Family Health Care Strategy, expressed by responsiveness as a care tool, the establishment of relationships and continued care. PMID:19142322

  2. Satisfaction survey on the critical care response team services in a teaching hospital

    OpenAIRE

    Saad Al Qahtani

    2011-01-01

    Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC), National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT).Methods: Our...

  3. Structure and characteristics of community-based multidisciplinary wound care teams in Ontario: an environmental scan.

    Science.gov (United States)

    Abrahamyan, Lusine; Wong, Josephine; Pham, Ba'; Trubiani, Gina; Carcone, Steven; Mitsakakis, Nicholas; Rosen, Laura; Rac, Valeria E; Krahn, Murray

    2015-01-01

    Multidisciplinary team approach is an essential component of evidence-based wound management in the community. The objective of this study was to identify and describe community-based multidisciplinary wound care teams in Ontario. For the study, a working definition of a multidisciplinary wound care team was developed, and a two-phase field evaluation was conducted. In phase I, a systematic survey with three search strategies (environmental scan) was conducted to identify all multidisciplinary wound care teams in Ontario. In phase II, the team leads were surveyed about the service models of the teams. We identified 49 wound care teams in Ontario. The highest ratio of Ontario seniors to wound team within each Ontario health planning region was 82,358:1; the lowest ratio was 14,151:1. Forty-four teams (90%) participated in the survey. The majority of teams existed for at least 5 years, were established as hospital outpatient clinics, and served patients with chronic wounds. Teams were heterogeneous in on-site capacity of specialized diagnostic testing and wound treatment, team size, and patient volume. Seventy-seven percent of teams had members from three or more disciplines. Several teams lacked essential disciplines. More research is needed to identify optimal service models leading to improved patient outcomes.

  4. Interdisciplinary collaboration in gerontology and geriatrics in Latin America: conceptual approaches and health care teams.

    Science.gov (United States)

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated "logical-rational approach," its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated "logical-instrumental approach." The third approach denominated "logical-subjective approach" has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the "complex problems" of older adults. PMID:23384004

  5. [Communication within the health care team: doctors and nurses].

    Science.gov (United States)

    Kollár, János

    2016-04-24

    Proper communication within the health care team is especially important in terms of creating safe emotional and professional conditions for the team members and for quality healing. The aim of the study is to explore the factors that hinder appropriate communication between doctors and nurses and thus to make the effective elimination of the communication disturbances possible. Investigation in main medical databases and general search engines were used for analysing the phenomenon. It was revealed that communication between doctors and nurses is restrained by factors that can be observed on individual, professional and system levels as well. Role confusion, lack of trust, communication barriers arising from hierarchical inequalities, leadership problems, differences in qualifications, burnout and organizational problems can equally be found amongst them. The effectiveness of communication between nurses and doctors in Hungary is especially strongly influenced by the fear of losing jobs, the financial problems arising from different degree of gratuity and the phenomenon of burnout. Changes on individual, professional and system levels are equally important for significant improvement in the communication between doctors and nurses. Joint trainings based on strong organizational development skills and joint conferences could promote significantly better flow of information, mutual appreciation and harmonization.

  6. Physician Assistants and Nurse Practitioners Perform Effective Roles on Teams Caring for Medicare Patients with Diabetes

    OpenAIRE

    Everett, Christine M.; Thorpe, Carolyn T; Palta, Mari; Carayon, Pascale; Bartels, Christie; Smith, Maureen A.

    2013-01-01

    Redesigning healthcare systems to deliver team-based care is considered important to improving care for chronically ill patients. Including physician assistants and/or nurse practitioners on primary care teams is one approach to the patient-centered medical home. However, understanding of the impact of team structure on outcomes is limited. Using Medicare claims and electronic health record data from a large physician group, we compared multiple patient outcomes for older patients with diabet...

  7. Exploring the leadership role of the clinical nurse specialist on an inpatient palliative care consulting team.

    Science.gov (United States)

    Stilos, Kalli; Daines, Pat

    2013-03-01

    Demand for palliative care services in Canada will increase owing to an aging population and the evolving role of palliative care in non-malignant illness. Increasing healthcare demands continue to shape the clinical nurse specialist (CNS) role, especially in the area of palliative care. Clinical nurse specialists bring specialized knowledge, skills and leadership to the clinical setting to enhance patient and family care. This paper highlights the clinical leadership role of the CNS as triage leader for a hospital-based palliative care consulting team. Changes to the team's referral and triage processes are emphasized as key improvements to team efficiency and timely access to care for patients and families.

  8. Exploring the leadership role of the clinical nurse specialist on an inpatient palliative care consulting team.

    Science.gov (United States)

    Stilos, Kalli; Daines, Pat

    2013-03-01

    Demand for palliative care services in Canada will increase owing to an aging population and the evolving role of palliative care in non-malignant illness. Increasing healthcare demands continue to shape the clinical nurse specialist (CNS) role, especially in the area of palliative care. Clinical nurse specialists bring specialized knowledge, skills and leadership to the clinical setting to enhance patient and family care. This paper highlights the clinical leadership role of the CNS as triage leader for a hospital-based palliative care consulting team. Changes to the team's referral and triage processes are emphasized as key improvements to team efficiency and timely access to care for patients and families. PMID:24863582

  9. Building New Teams for Late Life Care: Lessons From LifeCourse.

    Science.gov (United States)

    Schellinger, Sandra; Cain, Cindy L; Shibrowski, Kathleen; Elumba, Deborah; Rosenberg, Erin

    2016-07-01

    This article details team development within a longitudinal cohort study designed to bring team-based, whole person care early in the course of serious illness. The primary innovation of this approach is the use of nonclinically trained care guides who support patients and family members by focusing care around what matters most to patients, linking to resources, collaborating with other providers, and offering continuity through care transitions. By describing the development of this team, we document the kinds of questions others may ask during the process of team creation. PMID:25747670

  10. Negotiating the equivocality of palliative care: a grounded theory of team communicative processes in inpatient medicine.

    Science.gov (United States)

    Ledford, Christy J W; Canzona, Mollie Rose; Cafferty, Lauren A; Kalish, Virginia B

    2016-01-01

    In the majority of U.S. hospitals, inpatient medicine teams make palliative care decisions in the absence of a formalized palliative system. Using a grounded theory approach, interviews with inpatient team members were systematically analyzed to uncover how participants conceptualize palliative care and how they regard the communicative structures that underlie its delivery. During analysis, Weick's model of organizing emerged as a framework that fit the data. The 39 participant inpatient team members discussed palliative care as primarily a communicative process. Themes describing the meaning of palliative care emerged around the concepts of receiver of care, timeline of care, and location of care. The emerging model included four stages in the communicative processes of inpatient palliative care: (a) interpret the need, (b) initiate the conversation, (c) integrate the processes, and (d) identify what works. In contrast to stable, focused palliative care teams or hospice care teams, which have prescribed patient populations and processes, the inpatient medicine team faces the equivocality of providing palliative care within a broader practice. This research offers a four-phase model to show how these inpatient teams communicate within this context. Implications for the provision of palliative care are discussed.

  11. Study on team evaluation (3). Reliability and validity of behavior observation based team work evaluation method of power plant operator team

    International Nuclear Information System (INIS)

    This report discusses a method to evaluate team work through behavior observation under the view points of 12 which consist of the Team Work Element Model proposed in the series of this study. The method includes a check list with which users evaluate team work 5 rating scale for each viewpoint. The check lists are developed and applied to several real operator teams of power plants under the corporation with two training centers of thermal and nuclear power plants, respectively. Evaluators evaluate team work with watching the video-taped team behavior responding to abnormal conditions. This paper discusses the reliability from whether repeated evaluations shows the same result and multi-evaluators' results show the same result. This also discusses the validity of this method form whether the results from this method matches the evaluators' intuition. As a result, this method is applicable to evaluate team work through behavior observation. (author)

  12. Medical capability team: the clinical microsystem for combat healthcare delivery in counterinsurgency operations.

    Science.gov (United States)

    Clark, Susz; Van Steenvort, Jon K

    2008-01-01

    Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. This article proposes the Army Medical Department (AMEDD) develop and implement the medical capability team (MCT) for combat healthcare delivery. It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.

  13. Tractor Operation and Daily Care.

    Science.gov (United States)

    Fore, J. M.; And Others

    Written for the tractor operator, the manual describes, with the aid of colored illustrations and diagrams, the tasks involved in the proper operation and daily maintenance of tractors. It offers explanations for the desirability of the various servicing and adjustment operations, as well as guidelines for tractor operation and safety. The…

  14. Study on team evaluation (4). Reliability and validity of questionnaire survey-based team work evaluation method of power plant operator team

    International Nuclear Information System (INIS)

    The series of this study describes the necessity of the evaluation of team work from two aspects of operator's behavior and operators' mind. The authors propose Team Work Element Model which consists of necessary elements to build high performance team. This report discusses a method to evaluate team work from the second aspect, that is, competency trust, competition, for-the team spirit, etc. The authors survey the previous studies on psychological measures and organize a set of questions to evaluate 10 team work sub elements that are the parts of Team Work Element Model. The factor analysis shows that this set of questions is consists of 13 factors such as task-oriented leadership, harmony-oriented team atmosphere, etc. Close examination of the questions in each factor shows that 8 of 10 team work sub elements can be evaluated by this questionnaire. In addition, this questionnaire comprises scales additional 8 scales such as job satisfaction, leadership, etc. As a result, it is possible to evaluate team work from more comprehensive view points. (author)

  15. Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

    Science.gov (United States)

    Smith-Carrier, Tracy; Neysmith, Sheila

    2014-09-01

    Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation. PMID:26261888

  16. Community and team member factors that influence the operations phase of local prevention teams: the PROSPER Project.

    Science.gov (United States)

    Feinberg, Mark E; Chilenski, Sarah M; Greenberg, Mark T; Spoth, Richard L; Redmond, Cleve

    2007-09-01

    This study examined the longitudinal predictors of quality of functioning of community prevention teams during the "operations" phase of team development. The 14 community teams were involved in a randomized-trial of a university-community partnership project, PROSPER (Spoth et al., Prevention Science, 5(1): 31-39, 2004b), that implements evidence-based interventions intended to support positive youth development and reduce early substance use, as well as other problem behaviors. The study included a multi-informant approach to measurement of constructs, and included data from 137 team members, 59 human service agency directors and school administrators, 16 school principals, and 8 Prevention Coordinators (i.e. technical assistance providers). We examined how community demographics and social capital, team level characteristics, and team member attributes and attitudes are related to local team functioning across an 18-month period. Findings indicate that community demographics (poverty), social capital, team member attitudes towards prevention, and team members' views of the acceptability of teen alcohol use played a substantial role in predicting various indicators of the quality of team functioning 18 months later. PMID:17602297

  17. Using nursing resource teams to improve quality of care.

    Science.gov (United States)

    Mendez de Leon, Delphine; Stroot, Judy A Klauzer

    2013-08-01

    The process of setting up and monitoring nursing resource teams for maximum effectiveness involves five key steps: Set the resource team goals and approach. Plan for development and oversight. Gather and analyze the relevant information. Deploy the team. Reevaluate staffing levels and effectiveness. PMID:23957189

  18. Interdisciplinary Collaboration in Gerontology and Geriatrics in Latin America: Conceptual Approaches and Health Care Teams

    Science.gov (United States)

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a…

  19. The role of teams in resolving moral distress in intensive care unit decision-making

    OpenAIRE

    van Soeren, Mary; Miles, Adèle

    2003-01-01

    Conflicts arise within teams and with family members in end-of-life decision-making in critical care. This creates unnecessary discomfort for all involved, including the patient. Treatment plans driven by crisis open the team up to conflict, fragmented care and a lack of focus on the patient's wishes and realistic medical outcomes. Methods to resolve these issues involve planned ethical reviews and team meetings where open communication, clear plans and involvement in decision-making for all ...

  20. Huddle-coaching: a dynamic intervention for trainees and staff to support team-based care.

    Science.gov (United States)

    Shunk, Rebecca; Dulay, Maya; Chou, Calvin L; Janson, Susan; O'Brien, Bridget C

    2014-02-01

    Many outpatient clinics where health professionals train will transition to a team-based medical home model over the next several years. Therefore, training programs need innovative approaches to prepare and incorporate trainees into team-based delivery systems. To address this need, educators at the San Francisco Veterans Affairs (VA) Medical Center included trainees in preclinic team "huddles," or briefing meetings to facilitate care coordination, and developed an interprofessional huddle-coaching program for nurse practitioner students and internal medicine residents who function as primary providers for patient panels in VA outpatient primary care clinics. The program aimed to support trainees' partnerships with staff and full participation in the VA's Patient Aligned Care Teams. The huddle-coaching program focuses on structuring the huddle process via scheduling, checklists, and designated huddle coaches; building relationships among team members through team-building activities; and teaching core skills to support collaborative practice. A multifaceted evaluation of the program showed positive results. Participants rated training sessions and team-building activities favorably. In interviews, trainees valued their team members and identified improvements in efficiency and quality of patient care as a result of the team-based approach. Huddle checklists and scores on the Team Development Measure indicated progress in team processes and relationships as the year progressed. These findings suggest that the huddle-coaching program was a worthwhile investment in trainee development that also supported the clinic's larger mission to deliver team-based, patient-aligned care. As more training sites shift to team-based care, the huddle-coaching program offers a strategy for successfully incorporating trainees. PMID:24362383

  1. “It’s Like Being a Well-Loved Child”: Reflections From a Collaborative Care Team

    Science.gov (United States)

    Adorno, Gail

    2013-01-01

    Objective: The present case study examines how a collaborative care model for the treatment of depression works with a low-income, uninsured adult population in a primary care setting. Method: The qualitative interviews were conducted in 2010 at a primary care clinic as part of an evaluation of the Integrated Behavioral Health program, a collaborative care model of identifying and treating mild-to-moderate mental disorders in adults in a primary care setting. A single-case study design of an interdisciplinary team was used: the care manager, the primary care physician, the consulting psychiatrist, and the director of social services. Other units of analysis included clinical outcomes and reports that describe the patient demographics, services offered, staff, and other operational descriptions. Results: Multiple themes were identified that shed light on how one primary care practice successfully operationalized a collaborative care model, including the tools they used in novel ways, the role of team members, and perceived barriers to sustainability. Conclusions: The insights captured by this case study allow physicians, mental health practitioners, and administrators a view into key elements of the model as they consider implementation of a collaborative care model in their own settings. It is important to understand how the model operates on a day-to-day basis, with careful consideration of the more subtle aspects of the program such as team functioning and adapting tools to new processes of care to meet the needs of patients in unique contexts. Attention to barriers that still exist, especially regarding workforce and workload, will continue to be critical to organizations attempting integration. PMID:24800122

  2. What Does Change with Nutrition Team in Intensive Care Unit?

    Directory of Open Access Journals (Sweden)

    Ahmet Fatih Yılmaz

    2016-08-01

    Full Text Available Intrroduction: Clinical nutrition is the nutrition support therapy provided to patients under medical supervision at the hospital or home setting. It is a multidisciplinary task performed under the control of the physician, dietician, pharmacist and nurse. In this study, the changes in the patient admission statistics to the general intensive care unit (GICU, the exitus ratios, decubitus ulcer formation rates, albumin use rates, duration of the hospital stay, Acute Physiology and Chronic Health Evaluation (APACHE II scores, rate of usege of parenteral and enteral products, and the change in expenses per patient within the first year of activity of the nutrition team in comparison to the previous year was presented. Material and Method: In this study a 6-bed GICU was used. The patients who was admitted through retrospective file scanning between 1 January 2012 and 31 December 2012 and between 1 January 2013 and 31 December 2013 were compared. Results: The number of the patients admitted to the GICU was 341 in 2012 and 369 in 2013. The number of the patients who died in 2012 was 86 (25.2%, while it was 106 in 2013 (28.7%. In 2012, 122 patients (35.7% had decubitus ulcers, while this number was 92 (24.7% in 2013. Human albumin usage was reduced by 23% for the 100 mL (225 in 2012, 175 in 2013 and by 33% for the 50 mL doses (122 in 2012, 82 in 2013. Duration of stay in the hospital was 6.3±0.9 vs. 5.8±0.9 (days (p=0.06. The mean APACHE II scores were observed to be 24.7±6.9 vs. 30.5±11.4 (p=0.03. When the distribution of product types were analyzed, it was observed that the ratio of parenteral products: enteral products was 2:1 in 2012, however the ratio of enteral products to parenteral products was 2:1 in 2013. The daily expense of a patient decreased from 100 TL to 55 TL. Conclusion: The nutrition team directly influences the clinical process outcomes of patients under treatment in the ICU. It was thought that using appropriate nutritional

  3. The Team Approach to Home-Based Primary Care: Restructuring Care to Meet Patient, Program, and System Needs

    Science.gov (United States)

    Reckrey, Jennifer M.; Soriano, Theresa A.; Hernandez, Cameron R.; DeCherrie, Linda V.; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2016-01-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address patient, program, and system needs, we restructured a portion of our large, physician-led academic home-based primary care practice into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. Our Team Approach is an innovative way to improve interdisciplinary, team-based care though practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  4. The simulated operating theatre: comprehensive training for surgical teams.

    Science.gov (United States)

    Aggarwal, R; Undre, S; Moorthy, K; Vincent, C; Darzi, A

    2004-10-01

    Surgical excellence is traditionally defined in terms of technical performance, with little regard for the importance of interpersonal communication and leadership skills. Studies in the aviation industry have stressed the role of human factors in causing error and, in an attempt to reduce the occurrence of adverse events, led to the organisation of simulation based training scenarios. Similar strategies have recently been employed for the surgical team with the development of a simulated operating theatre project. This enables technical and non-technical performance of the surgeon and circulating staff to be assessed by experts situated in an adjacent control room, and provides an opportunity for constructive feedback. The scenarios have good face validity and junior surgeons can benefit from the process of learning new technical skills in a realistic environment. The effect of external influences such as distractions, new technology, or a crisis scenario can also be defined, with the ultimate aim of reducing the number of adverse events arising in the real operating room. PMID:15465952

  5. Care planning and decision-making in teams in Swedish elderly care: a study of interprofessional collaboration and professional boundaries.

    Science.gov (United States)

    Duner, Anna

    2013-05-01

    In front-line practice, joint working between different professionals in health/social care and rehabilitation is regarded as a means to reach a comprehensive assessment of the needs of the older care recipients, leading to decisions on appropriate care and services. The aim of this study was to examine professional collaboration and professional boundaries in interprofessional care planning teams. Two different care planning teams were studied, one performing care planning in the homes of older individuals and the other performing care planning for older people in hospital wards. The empirical data consisted of audio-recorded care planning meetings and interviews with the professionals in the teams. The integration between the professionals involved was most noticeable in the investigation and assessment phase, while it was lower in the planning phase and almost non-existent in decision-making. The home care planning team tended to work in a more integrated manner than the discharge planning team. The importance of clarifying the roles of all professions concerned with needs assessment and care planning for older people became evident in this study. PMID:23343434

  6. Enhancing primary care for complex patients. Demonstration project using multidisciplinary teams.

    OpenAIRE

    Farris, Karen B.; Côté, Isabelle; Feeny, David; Johnson, Jeffrey A.; Tsuyuki, Ross T.; Brilliant, Sandra; Dieleman, Sherry

    2004-01-01

    PROBLEM BEING ADDRESSED: Communication between community-based providers is often sporadic and problem-focused. OBJECTIVE OF PROGRAM: To implement collaborative community-based care among providers distant from one another and to improve or maintain the health of high-risk community-dwelling patients, with a focus on medication use. PROGRAM DESCRIPTION: Six primary health care teams were formed of a family physician, a pharmacist, and a home care case manager (nurse). Three of these teams als...

  7. Team Learning: Through the Relational Dynamics of Co-operation and Rivalry in Team Communities

    Science.gov (United States)

    Lotz, Maja

    2010-01-01

    This paper explores the constructive links between cooperation, rivalry, and learning within the structure of team communities. Drawing upon social learning theory and qualitative data from case studies conducted in Danish team-based firms, the main purpose is to argue that both cooperation and rivalry are important triggers for mobilizing…

  8. A review of instruments to measure interprofessional team-based primary care.

    Science.gov (United States)

    Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard

    2016-07-01

    Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings.

  9. A review of instruments to measure interprofessional team-based primary care.

    Science.gov (United States)

    Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard

    2016-07-01

    Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings. PMID:27212003

  10. Implementing a regional anesthesia block nurse team in the perianesthesia care unit increases patient safety and perioperative efficiency.

    Science.gov (United States)

    Russell, Rebecca Ann; Burke, Kimberly; Gattis, Katherine

    2013-02-01

    A lack of standardized nursing procedures regarding the management of patients receiving preoperative regional anesthesia in the perianesthesia setting raises a number of issues for perianesthesia nurses. In January 2010, Duke University Hospital's perianesthesia care unit implemented a regional anesthesia "block nurse" team in the preoperative holding area as a patient safety initiative. In January 2011, a retrospective data review was conducted. Results indicated that the implementation of the block nurse team not only increased patient safety but also increased perioperative efficiency and productivity, and decreased delays to operating room start times. This article describes the role of the regional anesthesia block nurse, the development of a block nurse team, and the early benefits of implementing a dedicated regional anesthesia block nurse team in the perianesthesia setting. PMID:23351242

  11. STAR Algorithm Integration Team - Facilitating operational algorithm development

    Science.gov (United States)

    Mikles, V. J.

    2015-12-01

    The NOAA/NESDIS Center for Satellite Research and Applications (STAR) provides technical support of the Joint Polar Satellite System (JPSS) algorithm development and integration tasks. Utilizing data from the S-NPP satellite, JPSS generates over thirty Environmental Data Records (EDRs) and Intermediate Products (IPs) spanning atmospheric, ocean, cryosphere, and land weather disciplines. The Algorithm Integration Team (AIT) brings technical expertise and support to product algorithms, specifically in testing and validating science algorithms in a pre-operational environment. The AIT verifies that new and updated algorithms function in the development environment, enforces established software development standards, and ensures that delivered packages are functional and complete. AIT facilitates the development of new JPSS-1 algorithms by implementing a review approach based on the Enterprise Product Lifecycle (EPL) process. Building on relationships established during the S-NPP algorithm development process and coordinating directly with science algorithm developers, the AIT has implemented structured reviews with self-contained document suites. The process has supported algorithm improvements for products such as ozone, active fire, vegetation index, and temperature and moisture profiles.

  12. The role of the intermediate care team in detecting and responding to loneliness in older clients.

    Science.gov (United States)

    Chana, Richard; Marshall, Paul; Harley, Clare

    2016-06-01

    The intermediate care team supports patients in their own homes to manage complex needs. They are ideally placed in the community to identify older adults at risk of loneliness. However, little is known about how intermediate care team professionals perceive, detect or respond to loneliness in their clients. This study explores intermediate care team professionals' attitudes to loneliness in the context of perceived service priorities and their experiences of managing loneliness in their clients. Eight professionals (n=2 physiotherapists, n=3 occupational therapists, n=3 nurses) took part in semi-structured interviews. Data were analysed thematically using framework analysis, applying the theory of planned behaviour as an interpretive framework. Intermediate care team professionals see loneliness as a significant issue for many of their older clients but a low priority for intermediate care team services. They believe that loneliness often goes undetected because it is difficult to measure objectively. Barriers to managing loneliness included high workloads, unsatisfactory referral systems and lack of close working with social care and independent sector services. Brief but reliable loneliness assessments into routine practice, receiving training on detecting and managing loneliness, and improving working relationships with social care and independent sector services were highlighted as strategies that could improve the detection and management of loneliness in intermediate care team clients. PMID:27270197

  13. The role of the intermediate care team in detecting and responding to loneliness in older clients.

    Science.gov (United States)

    Chana, Richard; Marshall, Paul; Harley, Clare

    2016-06-01

    The intermediate care team supports patients in their own homes to manage complex needs. They are ideally placed in the community to identify older adults at risk of loneliness. However, little is known about how intermediate care team professionals perceive, detect or respond to loneliness in their clients. This study explores intermediate care team professionals' attitudes to loneliness in the context of perceived service priorities and their experiences of managing loneliness in their clients. Eight professionals (n=2 physiotherapists, n=3 occupational therapists, n=3 nurses) took part in semi-structured interviews. Data were analysed thematically using framework analysis, applying the theory of planned behaviour as an interpretive framework. Intermediate care team professionals see loneliness as a significant issue for many of their older clients but a low priority for intermediate care team services. They believe that loneliness often goes undetected because it is difficult to measure objectively. Barriers to managing loneliness included high workloads, unsatisfactory referral systems and lack of close working with social care and independent sector services. Brief but reliable loneliness assessments into routine practice, receiving training on detecting and managing loneliness, and improving working relationships with social care and independent sector services were highlighted as strategies that could improve the detection and management of loneliness in intermediate care team clients.

  14. The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project.

    Science.gov (United States)

    Ladden, Maryjoan D; Bodenheimer, Thomas; Fishman, Nancy W; Flinter, Margaret; Hsu, Clarissa; Parchman, Michael; Wagner, Edward H

    2013-12-01

    Many primary care practices are changing the roles played by the members of their health care teams. The purpose of this article is to describe some of these new roles, using the authors' preliminary observations from 25 site visits to high-performing primary care practices across the United States in 2012-2013. These sites visits, to practices using their workforce creatively, were part of the Robert Wood Johnson Foundation-funded initiative, The Primary Care Team: Learning From Effective Ambulatory Practices.Examples of these new roles that the authors observed on their site visits include medical assistants reviewing patient records before visits to identify care gaps, ordering and administering immunizations using protocols, making outreach calls to patients, leading team huddles, and coaching patients to set self-management goals. The registered nurse role has evolved from an emphasis on triage to a focus on uncomplicated acute care, chronic care management, and hospital-to-home transitions. Behavioral health providers (licensed clinical social workers, psychologists, or licensed counselors) were colocated and integrated within practices and were readily available for immediate consults and brief interventions. Physicians have shifted from lone to shared responsibility for patient panels, with other team members empowered to provide significant portions of chronic and preventive care.An innovative team-based primary care workforce is emerging. Spreading and sustaining these changes will require training both health professionals and nonprofessionals in new ways. Without clinical experiences that model this new team-based care and role models who practice it, trainees will not be prepared to practice as a team. PMID:24128622

  15. Operation of a support service team in the emergency department of a general hospital.

    OpenAIRE

    Condra, M; Groll, L; Walker, D M; Abrams, M O; Sims, P.

    1987-01-01

    We describe the development and operation of an emergency support service team in the Emergency Department of the Kingston General Hospital, Kingston, Ont. The team, composed of professionals from other departments of the hospital, provides emotional and practical support to family members or survivors in medical emergencies. We discuss the roles of the team members and their procedures for dealing with distress and grief.

  16. Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

    Directory of Open Access Journals (Sweden)

    Tait GR

    2015-08-01

    Full Text Available Glendon R Tait,1 Joanna Bates,2 Kori A LaDonna,3 Valerie N Schulz,4 Patricia H Strachan,5 Allan McDougall,3 Lorelei Lingard3 1Department of Psychiatry and Division of Medical Education, Dalhousie University, Halifax, NS, 2Centre for Health Education Scholarship, Vancouver General Hospital, Vancouver, BC, 3Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, 4Palliative Care, London Health Sciences Centre, University Hospital, London; 5School of Nursing, McMaster University, Hamilton, ON, Canada Background: Heart failure (HF, one of the three leading causes of death, is a chronic, progressive, incurable disease. There is growing support for integration of palliative care’s holistic approach to suffering, but insufficient understanding of how this would happen in the complex team context of HF care. This study examined how HF care teams, as defined by patients, work together to provide care to patients with advanced disease. Methods: Team members were identified by each participating patient, generating team sampling units (TSUs for each patient. Drawn from five study sites in three Canadian provinces, our dataset consists of 209 interviews from 50 TSUs. Drawing on a theoretical framing of HF teams as complex adaptive systems (CAS, interviews were analyzed using the constant comparative method associated with constructivist grounded theory. Results: This paper centers on the dominant theme of system practices, how HF care delivery is reported to work organizationally, socially, and practically, and describes two subthemes: “the way things work around here”, which were commonplace, routine ways of doing things, and “the way we make things work around here”, which were more conscious, effortful adaptations to usual practice in response to emergent needs. An adaptive practice, often a small alteration to routine, could have amplified effects beyond those intended by the innovating team

  17. [Coordination of care-related risk management, team experience].

    Science.gov (United States)

    Thirel, Chrislaine; Cottin, Nathalie; Kholladi, Fanny

    2016-04-01

    An approach implemented within a hospital has enabled the process for reporting adverse events to be defined in its entirety. It was combined with a pedagogical approach with the teams in order to give it meaning. PMID:27085924

  18. The Interdisciplinary eHealth Team: Chronic Care for the Future

    OpenAIRE

    Wiecha, John; Pollard, Timothy

    2004-01-01

    An interdisciplinary clinical team is a consistent grouping of people from relevant clinical disciplines, ideally inclusive of the patient, whose interactions are guided by specific team functions and processes to achieve team-defined favorable patient outcomes. Teamwork supported by properly designed eHealth applications could help create more effective systems of care for chronic disease. Given its synchronous and asynchronous communication capacity and information-gathering and -sharing ca...

  19. A framework to support team-based models of primary care within the Australian health care system.

    Science.gov (United States)

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system. PMID:25370088

  20. A framework to support team-based models of primary care within the Australian health care system.

    Science.gov (United States)

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system.

  1. Building Teams in Primary Care: What Do Nonlicensed Allied Health Workers Want?

    OpenAIRE

    Saba, George W.; Taché, Stephanie; Ward, Lisa; Chen, Ellen H.; Hammer, Hali

    2011-01-01

    Introduction: Nonlicensed allied health workers are becoming increasingly important in collaborative team care, yet we know little about their experiences while filling these roles. To explore their perceptions of working as health coaches in a chronic-disease collaborative team, the teamlet model, we conducted a qualitative study to understand the nature and dynamics of this emerging role.

  2. What Should You Ask Your Health Care Team About Pancreatic Cancer?

    Science.gov (United States)

    ... should you ask your health care team about pancreatic cancer? It’s important to have honest, open discussions with ... these questions: When you’re told you have pancreatic cancer What kind of pancreatic cancer do I have? ...

  3. Extending the team component of the Latimer ethical decision-making model for palliative care

    Directory of Open Access Journals (Sweden)

    Purkis ME

    2011-04-01

    Full Text Available Mary Ellen Purkis1, Elizabeth Borycki1,2, Craig Kuziemsky3, Fraser Black4, Denise Cloutier-Fisher5, Lee Ann Fox6, Patricia MacKenzie7, Ann Syme1,8, Coby Tschanz1,41School of Nursing, 2School of Health Information Science, University of Victoria, Victoria, British Columbia; 3Telfer School of Management, University of Ottawa, Ottawa, Ontario; 4Victoria Hospice Society, Victoria, British Columbia; 5Department of Geography, University of Victoria, Victoria, British Columbia; 6Kingston General Hospital, Kingston, Ontario; 7School of Social Work, University of Victoria, Victoria, British Columbia; 8British Columbia Cancer Agency, Vancouver Island Centre, Victoria, British Columbia, CanadaBackground: Each year more than 240,000 Canadians die from terminal and chronic illnesses. It is estimated that 62% of those deaths require palliative care. Palliative care is a specialized domain of health professional team practice that requires discipline-specific knowledge, skills, judgment, and expertise in order to address patient hopes, wishes, symptoms, and suffering. With the emergence of palliative care as a specialized area of interdisciplinary practice, new practice models have also emerged, eg, the Latimer ethical decision-making model for palliative care. The purpose of this research was to undertake a descriptive ethnographic field study of palliative care team practices to understand better the interdisciplinary team communication and the issues that arise when members of different health professions work together as a team.Methods: Study data were collected by observing and videotaping palliative care team meetings. Data were then analyzed using direct content analysis.Results: The study findings substantiated many of the team practice concepts outlined in Latimer's model. Palliative care teams engage in a number of processes that address patient symptoms, suffering, hopes, and plans. However, several new findings also emerged from the data that were

  4. Satisfaction survey on the critical care response team services in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Saad Al Qahtani

    2011-03-01

    Full Text Available Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC, National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT.Methods: Our hospital has 900 beds. A self-administered survey was given onsite to all ward nurses. Survey items were identified, discussed, reviewed, piloted, and finalized over a 3-month period in a focus group discussion format during three CCRT core group meetings. Responses were anonymous and collected by the nurses onsite.Results: The total number of returned and analyzed surveys was 274 (98.6%. Ninety-seven percent agreed that CCRT staff arrived in a timely manner. Ninety-four percent reported that CCRT staff helped in managing sick patients and ~70% reported that it strengthened team dynamics. Only 50% of the nurses felt CCRT staff improved competence at the bedside. The overall satisfaction was 100%; none of the nurses were dissatisfied with the team.Conclusion: The CCRT helped manage sick patients in the wards. However, CRRT staff should remember to involve and communicate with the team initiator and the patient’s physician to optimize patient health care.Keywords: rapid response team, medical emergency team, critical care response team, satisfaction

  5. Cross-functional, integrative team decision making: essential for effective QI in health care.

    Science.gov (United States)

    Fargason, C A; Haddock, C C

    1992-05-01

    Quality improvement methods first developed in industry can be applied in health care, but major adjustments in the traditional health care organization are needed for continuous improvement processes to work. One change is establishing cross-functional or multidisciplinary teams to carry out integrative decision making in the place of departmental hierarchical decision making within the functional areas and disciplines. This article cites examples from experience with one service process--delivery of care to newborns--and examines techniques from the group behavior and conflict resolution literature which could enhance the success of cross-functional teams in health care organizations. PMID:1614696

  6. Internal Medicine Residents’ Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study

    OpenAIRE

    Soones, TN; O Brien, BC; Julian, KA

    2015-01-01

    © 2015, Society of General Internal Medicine. BACKGROUND : In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents’ education in the ambulatory setting. OBJECTIVE: To identify factors affecting residents’ experience of team-based care within continuity clinics and the impact of these teams ...

  7. Team meetings in specialist palliative care: Asking questions as a strategy within interprofessional interaction

    OpenAIRE

    Arber, A

    2008-01-01

    In this article, I explore what happens when specialist palliative care staff meet together to discuss patients under their care. Many studies (e.g., Atkinson) have discussed how health care practitioners in various settings use rhetorical strategies when presenting cases in situations such as ward rounds and team meetings. Strategies for arguing and persuading are central to medical practice in the interprofessional context. The context of specialist palliative care is an interesting place...

  8. Developing patient-centered teams: The role of sharing stories about patients and patient care.

    Science.gov (United States)

    Bennett, Ariana H; Hassinger, Jane A; Martin, Lisa A; Harris, Lisa H; Gold, Marji

    2015-09-01

    Research indicates that health care teams are good for staff, patients, and organizations. The characteristics that make teams effective include shared objectives, mutual respect, clarity of roles, communication, trust, and collaboration. We were interested in examining how teams develop these positive characteristics. This paper explores the role of sharing stories about patients in developing patient-centered teams. Data for this paper came from 1 primary care clinic as part of a larger Providers Share Workshop study conducted by the University of Michigan. Each workshop included 5 facilitated group sessions in which staff met to talk about their work. This paper analyzes qualitative data from the workshops. Through an iterative process, research team members identified major themes, developed a coding scheme, and coded transcripts for qualitative data analysis. One of the most powerful ways group members connected was through sharing stories about their patients. Sharing clinical cases and stories helped participants bond around their shared mission of patient-centered care, build supportive relationships, enhance compassion for patients, communicate and resolve conflict, better understand workflows and job roles, develop trust, and increase morale. These attributes highlighted by participants correspond to those documented in the literature as important elements of teambuilding and key indicators of team effectiveness. The sharing of stories about patients seems to be a promising tool for positive team development in a primary care clinical setting and should be investigated further. PMID:26348238

  9. Kennedy Space Center Orion Processing Team Planning for Ground Operations

    Science.gov (United States)

    Letchworth, Gary; Schlierf, Roland

    2011-01-01

    Topics in this presentation are: Constellation Ares I/Orion/Ground Ops Elements Orion Ground Operations Flow Orion Operations Planning Process and Toolset Overview, including: 1 Orion Concept of Operations by Phase 2 Ops Analysis Capabilities Overview 3 Operations Planning Evolution 4 Functional Flow Block Diagrams 5 Operations Timeline Development 6 Discrete Event Simulation (DES) Modeling 7 Ground Operations Planning Document Database (GOPDb) Using Operations Planning Tools for Operability Improvements includes: 1 Kaizen/Lean Events 2 Mockups 3 Human Factors Analysis

  10. Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

    Directory of Open Access Journals (Sweden)

    Hrisos Susan

    2009-04-01

    Full Text Available Abstract Background Type 2 diabetes is an increasingly prevalent chronic illness and is an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of the primary care team. Studies of the quality of care for patients with diabetes suggest less than optimum care in a number of areas. Aim The aim of this study is to improve the quality of care for patients with diabetes cared for in primary care in the UK by identifying individual, team, and organisational factors that predict the implementation of best practice. Design Participants will be clinical and non-clinical staff within 100 general practices sampled from practices who are members of the MRC General Practice Research Framework. Self-completion questionnaires will be developed to measure the attributes of individual health care professionals, primary care teams (including both clinical and non-clinical staff, and their organisation in primary care. Questionnaires will be administered using postal survey methods. A range of validated theories will be used as a framework for the questionnaire instruments. Data relating to a range of dimensions of the organisational structure of primary care will be collected via a telephone interview at each practice using a structured interview schedule. We will also collect data relating to the processes of care, markers of biochemical control, and relevant indicator scores from the quality and outcomes framework (QOF. Process data (as a proxy indicator of clinical behaviours will be collected from practice databases and via a postal questionnaire survey of a random selection of patients from each practice. Levels of biochemical control will be extracted from practice databases. A series of analyses will be conducted to relate the individual, team, and organisational data to the process, control, and QOF data to identify configurations associated with high quality care. Study

  11. Study on team evaluation (5). On application of behavior observation-based teamwork evaluation sheet for power plant operator team

    International Nuclear Information System (INIS)

    This report discusses the range of application of the behavior observation-based teamwork evaluation sheet. Under the concept of this method, teamwork evaluation sheet is developed, which assumes a certain single failure (failure of feed water transmitter). The evaluation sheets are applied to evaluate team work of 26 thermal power plant operator teams in combined under abnormal operating conditions of failure of feed water transmitter, feed draft fan or steam flow governor. As a result of ANOVA, it finds that there are no differences between 3 kinds of single failure. In addition, the similar analysis is executed to 3 kinds of multiple failures (steam generator tube rapture, loss of coolant accident and loss of secondary coolant accident) under which 7 PWR nuclear power plant operator teams are evaluated. As a result, ANOVA shows no differences between 3 kinds of multiple failures. These results indicate that a behavior observation-based team work evaluation sheet, which is designed for a certain abnormal condition, is applicable to the abnormal conditions that have the same development of abnormal conditions. (author)

  12. Promoting Collaboration in Health Care Teams through Interprofessional Education: A Simulation Case Study

    Science.gov (United States)

    Ekmekci, Ozgur

    2013-01-01

    This simulation study explores how the integration of interprofessional components into health care curriculum may impact professional stereotyping and collaborative behavior in care delivery teams comprised of a physician, a registered nurse, a physician's assistant, a physical therapist, and a radiation therapist. As part of the agent-based…

  13. Is the job satisfaction of primary care team members associated with patient satisfaction?

    NARCIS (Netherlands)

    Szecsenyi, J.; Goetz, K.; Campbell, S.M.; Broge, B.; Reuschenbach, B.; Wensing, M.J.P.

    2011-01-01

    BACKGROUND Previous research has shown a correlation between physician job satisfaction and patient satisfaction with quality of care, but the connection between job satisfaction of other primary care team members and patient satisfaction is yet unclear. OBJECTIVE To evaluate whether there is an ass

  14. Development of a standardised pro forma for specialist palliative care multidisciplinary team meetings.

    Science.gov (United States)

    Gallagher, Jennifer; Forman, Margaret Louise

    2012-05-01

    A pro forma of the caseload of the community palliative care clinical nurse specialists in the Central Lancashire Community Specialist Palliative Care Team was devised to provide a brief overview of each patient's plan of care for use in the multidisciplinary team meetings and as a consequence of preparing for the UK Department of Health's peer review process. The pro forma was also designed to be used in everyday clinical practice in Gold Standards Framework meetings in the community. It has been evaluated by the team and found to be helpful for highlighting key issues in clinical practice, such as symptoms, psychological and emotional needs, and Preferred Priorities of Care. Over the past 2 years, it has also complemented the organisation's drive to become 'paperless'. This article looks at how the pro forma was developed, how it has evolved over time, and how it works today. Consideration has also been given to its benefits and limitations.

  15. An evaluation of the influence of primary care team functioning on the health of Medicare beneficiaries.

    Science.gov (United States)

    Roblin, Douglas W; Howard, David H; Junling Ren; Becker, Edmund R

    2011-04-01

    In service industries other than health care, unit employees who report a favorable service climate--characterized by commitment to a team concept and intrateam interactions that are supportive, collegial, and collaborative--have high levels of consumer satisfaction and work unit productivity. The authors evaluated whether similar primary care team (PCT) functioning influenced the short-term future health (SF-36) of elderly Medicare beneficiaries (N = 991) in a group model managed care organization (MCO). PCT functioning was assessed by surveys of practitioners and support staff on the MCO's 14 primary care practices and included measures of perceived task delegation, role collaboration, patient orientation, and team ownership. On average, patient physical and emotional health declined over 2 years. Medicare beneficiaries empanelled to relatively high functioning PCTs had significantly better physical and emotional health at 2 years following baseline assessment than those empanelled to relatively low functioning PCTs.

  16. Pharmacist contributions for basic care from the perspective of professionals of familial health care teams

    Directory of Open Access Journals (Sweden)

    Gecioni Loch-Neckel

    2009-06-01

    Full Text Available This study aimed to investigate the social representations of professionals included in the team of Family Health Strategy (physicians, nurses and dentists respecting the action possibilities and contributions of the pharmacist for the basic care, and based on social psychology and, particularly, on the theory of social representations. The epistemological basis of the research is qualitative, and the data were collected by means of individual semi-structured interviews, which were submitted to analysis of categorical thematic content. Apparently, the majority of professionals already inserted in the team know and recognize the importance of professional pharmacists in the basic care, as well as their potential contribution to this topic. The representations were constructed according to the following parameters: a the study object and the intervention area, b the individual practice of every professional and c his/her action in specific cases. The quality of the professional or personal experience concerning the action of these professionals has contributed for the knowledge about the possibilities of pharmacists' intervention in basic care.Este estudo teve por objetivo investigar as representações sociais dos profissionais incluídos na equipe de Estratégia em Saúde da Família (médico, enfermeiro e odontólogo, sobre as possibilidades de atuação e as contribuições do farmacêutico na atenção básica, tendo por fundamento a psicologia social e, particularmente, a teoria das representações sociais. A base epistemológica da pesquisa é qualitativa, sendo os dados coletados por meio de entrevistas individuais semi-estruturadas e analisados por meio de análise de conteúdo categorial temático. Constatou-se que a maioria dos profissionais já inseridos na equipe conhece e reconhece a importância do profissional farmacêutico na atenção básica e as suas possibilidades de contribuição. As representações foram construídas a

  17. Integrating physiotherapists within primary health care teams: perspectives of family physicians and nurse practitioners.

    Science.gov (United States)

    Dufour, Sinéad Patricia; Brown, Judith; Deborah Lucy, S

    2014-09-01

    The international literature suggests a number of benefits related to integrating physiotherapists into primary health care (PHC) teams. Considering the mandate of PHC teams in Canada, emphasizing healthy living and chronic disease management, a broad range of providers, inclusive of physiotherapists is required. However, physiotherapists are only sparsely integrated into these teams. This study explores the perspectives of "core" PHC team members, family physicians and nurse practitioners, regarding the integration of physiotherapists within Ontario (Canada) PHC teams. Twenty individual semi-structured in-depth interviews were conducted, transcribed verbatim, and then analyzed following an iterative process drawing from an interpretive phenomenological approach. Five key themes emerged which highlighted "how physiotherapists could and do contribute as team members within PHC teams particularly related to musculoskeletal health and chronic disease management". The perceived value of physiotherapists within Ontario, Canada PHC teams was a unanimous sentiment particularly in terms of musculoskeletal health, chronic disease management and maximizing health human resources efficiency to ensure the right care, is delivered by the right practitioner, at the right time.

  18. Role construction and boundaries in interprofessional primary health care teams: a qualitative study

    OpenAIRE

    MacNaughton, Kate; Chreim, Samia; Bourgeault, Ivy Lynn

    2013-01-01

    Background The move towards enhancing teamwork and interprofessional collaboration in health care raises issues regarding the management of professional boundaries and the relationship among health care providers. This qualitative study explores how roles are constructed within interprofessional health care teams. It focuses on elucidating the different types of role boundaries, the influences on role construction and the implications for professionals and patients. Methods A comparative case...

  19. The 5As team intervention: bridging the knowledge gap in obesity management among primary care practitioners

    OpenAIRE

    Ogunleye, Ayodele; Osunlana, Adedayo; Asselin, Jodie; Cave, Andrew; Sharma, Arya Mitra; Campbell-Scherer, Denise Lynn

    2015-01-01

    Background Despite opportunities for didactic education on obesity management, we still observe low rates of weight management visits in our primary care setting. This paper describes the co-creation by front-line interdisciplinary health care providers and researchers of the 5As Team intervention to improve obesity prevention and management in primary care. Methods We describe the theoretical foundations, design, and core elements of the 5AsT intervention, and the process of eliciting practi...

  20. Nurse′s perceptions of physiotherapists in critical care team: Report of a qualitative study

    Directory of Open Access Journals (Sweden)

    Pranati Gupte

    2016-01-01

    Full Text Available Background: Interprofessional relationship plays a major role in effective patient care. Specialized units such as critical care require multidisciplinary care where perception about every members role may affect the delivery of patient care. The objective of this study was to find out nurses′ perceptions of the role of physiotherapists in the critical care team. Methods: Qualitative study by using semi-structured interview was conducted among the qualified nurses working in the Intensive Care Unit of a tertiary care hospital. The interview consisted of 19 questions divided into 3 sections. Interviews were audio recorded and transcribed. In-depth content analysis was carried out to identify major themes in relation to the research question. Results: Analysis identified five major issues which included role and image of a physiotherapist, effectiveness of treatment, communications, teamwork, and interprofessional relations. Physiotherapists were perceived to be an important member of the critical team with the role of mobilizing the patients. The respondents admitted that there existed limitations in interprofessional relationship. Conclusion: Nurses perceived the role of physiotherapist in the critical care unit as an integral part and agreed on the need for inclusion of therapist multidisciplinary critical care team.

  1. Using Digital Crumbs from an Electronic Health Record to Identify, Study and Improve Health Care Teams

    Science.gov (United States)

    Gray, James E; Feldman, Henry; Reti, Shane; Markson, Larry; Lu, Xiaoning; Davis, Roger B.; Safran, Charles A

    2011-01-01

    We have developed a novel approach, the Digital Crumb Investigator, for using data collected as a byproduct of Electonic Health Record (EHR) use to help define care teams and care processes. We are developing tools and methods to utilize these routinely collected data to visualize and quantify care networks across acute care and ambulatory settings We have chosen a clinical care domain where clinicians use EHRs in their offices, on the maternity wards and in the neonatal intensive care units as a test paradigm for this technology. The tools and methods we deliver should readily translate to other health care settings that collect behind-the-scenes electronic metadata such as audit trails. We believe that by applying the methods of social networking to define clinical relationships around a patient’s care we will enable new areas of research into the usage of EHRs to promote patient safety and other improvements in care. PMID:22195103

  2. Interprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units.

    Science.gov (United States)

    Paradis, Elise; Leslie, Myles; Gropper, Michael A

    2016-10-01

    Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the success of MIRs. We conducted a year-long comparative ethnographic study of interprofessional collaboration and patient and family involvement in four ICUs in tertiary academic hospitals in two American cities. The study included 576 h of observation of team interactions, 47 shadowing sessions and 40 clinician interviews. In line with best practices in ethnographic research, data collection and analysis were done iteratively using the constant comparative method. Member check was conducted regularly throughout the project. MIRs were implemented on all units with the explicit goals of improving team-based and patient-centered care. Operational conditions on the units, despite interprofessional commitment and engagement, appeared to thwart ICU teams from achieving these goals. Specifically, time constraints, struggles over space, and conflicts between MIRs' educational and care-plan-development functions all prevented teams from achieving collaboration and patient-involvement. Moreover, physicians' de facto control of rounds often meant that they resembled medical rounds (their historical predecessors), and sidelined other providers' contributions. This study suggests that the MIRs model, as presently practiced, might not be well suited to the provision of team-based, patient-centered care. In the interest of interprofessional collaboration, of the optimization of clinicians' time, of high-quality medical education and of patient-centered care, further research on interprofessional rounds models is needed. PMID:26704051

  3. Interprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units.

    Science.gov (United States)

    Paradis, Elise; Leslie, Myles; Gropper, Michael A

    2016-10-01

    Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the success of MIRs. We conducted a year-long comparative ethnographic study of interprofessional collaboration and patient and family involvement in four ICUs in tertiary academic hospitals in two American cities. The study included 576 h of observation of team interactions, 47 shadowing sessions and 40 clinician interviews. In line with best practices in ethnographic research, data collection and analysis were done iteratively using the constant comparative method. Member check was conducted regularly throughout the project. MIRs were implemented on all units with the explicit goals of improving team-based and patient-centered care. Operational conditions on the units, despite interprofessional commitment and engagement, appeared to thwart ICU teams from achieving these goals. Specifically, time constraints, struggles over space, and conflicts between MIRs' educational and care-plan-development functions all prevented teams from achieving collaboration and patient-involvement. Moreover, physicians' de facto control of rounds often meant that they resembled medical rounds (their historical predecessors), and sidelined other providers' contributions. This study suggests that the MIRs model, as presently practiced, might not be well suited to the provision of team-based, patient-centered care. In the interest of interprofessional collaboration, of the optimization of clinicians' time, of high-quality medical education and of patient-centered care, further research on interprofessional rounds models is needed.

  4. College and University Health Care Professionals: An Expanding Team.

    Science.gov (United States)

    Grier, Phillip M.

    1980-01-01

    An historical perspective of the American College Health Association emphasizes the importance of teamwork among health personnel. The current trend in litigation toward health care professionals and the regulatory role of government has resulted in an apparent increase in legal activity, and necessitates teamwork between doctors and lawyers. (JN)

  5. Intervention in health care teams and working relationships

    Directory of Open Access Journals (Sweden)

    Laurenson M

    2012-09-01

    Full Text Available Mary Laurenson, Tracey Heath, Sarah GribbinUniversity of Hull, Faculty of Health and Social Care, Department of Health Professional Studies, Cottingham, Hull, United KingdomIntroduction: Communication is an intrinsic part of collaborative working but can be problematic when the complexities of professional and personal identities inhibit quality care provision. This paper investigates these complexities and recommends interventions to facilitate collaborative working.Methods: A qualitative comparative approach examined data collected from participants using purposive non-probability sampling. Perspectives were obtained from four professional groups (nurses, social workers, care managers, and police, from different organizations with different theoretical and practice frameworks, and from a fifth group (informal carers.Results: Curriculum change and leadership initiatives are required to address the complexities inhibiting collaborative working relationships. Integrating complexity theory, personality typology, and problem-based learning into the curriculum to understand behavioral actions will enable interventions to effect change and promote the centrality of those being cared for.Keywords: interprofessional education and working, complexity, communication, personality, problem-based learning

  6. Evaluation of an Interdisciplinary Curriculum Teaching Team-Based Palliative Care Integration in Oncology.

    Science.gov (United States)

    Head, Barbara A; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeiffer, Mark

    2016-06-01

    For students of the health care professions to succeed in today's health care environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work, and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences. PMID:25708910

  7. Know Your Client and Know Your Team: A Complexity Inspired Approach to Understanding Safe Transitions in Care

    Directory of Open Access Journals (Sweden)

    Deborah Tregunno

    2013-01-01

    Full Text Available Background. Transitions in care are one of the most important and challenging client safety issues in healthcare. This project was undertaken to gain insight into the practice setting realities for nurses and other health care providers as they manage increasingly complex care transitions across multiple settings. Methods. The Appreciative Inquiry approach was used to guide interviews with sixty-six healthcare providers from a variety of practice settings. Data was collected on participants’ experience of exceptional care transitions and opportunities for improving care transitions. Results. Nurses and other healthcare providers need to know three things to ensure safe care transitions: (1 know your client; (2 know your team on both sides of the transfer; and (3 know the resources your client needs and how to get them. Three themes describe successful care transitions, including flexible structures; independence and teamwork; and client and provider focus. Conclusion. Nurses often operate at the margins of acceptable performance, and flexibility with regulation and standards is often required in complex sociotechnical work like care transitions. Priority needs to be given to creating conditions where nurses and other healthcare providers are free to creatively engage and respond in ways that will optimize safe care transitions.

  8. Care in psychiatric hospital under the perspective of a nursing team

    Directory of Open Access Journals (Sweden)

    Claudia Mara de Melo Tavares

    2014-06-01

    Full Text Available The present study is aimed at describing the perception of the nursing team concerning the care in a psychiatric hospital. The research used a qualitative approach, exploratory type, using focus group technique, with five participants, in August 2011, in Niteroi, RJ, Brazil. From the data analysis five categories emerged, covering: sensitive listening; personal availability; therapeutic projects; human issues of the team; Traditional Psychiatry vs. Psychosocial Paradigm tension. It was concluded that despite the research, the subjects were still working at the hospital model. It was possible to bring awareness in a human, comprehensive and complete manner. But this perception of care has frailties once it does not bring any evidence of scientific basis of nursing. It is recommended that the professional nursing team invest in their role of caring in the context of the Psychiatric Reform, in the pursuit of an approach centered on the subject and in his way of living.

  9. Prerequisites for sustainable care improvement using the reflective team as a work model.

    Science.gov (United States)

    Jonasson, Lise-Lotte; Carlsson, Gunilla; Nyström, Maria

    2014-01-01

    Several work models for care improvement have been developed in order to meet the requirement for evidence-based care. This study examines a work model for reflection, entitled the reflective team (RT). The main idea behind RTs is that caring skills exist among those who work closest to the patients. The team leader (RTL) encourages sustainable care improvement, rooted in research and proven experience, by using a lifeworld perspective to stimulate further reflection and a developmental process leading to research-based caring actions within the team. In order to maintain focus, it is important that the RTL has a clear idea of what sustainable care improvement means, and what the prerequisites are for such improvement. The aim of the present study is, therefore, to explore the prerequisites for improving sustainable care, seeking to answer how RTLs perceive these and use RTs for concrete planning. Nine RTLs were interviewed, and their statements were phenomenographically analysed. The analysis revealed three separate qualitative categories, which describe personal, interpersonal, and structural aspects of the prerequisites. In the discussion, these categories are compared with previous research on reflection, and the conclusion is reached that the optimal conditions for RTs to work, when focussed on sustainable care improvement, occur when the various aspects of the prerequisites are intertwined and become a natural part of the reflective work.

  10. Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?

    Science.gov (United States)

    Freund, Tobias; Everett, Christine; Griffiths, Peter; Hudon, Catherine; Naccarella, Lucio; Laurant, Miranda

    2015-03-01

    World-wide, shortages of primary care physicians and an increased demand for services have provided the impetus for delivering team-based primary care. The diversity of the primary care workforce is increasing to include a wider range of health professionals such as nurse practitioners, registered nurses and other clinical staff members. Although this development is observed internationally, skill mix in the primary care team and the speed of progress to deliver team-based care differs across countries. This work aims to provide an overview of education, tasks and remuneration of nurses and other primary care team members in six OECD countries. Based on a framework of team organization across the care continuum, six national experts compare skill-mix, education and training, tasks and remuneration of health professionals within primary care teams in the United States, Canada, Australia, England, Germany and the Netherlands. Nurses are the main non-physician health professional working along with doctors in most countries although types and roles in primary care vary considerably between countries. However, the number of allied health professionals and support workers, such as medical assistants, working in primary care is increasing. Shifting from 'task delegation' to 'team care' is a global trend but limited by traditional role concepts, legal frameworks and reimbursement schemes. In general, remuneration follows the complexity of medical tasks taken over by each profession. Clear definitions of each team-member's role may facilitate optimally shared responsibility for patient care within primary care teams. Skill mix changes in primary care may help to maintain access to primary care and quality of care delivery. Learning from experiences in other countries may inspire policy makers and researchers to work on efficient and effective teams care models worldwide.

  11. Interprofessional team management in pediatric critical care: some challenges and possible solutions

    Directory of Open Access Journals (Sweden)

    Stocker M

    2016-02-01

    Full Text Available Martin Stocker,1 Sina B Pilgrim,2 Margarita Burmester,3 Meredith L Allen,4 Wim H Gijselaers5 1Neonatal and Pediatric Intensive Care Unit, Children's Hospital Lucerne, Lucerne, 2Pediatric Intensive Care, University Children's Hospital Berne, Berne, Switzerland; 3Pediatric Intensive Care Unit, Royal Brompton Hospital, London, UK; 4Department of Pediatrics, The Royal Children's Hospital, Victoria, Australia; 5Educational Research and Development, School of Business and Economics, Maastricht University, Maastricht, the Netherlands Background: Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous.Methods: We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts.Findings: The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal

  12. What Does Change with Nutrition Team in Intensive Care Unit?

    OpenAIRE

    Ahmet Fatih Yılmaz; Ertuğrul Kılıç; Sema Gürsel; Nazlı Tiryaki

    2016-01-01

    Intrroduction: Clinical nutrition is the nutrition support therapy provided to patients under medical supervision at the hospital or home setting. It is a multidisciplinary task performed under the control of the physician, dietician, pharmacist and nurse. In this study, the changes in the patient admission statistics to the general intensive care unit (GICU), the exitus ratios, decubitus ulcer formation rates, albumin use rates, duration of the hospital stay, Acute Physiology and Chronic Hea...

  13. Doing Interdisciplinary Mixed Methods Health Care Research: Working the Boundaries, Tensions, and Synergistic Potential of Team-Based Research.

    Science.gov (United States)

    Hesse-Biber, Sharlene

    2016-04-01

    Current trends in health care research point to a shift from disciplinary models to interdisciplinary team-based mixed methods inquiry designs. This keynote address discusses the problems and prospects of creating vibrant mixed methods health care interdisciplinary research teams that can harness their potential synergy that holds the promise of addressing complex health care issues. We examine the range of factors and issues these types of research teams need to consider to facilitate efficient interdisciplinary mixed methods team-based research. It is argued that concepts such as disciplinary comfort zones, a lack of attention to team dynamics, and low levels of reflexivity among interdisciplinary team members can inhibit the effectiveness of a research team. This keynote suggests a set of effective strategies to address the issues that emanate from the new field of research inquiry known as team science as well as lessons learned from tapping into research on organizational dynamics. PMID:26984708

  14. Doing Interdisciplinary Mixed Methods Health Care Research: Working the Boundaries, Tensions, and Synergistic Potential of Team-Based Research.

    Science.gov (United States)

    Hesse-Biber, Sharlene

    2016-04-01

    Current trends in health care research point to a shift from disciplinary models to interdisciplinary team-based mixed methods inquiry designs. This keynote address discusses the problems and prospects of creating vibrant mixed methods health care interdisciplinary research teams that can harness their potential synergy that holds the promise of addressing complex health care issues. We examine the range of factors and issues these types of research teams need to consider to facilitate efficient interdisciplinary mixed methods team-based research. It is argued that concepts such as disciplinary comfort zones, a lack of attention to team dynamics, and low levels of reflexivity among interdisciplinary team members can inhibit the effectiveness of a research team. This keynote suggests a set of effective strategies to address the issues that emanate from the new field of research inquiry known as team science as well as lessons learned from tapping into research on organizational dynamics.

  15. Alpers–Huttenlocher syndrome: the role of a multidisciplinary health care team

    Directory of Open Access Journals (Sweden)

    Saneto RP

    2016-07-01

    Full Text Available Russell P Saneto1,2 1Department of Neurology, University of Washington, 2Division of Pediatric Neurology, Seattle Children’s Hospital, Seattle, WA, USA Abstract: Alpers–Huttenlocher syndrome (AHS is a mitochondrial DNA-depletion syndrome. Age of onset is bimodal: early onset at 2–4 years and later adolescent onset at 17–24 years of age. Early development is usually normal, with epilepsy heralding the disorder in ~50% of patients. The onset of seizures is coupled with progressive cognitive decline. Hepatopathy is variable, and when present is a progressive dysfunction leading to liver failure in many cases. These features of seizures, cognitive degeneration, and hepatopathy represent the “classic triad” of AHS. However, most patients develop other system involvement. Therefore, although AHS is ultimately a lethal disorder, medical care is required for sustained quality of life. Frequently, additional organ systems – gastrointestinal, respiratory, nutritional, and psychiatric – abnormalities appear and need treatment. Rarely, cardiovascular dysfunction and even pregnancy complicate medical treatment. Optimal care requires a team of physicians and caretakers to make sure quality of life is optimized. The care team, together with the family and palliative care specialists, need to be in communication as the disease progresses and medical changes occur. Although the unpredictable losses of function challenge medical care, the team approach can foster the individual quality-of-life care needed for the patient and family. Keywords: Mitochondrial depletion syndrome, polymerase gamma 1, clinical care, mitochondria

  16. An interdisciplinary-interuniversity health care team management decision-making case study course.

    Science.gov (United States)

    DeSalvo, R J; Arlinghaus, E J; Rowe, K W

    1985-01-01

    An elective case study course involving graduate students from various health profession disciplines from two universities was developed in order to provide a forum for health care teams to discuss the philosophical and functional impact of situations and their alternative solutions. The case studies stressed various aspects of the decision-making process and were nonclinical/technical but health care administratively oriented in nature. Course evaluations manifest that participants from each discipline improved their problem-solving and leadership abilities, and created a cross-fertilization of knowledge and understanding of the various health care disciplines and their perspectives that each brings to the health care system.

  17. Challenges in interdisciplinary weight management in primary care: lessons learned from the 5As Team study.

    Science.gov (United States)

    Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D

    2016-04-01

    Increasingly, research is directed at advancing methods to address obesity management in primary care. In this paper we describe the role of interdisciplinary collaboration, or lack thereof, in patient weight management within 12 teams in a large primary care network in Alberta, Canada. Qualitative data for the present analysis were derived from the 5As Team (5AsT) trial, a mixed-method randomized control trial of a 6-month participatory, team-based educational intervention aimed at improving the quality and quantity of obesity management encounters in primary care practice. Participants (n = 29) included in this analysis are healthcare providers supporting chronic disease management in 12 family practice clinics randomized to the intervention arm of the 5AsT trial including mental healthcare workers (n = 7), registered dietitians (n = 7), registered nurses or nurse practitioners (n = 15). Participants were part of a 6-month intervention consisting of 12 biweekly learning sessions aimed at increasing provider knowledge and confidence in addressing patient weight management. Qualitative methods included interviews, structured field notes and logs. Four common themes of importance in the ability of healthcare providers to address weight with patients within an interdisciplinary care team emerged, (i) Availability; (ii) Referrals; (iii) Role perception and (iv) Messaging. However, we find that what was key to our participants was not that these issues be uniformly agreed upon by all team members, but rather that communication and clinic relationships support their continued negotiation. Our study shows that firm clinic relationships and deliberate communication strategies are the foundation of interdisciplinary care in weight management. Furthermore, there is a clear need for shared messaging concerning obesity and its treatment between members of interdisciplinary teams. PMID:26815638

  18. Conflict on interprofessional primary health care teams--can it be resolved?

    Science.gov (United States)

    Brown, Judith; Lewis, Laura; Ellis, Kathy; Stewart, Moira; Freeman, Thomas R; Kasperski, M Janet

    2011-01-01

    Increasingly, primary health care teams (PHCTs) depend on the contributions of multiple professionals. However, conflict is inevitable on teams. This article examines PHCTs members' experiences with conflict and responses to conflict. This phenomenological study was conducted using in-depth interviews with 121 participants from 16 PHCTs (10 urban and 6 rural) including a wide range of health care professionals. An iterative analysis process was used to examine the verbatim transcripts. The analysis revealed three main themes: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Sources of team conflict included: role boundary issues; scope of practice; and accountability. Barriers to conflict resolution were: lack of time and workload; people in less powerful positions; lack of recognition or motivation to address conflict; and avoiding confrontation for fear of causing emotional discomfort. Team strategies for conflict resolution included interventions by team leaders and the development of conflict management protocols. Individual strategies included: open and direct communication; a willingness to find solutions; showing respect; and humility. Conflict is inherent in teamwork. However, understanding the potential barriers to conflict resolution can assist PHCTs in developing strategies to resolve conflict in a timely fashion. PMID:20795830

  19. Interprofessional teamwork and team interventions in chronic care: A systematic review.

    Science.gov (United States)

    Körner, Mirjam; Bütof, Sarah; Müller, Christian; Zimmermann, Linda; Becker, Sonja; Bengel, Jürgen

    2016-01-01

    To identify key features of teamwork and interventions for enhancing interprofessional teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systematic literature review of IPT in chronic care for the years 2002-2014. Database searches yielded 3217 abstracts, 21 of which fulfilled inclusion criteria. We identified two more studies on the topic by scanning the reference lists of included articles, which resulted in a final total of 23 included studies. The key features identified in the articles (e.g., team member characteristics, common task, communication, cooperation, coordination, responsibility, participation, staff satisfaction, patient satisfaction, and efficiency) were structured in line with the input-process-output model, and evaluated interventions, such as tools, workshops, and changes in team structure, were added to the model. The most frequently evaluated team interventions were complex intervention programs. All but one of the 14 evaluation studies resulted in enhancement of teamwork and/or staff-related, patient-related, and organization-related outcome criteria. To date, there is no consensus about the main features of IPT and the most effective team interventions in chronic care. However, the findings may be used to standardize the implementation and evaluation of IPT and team interventions in practice and for further research.

  20. Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning.

    Science.gov (United States)

    Frame, Tracy R; Gryka, Rebecca; Kiersma, Mary E; Todt, Abby L; Cailor, Stephanie M; Chen, Aleda M H

    2016-04-25

    Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura's Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students' skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations.

  1. Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning.

    Science.gov (United States)

    Frame, Tracy R; Gryka, Rebecca; Kiersma, Mary E; Todt, Abby L; Cailor, Stephanie M; Chen, Aleda M H

    2016-04-25

    Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura's Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students' skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations. PMID:27170817

  2. Real-Time Support of Pediatric Diabetes Self-Care by a Transport Team

    OpenAIRE

    Franklin, Brandi E.; Crisler, S. Crile; Shappley, Rebekah; Armour, Meri M.; McCommon, Dana T.; Ferry, Robert J.

    2013-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis ...

  3. Role of the primary health care team in preventing accidents to children.

    OpenAIRE

    Kendrick, D

    1994-01-01

    Accidents are the most common cause of mortality in children and account for considerable childhood morbidity. The identification of risk factors for childhood accidents suggests that many are predictable and therefore preventable. Numerous interventions have been found to be effective in reducing the morbidity and mortality from childhood accidents. The scope for accident prevention within the primary care setting and the roles of the members of the primary health care team are discussed. Fi...

  4. The Transition from VMS to Unix Operations for STScI's Science Planning and Scheduling Team

    Science.gov (United States)

    Adler, D. S.; Taylor, D. K.

    The Science Planning and Scheduling Team of the Space Telescope Science Institute currently uses the VMS operating system. SPST began a transition to Unix-based operations in the summer of 1999. The main tasks for SPST to address in the Unix transition are: (1) converting the current SPST operational tools from DCL to Python; (2) converting our database report scripts from SQL; (3) adopting a Unix-based code management system; and (4) training the SPST staff. The goal is to fully transition the team to Unix operations by the end of 2001.

  5. Alpers-Huttenlocher syndrome: the role of a multidisciplinary health care team.

    Science.gov (United States)

    Saneto, Russell P

    2016-01-01

    Alpers-Huttenlocher syndrome (AHS) is a mitochondrial DNA-depletion syndrome. Age of onset is bimodal: early onset at 2-4 years and later adolescent onset at 17-24 years of age. Early development is usually normal, with epilepsy heralding the disorder in ~50% of patients. The onset of seizures is coupled with progressive cognitive decline. Hepatopathy is variable, and when present is a progressive dysfunction leading to liver failure in many cases. These features of seizures, cognitive degeneration, and hepatopathy represent the "classic triad" of AHS. However, most patients develop other system involvement. Therefore, although AHS is ultimately a lethal disorder, medical care is required for sustained quality of life. Frequently, additional organ systems - gastrointestinal, respiratory, nutritional, and psychiatric - abnormalities appear and need treatment. Rarely, cardiovascular dysfunction and even pregnancy complicate medical treatment. Optimal care requires a team of physicians and caretakers to make sure quality of life is optimized. The care team, together with the family and palliative care specialists, need to be in communication as the disease progresses and medical changes occur. Although the unpredictable losses of function challenge medical care, the team approach can foster the individual quality-of-life care needed for the patient and family. PMID:27555780

  6. Accountability in integrated working: Meaning and implications for cancer care teams

    International Nuclear Information System (INIS)

    This article presents a critical evaluation of the concepts of accountability and delegated authority and how this impacts on integrated working in cancer care teams. It looks at the difficulties experienced by radiographers in establishing their roles in integrated teams through an analysis of how professional teams have developed from a sociological and historical perspective. The paper highlights the contestability of the terms and contends that many non-medical professional practitioners experience problems with assuming full accountability. The article acknowledges and advocates that the wishes of patients and clients must be prioritised in the decision making process, thus requiring professionals to embrace accountability fully and differentiate and manage risk. The importance of leadership in furthering the achievement of integrated working is recognised. In conclusion, the article proposes that shared accountability among teams is challenging for radiographers and others, and that education providers should take this into account when designing curricula.

  7. A cross-sectional survey of the activity of palliative care teams in Portugal.

    Science.gov (United States)

    Gonçalves, Ferraz; Almeida, Ana; Antunes, Catarina; Cardoso, Alice; Carvalho, Margarida; Claro, Maria; Coimbra, Francisca; Diniz, Inês; Fonseca, Bruno; Fradique, Emília; Gonçalves, Edna; Gonçalves, Florbela; Gonçalves, Maria; Magalhães, Américo; Pina, Paulo; Pires, Conceição; Silva, Paula; Silva, Ricardo; Silva, Rui; Tavares, Filipa; Teixeira, Laura

    2013-11-01

    Of the 21 Portuguese teams identified, 10 accepted to participate in the study. A total of 164 patients were included with a median of 15.5 per team (4-32). Of all the patients included, 60 (37%) were identified as inpatients in palliative care units; 59 (36%) by an intrahospital support team; 26 (16%) as outpatients; and 19 (12%) at home. The median age was 71 years (16-95). Fifty-one percent were females. The diagnosis was cancer in 151 (92%) patients. The most common cancer was colorectal in 22 (15%) patients, followed by gastric 17 (11%), head and neck 17 (11%), breast 15 (10%), and lung cancers 14 (9%). All patients were treated by doctors and nurses experienced in palliative care.

  8. Experimental studies of computerized procedures and team size in nuclear power plant operations

    International Nuclear Information System (INIS)

    The operation of a nuclear power plant is so complex that it requires teamwork. To support team performance, a system need to provide all team members integrated information displays as well as decision aids (e.g., computerized procedures). Two experiments were conducted to investigate the effects of computerized procedures and team size on operating performance. Forty-five participants were involved in the experiments. Each participant executed decision and action tasks to deal with alarm signals, while detecting occasional system errors in the interface. Results showed that effects of computerized procedures were significant on various performance indicators, such as operation time, operation errors, and learning effect, and that two operators would be a satisfactory size in the teamwork system providing computerized procedures

  9. Effectiveness of Advanced Illness Care Teams for Nursing Home Residents with Dementia

    Science.gov (United States)

    Chapman, Dennis G.; Toseland, Ronald W.

    2007-01-01

    This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and…

  10. Organizational culture, team climate and diabetes care in small office-based practices

    Directory of Open Access Journals (Sweden)

    van der Weijden Trudy

    2008-08-01

    Full Text Available Abstract Background Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary teamwork and different types of organizational culture are associated with high quality diabetes care in small office-based general practices. Methods We conducted cross-sectional analyses of data from 83 health care professionals involved in diabetes care from 30 primary care practices in the Netherlands, with a total of 752 diabetes mellitus type II patients participating in an improvement study. We used self-reported measures of team climate (Team Climate Inventory and organizational culture (Competing Values Framework, and measures of quality of diabetes care and clinical patient characteristics from medical records and self-report. We conducted multivariate analyses of the relationship between culture, climate and HbA1c, total cholesterol, systolic blood pressure and a sum score on process indicators for the quality of diabetes care, adjusting for potential patient- and practice level confounders and practice-level clustering. Results A strong group culture was negatively associated to the quality of diabetes care provided to patients (β = -0.04; p = 0.04, whereas a more 'balanced culture' was positively associated to diabetes care quality (β = 5.97; p = 0.03. No associations were found between organizational culture, team climate and clinical patient outcomes. Conclusion Although some significant associations were found between high quality diabetes care in general practice and different organizational cultures, relations were rather marginal. Variation in clinical patient outcomes could not be attributed to organizational culture or teamwork. This study therefore contributes to the discussion about the legitimacy of the widespread idea

  11. Piloting the role of a pharmacist in a community palliative care multidisciplinary team: an Australian experience

    Directory of Open Access Journals (Sweden)

    Box Margaret

    2011-10-01

    Full Text Available Abstract Background While the home is the most common setting for the provision of palliative care in Australia, a common problem encountered here is the inability of patient/carers to manage medications, which can lead to misadventure and hospitalisation. This can be averted through detection and resolution of drug related problems (DRPs by a pharmacist; however, they are rarely included as members of the palliative care team. The aim of this study was to pilot a model of care that supports the role of a pharmacist in a community palliative care team. A component of the study was to develop a cost-effective model for continuing the inclusion of a pharmacist within a community palliative care service. Methods The study was undertaken (February March 2009-June 2010 in three phases. Development (Phase 1 involved a literature review; scoping the pharmacist's role; creating tools for recording DRPs and interventions, a communication and education strategy, a care pathway and evidence based patient information. These were then implemented in Phase 2. Evaluation (Phase 3 of the impact of the pharmacist's role from the perspectives of team members was undertaken using an online survey and focus group. Impact on clinical outcomes was determined by the number of patients screened to assess their risk of medication misadventure, as well as the number of medication reviews and interventions performed to resolve DRPs. Results The pharmacist screened most patients (88.4%, 373/422 referred to the palliative care service to assess their risk of medication misadventure, and undertook 52 home visits. Medication reviews were commonly conducted at the majority of home visits (88%, 46/52, and a variety of DRPs (113 were detected at this point, the most common being "patient requests drug information" (25%, 28/113 and "condition not adequately treated" (22%, 25/113. The pharmacist made 120 recommendations in relation to her interventions. Fifty percent of online

  12. 2015 ACC Health Policy Statement on Cardiovascular Team-Based Care and the Role of Advanced Practice Providers.

    Science.gov (United States)

    Brush, John E; Handberg, Eileen M; Biga, Cathleen; Birtcher, Kim K; Bove, Alfred A; Casale, Paul N; Clark, Michael G; Garson, Arthur; Hines, Jerome L; Linderbaum, Jane A; Rodgers, George P; Shor, Robert A; Thourani, Vinod H; Wyman, Janet F

    2015-05-19

    The mission of the American College of Cardiology is "to transform cardiovascular care and improve heart health." Cardiovascular team-based care is a paradigm for practice that can transform care, improve heart health, and help meet the demands of the future. One strategic goal of the College is to help members successfully transition their clinical practices to the future, with all its complexity, challenges, and opportunities. The ACC's strategic plan is aligned with the triple aim of improved care, improved population health, and lower costs per capita. The traditional understanding of quality, access, and cost is that you cannot improve one component without diminishing the others. With cardiovascular team-based care, it is possible to achieve the triple aim of improving quality, access, and cost simultaneously to also improve cardiovascular health. Striving to serve the best interests of patients is the true north of our guiding principles. Cardiovascular team-based care is a model that can improve care coordination and communication and allow each team member to focus more on the quality of care. In addition, the cardiovascular team-based care model increases access to cardiovascular care and allows expansion of services to populations and geographic areas that are currently underserved. This document will increase awareness of the important components of cardiovascular team-based care and create an opportunity for more discussion about the most creative and effective means of implementing it. We hope that this document will stimulate further discussions and activities within the ACC and beyond about team-based care. We have identified areas that need improvement, specifically in APP education and state regulation. The document encourages the exploration of collaborative care models that should enable team members to optimize their education, training, experience, and talent. Improved team leadership, coordination, collaboration, engagement, and efficiency

  13. Evaluation of communication characteristics of operating teams in NPPs using SNA technique

    International Nuclear Information System (INIS)

    Inappropriate communications within operational teams can lead to serious consequences of a system since it can cause lack of exchange of important information to perform the task to secure the safety of the system in nuclear power plants (NPPs). For that reason, we studied the communication characteristics However, existing studies on the communication characteristics seem to have problem since they have characterized team communications from a single perspective. According that, we have developed an evaluation method to characterize team communications using social network techniques which can evaluate them from various perspectives which are group cohesiveness, frequency of communications, degree of hierarchy, and communication contents. In addition, we suggested some kids of specific communication characteristics of operating teams that can reduce the occurrence of inappropriate communications. Eight verbal protocol data which are audio-visual recorded under emergency training sessions by main control room (MCR) operating teams are used. As a result of the study, there was negative relationship between group cohesiveness and the ratio of inappropriate communications. Moreover, some kinds of specific communication contents are related to the ratio of inappropriate communications. Consequently, we can evaluate communications characteristics of operating teams in NPPs and suggest specific characteristics to provide useful insights to prevent inappropriate communications

  14. The knowledge of family health team on the action of physical therapist in primary care

    Directory of Open Access Journals (Sweden)

    Greicimar de Oliveira

    2011-12-01

    Full Text Available Objective: To evaluate the knowledge of health team from Basic Health Units in the city of Coari-AM, Brazil, on the action of physical therapist in primary care. Methods: A quantitative,exploratory and descriptive study, like a field survey conducted in 11 primary care units in Coari, Amazonas state. The data were collected through a questionnaire comprising closed questions regarding the action of physical therapist in primary care. 76 professionals joinedin the survey by category: (05 physicians, (10 nurses, (08 nursing technicians and (53 community health workers. Results: 61.64% (n = 45 of the professionals working in the family health team reported knowing the action of physical therapist in primary care; 79.45%(n = 58 referred it in secondary level and 69.86% (n = 51 at the tertiary level of health care. Conclusion: This work showed some knowledge of professionals on the professional action of physical therapists in primary care; however, the knowledge for this level presents itself disadvantaged in relation to other levels of health care. We demonstrated that a share of professionals presented difficulties to consider the possibility of physiotherapeuticintervention in diseases mostly worked in primary care, but the reference to the viability of action of physical therapist for different publics was satisfactory. This conclusion does notexhaust the possibility of discussing the proposed theme.

  15. The knowledge of family health team on the action of physical therapist in primary care -

    Directory of Open Access Journals (Sweden)

    Greicimar de Oliveira

    2012-01-01

    Full Text Available Objective: To evaluate the knowledge of health team from Basic Health Units in the city of Coari-AM, Brazil, on the action of physical therapist in primary care. Methods: A quantitative, exploratory and descriptive study, like a field survey conducted in 11 primary care units in Coari, Amazonas state. The data were collected through a questionnaire comprising closed questions regarding the action of physical therapist in primary care. 76 professionals joined in the survey by category: (05 physicians, (10 nurses, (08 nursing technicians and (53 community health workers. Results: 61.64% (n = 45 of the professionals working in the family health team reported knowing the action of physical therapist in primary care; 79.45% (n = 58 referred it in secondary level and 69.86% (n = 51 at the tertiary level of health care. Conclusion: This work showed some knowledge of professionals on the professional action of physical therapists in primary care; however, the knowledge for this level presents itself disadvantaged in relation to other levels of health care. We demonstrated that a share of professionals presented difficulties to consider the possibility of physiotherapeutic intervention in diseases mostly worked in primary care, but the reference to the viability of action of physical therapist for different publics was satisfactory. This conclusion does not exhaust the possibility of discussing the proposed theme.

  16. Characterizing the Structure of a Patient's Care Team through Electronic Encounter Data Analysis.

    Science.gov (United States)

    He, Shan; Gurr, Greg; Rea, Susan; Thornton, Sidney N

    2015-01-01

    As the field of medicine grows more complicated and doctors become more specialized in a particular field, the number of healthcare providers involved in healing an individual patient increases. This is particularly true of patients with multiple chronic conditions. Establishing effective communications among the care providers becomes critical to facilitate care coordination and more efficient resource use, which will ultimately result in health outcome improvement. The first step for care coordination is to understand who have been involved in a patient's care and their relationships with the patient. The widespread adoption of Electronic Health Records provides us an opportunity to explore solutions to well-coordinated care. This paper presents the concept of a patient's care team and demonstrates the feasibility of identifying relevant healthcare providers for an individual patient by leveraging electronic patient encounter data. Combined with network analysis techniques, we further visualize the care team structure with quantified strength of patient-provider relationships. Our work is foundational to the larger goal of patient-centered, coordinated care in the digital age of healthcare.

  17. OSART Guidelines. 2015 Edition. Reference Report for IAEA Operational Safety Review Teams (OSARTs)

    International Nuclear Information System (INIS)

    The IAEA works to provide a global nuclear safety and security framework for the protection of people and the environment from the effects of ionizing radiation, the minimization of the likelihood of accidents that could endanger life and property, and effective mitigation of the effects of any such events, should they occur. The strategic approach to achieving such a framework involves continual improvement in four areas: national and international safety infrastructures; the establishment and global acceptance of IAEA safety standards; an integrated approach to the provision for the application of the safety standards; and a global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. Conservative design, careful manufacture and sound construction are all prerequisites for the safe operation of nuclear power plants. However, the safety of the plant also depends ultimately on: sound management, policies, procedures, processes and practices; the capability and reliability of commissioning and operating personnel; comprehensive instructions; sound accident management and emergency preparedness; and adequate resources. Finally, a positive attitude and conscientiousness on the part of all staff in discharging their responsibilities is important to safety. The OSART programme is based on the safety standards applicable to nuclear power plants. IAEA safety standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Group identify important current nuclear safety issues and also serve as references during an OSART review. The publication OSART Guidelines provides overall guidance on the conduct of OSART

  18. How teams work--or don't--in primary care: a field study on internal medicine practices.

    Science.gov (United States)

    Chesluk, Benjamin J; Holmboe, Eric S

    2010-05-01

    We conducted a field study in three primary care practices representing different practice types: a solo practice; a certified patient-centered medical home; and a multiphysician, multispecialty practice connected to a local university. All three practices shared a common culture in the way that practice members related to each other. In each instance, the practice team operated in separate social "silos," isolating physicians from each other and from the rest of the practice staff. We concluded that current practice structures are primarily focused on supporting physicians' hectic routines and have trouble accommodating the diversity of patients' needs. For practices to succeed in managing diverse patients and in helping them understand and manage their own health, it will be critical to break down the silos and organize teams with shared roles and responsibilities. PMID:20439874

  19. Effects of chemical protective equipment on team process performance in small unit rescue operations.

    Science.gov (United States)

    Grugle, Nancy L; Kleiner, Brian M

    2007-09-01

    In the event of a nuclear, biological, or chemical terrorist attack against civilians, both military and civilian emergency response teams must be able to respond and operate efficiently while wearing protective equipment. Chemical protective equipment protects the user by providing a barrier between the individual and hazardous environment. Unfortunately, the same equipment that is designed to support the user can potentially cause heat stress, reduced task efficiency, and reduced range-of-motion. Targeted Acceptable Responses to Generated Events of Tasks (TARGETS), an event-based team performance measurement methodology was used to investigate the effects of Mission Oriented Protective Posture (MOPP) on the behavioral processes underlying team performance during simulated rescue tasks. In addition, this study determined which team processes were related to team performance outcomes. Results of six primary analyses indicated that team process performance was not degraded by MOPP 4 on any rescue task and that the team processes critical for successful task performance are task-dependent. This article discusses the implications of these results with respect to the study design and the limitations of using an event-based team performance measurement methodology.

  20. The Effect of Rapid Response Teams on End-of-Life Care: A Retrospective Chart Review

    OpenAIRE

    Benjamin Tam; Mary Salib; Alison Fox-Robichaud

    2014-01-01

    BACKGROUND: A subset of critically ill patients have end-of-life (EOL) goals that are unclear. Rapid response teams (RRTs) may aid in the identification of these patients and the delivery of their EOL care.OBJECTIVES: To characterize the impact of RRT discussion on EOL care, and to examine how a preprinted order (PPO) set for EOL care influenced EOL discussions and outcomes.METHODS: A single-centre retrospective chart review of all RRT calls (January 2009 to December 2010) was performed. The ...

  1. The Finnish forward surgical team: lessons from the European Union Forces Operation République Démocratique du Congo.

    Science.gov (United States)

    Lauri, Handolin; Olli, Kiviluoto

    2008-05-01

    The European Union Forces Operation République Démocratique du Congo in the Democratic Republic of the Congo in 2006 was the first operation planned and conducted solely by the European Union Forces. The Finnish forward surgical team (FST) was deployed for 4 months in Kinshasa, the capital of the Democratic Republic of the Congo. Because of the peacekeeping nature of the operation, the surgical workload was light and the total number of patients treated by the FST was 12. However, there is an obvious need to establish similar surgical assets in future operations. The lessons and experiences regarding the variables in the composition of the FST (mobility, surgical ability, staffing, patient care, physical stability, environmental adaptation, and independence) are discussed in the present article. The major future challenges are to resource the FST units optimally to remain light and easily deployable and to maintain the effectiveness of the unit during nonclinical periods.

  2. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  3. Women's Health Care Teams and the Future of Obstetrics and Gynecology.

    Science.gov (United States)

    Hollier, Lisa M; Promecene, Pamela A; Owens, Michelle Y; Hampton, Moss; Gala, Rajiv; Kulbida, Nicholas; Tomich, Paul; Gregg, Laurie; Rothenberg, Jeffrey; Phelan, Sharon T; Jennings, John C

    2015-12-01

    Health care delivery is in a stage of transformation and a meaningful change in provision of care must also be accompanied by changes in the educational process of health care professionals. This article lays out a roadmap to better prepare obstetrician-gynecologists (ob-gyns) to succeed in interdisciplinary women's health care teams. Just as our current educational programs emphasize the development of competent surgical skills, our future programs must encourage and support the development of communication, teamwork, and leadership skills for ob-gyns. Formal integration of these fundamentals at all levels of the health care training continuum will create an educational system designed to equip all practitioners with a basic level of knowledge and provide opportunities to acquire additional knowledge and skills as needs and interest dictate. Integral to the implementation will be the evaluation of the effects of the contributions of interprofessional education on patient, practice, and health system outcomes. Successful demonstration of value will lead to the sustainability of the educational programs through recognition by physicians, health care teams, academia, health care systems, and payers. PMID:26551185

  4. Post-operative care to promote recovery for thoracic surgical patients: a nursing perspective

    OpenAIRE

    Yeung, Wilfred Wai Kit

    2016-01-01

    The change in patient population leads to an inevitable transformation among the healthcare system. Over the past decades, thoracic surgical technique has been evolving from conventional open thoracotomy to minimally invasive video assisted thoracoscopic surgery (VATS). Thoracic nursing team of Prince of Wales Hospital (PWH) grows together with the evolution and aims at providing holistic and quality care to patients require thoracic operation. In order to enhance patient post-operative recov...

  5. Primary care provider preferences for working with a collaborative support team

    Directory of Open Access Journals (Sweden)

    Flores Jennifer A

    2007-05-01

    Full Text Available Abstract Background Clinical interventions based on collaborative models require effective communication between primary care providers (PCPs and collaborative support teams. Despite growing interest in collaborative care, we have identified no published studies describing how PCPs prefer to communicate and interact with collaborative support teams. This manuscript examines the communication and interaction preferences of PCPs participating in an ongoing randomized clinical trial of a collaborative intervention for chronic pain and depression. Methods The trial is being conducted in five primary care clinics of a Veterans Affairs Medical Center. Twenty-one PCPs randomized to the study intervention completed a survey regarding preferences for interacting with the collaborative support team. Results A majority of PCPs identified email (95% and telephone calls (68% as preferred modes for communicating with members of the support team. In contrast, only 29% identified in-person communications as preferred. Most PCPs preferred that the care manager and physician pain specialist assess patients (76% and make initial treatment changes (71% without first conferring with the PCP. One-half wanted to be designated cosigners of all support team notes in the electronic medical record, one-half wanted to receive brief and focused information rather than in-depth information about their patients, and one-half wanted their practice nurses automatically included in communications. Panel size was strongly associated (p Conclusion The substantial variation in PCP communication preferences suggests the need for knowledge of these preferences when designing and implementing collaborative interventions. Additional research is needed to understand relationships between clinician and practice characteristics and interaction preferences.

  6. Describing the Primary Care Actions of Oral Health Teams in Brazil

    Directory of Open Access Journals (Sweden)

    Clarice Magalhães Rodrigues dos Reis

    2015-01-01

    Full Text Available Objective: To describe the primary care actions performed by oral health teams (OHTs that participated in a large national survey led by the Ministry of Health in 2012. Methods: A total of 12,403 dentists from OHTs completed a set of survey questions (response rate = 85.01% on the organization of care, basic dental procedures and oral health surveillance actions of OHTs. Descriptive and hierarchical cluster analyses were developed. Results: The majority of OHTs (85.2% reported that they performed “patient welcoming”. The delivery of services was based on a patient’s identified disease risk (83.1%, and continuity of care was ensured by 85.9% of OHTs. Individual preventive, restorative and surgical procedures were performed by the majority of the teams; however, screening for oral cancer and construction of dental prostheses/dentures occurred less frequently. Cluster 1 was composed of OHTs with the lowest proportion of oral healthcare actions related to oral cancer and dental prostheses/dentures, and the Southeastern and Southern regions had higher proportions of OHTs from cluster 2. Conclusions: OHTs adhere to some of the principles of primary care organizations; however, the teams perform fewer actions related to oral cancer treatment and rehabilitation with complete dentures. The geographical distribution of the clusters was unequal in Brazil.

  7. Stepped Skills: A team approach towards communication about sexuality and intimacy in cancer and palliative care

    Directory of Open Access Journals (Sweden)

    Hilde de Vocht

    2011-11-01

    Full Text Available BackgroundCancer often has a profound and enduring impact on sexuality, affecting both patients and their partners. Most healthcare professionals in cancer and palliative care are struggling to address intimate issues with the patients in their care.MethodsStudy 1: An Australian study using semi-structured interviews and documentary data analysis.Study 2: Building on this Australian study, using a hermeneutic phenomenological approach, data were collected in the Netherlands through interviewing 15 cancer patients, 13 partners and 20 healthcare professionals working in cancer and palliative care. The hermeneutic analysis was supported by ATLAS.ti and enhanced by peer debriefing and expert consultation.ResultsFor patients and partners a person-oriented approach is a prerequisite for discussing the whole of their experience regarding the impact of cancer treatment on their sexuality and intimacy. Not all healthcare professionals are willing or capable of adopting such a person-oriented approach.ConclusionA complementary team approach, with clearly defined roles for different team members and clear referral pathways, is required to enhance communication about sexuality and intimacy in cancer and palliative care. This approach, that includes the acknowledgement of the importance of patients’ and partners’ sexuality and intimacy by all team members, is captured in the Stepped Skills model that was developed as an outcome of the Dutch study.

  8. Terms of the ICNP® used by the team of nurses assisting people in palliative care

    Directory of Open Access Journals (Sweden)

    Rudval Souza da Silva

    2015-06-01

    Full Text Available The aim of this study was to identify the terms that characterize specific nursing jargon, used by the nursing team at the intensive care unit of an oncology hospital when assisting people in palliative care, as well as mapping them alongside with the 7-Axis Model of the ICNP® 2011. This study was conducted between January and April 2013 through interviews with the nursing team professionals. The terms that characterize assistance to people in palliative care were identified in the interviews and later grouped together. Once the mapping was finished, 432 terms were identified. After the terms had been standardized, we applied cross-mapping and identified the terms that were either listed or not listed in the ICNP® 2011. We found 167 listed terms and 95 that were not listed. The development of this study allowed to learn the terms used by the nursing team when assisting people in palliative care, which will enable further contributions to the terminology of this area.

  9. Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation.

    Science.gov (United States)

    Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra

    2016-01-01

    Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery. PMID:27026192

  10. Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation.

    Science.gov (United States)

    Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra

    2016-01-01

    Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.

  11. Integrated care for diabetes: clinical, psychosocial, and economic evaluation. Diabetes Integrated Care Evaluation Team.

    OpenAIRE

    1994-01-01

    OBJECTIVES--To evaluate integrated care for diabetes in clinical, psychosocial, and economic terms. DESIGN--Pragmatic randomised trial. SETTING--Hospital diabetic clinic and three general practice groups in Grampian. PATIENTS--274 adult diabetic patients attending a hospital clinic and registered with one of three general practices. INTERVENTION--Random allocation to conventional hospital clinic care or integrated care. Integrated care patients seen in general practice every three or four mon...

  12. Information delivery in team communication of MCR operators for an emergency task

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kwang Sub; Park, Jin Kyun; Jung, Won Dae

    2005-01-01

    Team performance is a major measure to evaluate the ability of team when a lot of people perform a task of common purpose such as the main control room operators in the nuclear power plant. A team performance is affected the collaboration and communication among operators under dynamic situation as well as by the cognitive process of each team member. Specially, under the emergency situation, more clear and apparent communication in a team is a critical key for the appropriate response to emergency situation. As a general human factor analysis accesses the operator's behavior, it leads to a resulting action of planning, decision, problem-solving. In order to access the internal information and background information of his/her behavior, the verbal protocol analysis is applied. The impact factors on the team performance are derived from the state of the art for team performance, and it is found that the communication is a common key for all impact factors. And, in turn, the impact factors for the communication are accesses and the more detailed analysis is performed. The recorded data for the operator training for emergency situation of nuclear power plant training center are analyzed according to the verbal protocol analysis that are being generally utilized in cognitive psychology, educational psychology, and cognitive science. Two aspects, external (syntax) and internal (symantic) aspects of communication are reviewed. From the syntax analysis, it is found that the task of each step in EOP is separated according to each corresponding operator and the ordinary training is important, and the weak-points for a sentence presentation can be found team-by-team. And, from the symantic analysis for the diagnostic procedure of EOP is performed and the communication errors due to different situation awareness by operators could be found, and it lead to a diagnosis failure. The factors for different symantic cognition for a situation are analyzed and the affecting

  13. Information delivery in team communication of MCR operators for an emergency task

    International Nuclear Information System (INIS)

    Team performance is a major measure to evaluate the ability of team when a lot of people perform a task of common purpose such as the main control room operators in the nuclear power plant. A team performance is affected the collaboration and communication among operators under dynamic situation as well as by the cognitive process of each team member. Specially, under the emergency situation, more clear and apparent communication in a team is a critical key for the appropriate response to emergency situation. As a general human factor analysis accesses the operator's behavior, it leads to a resulting action of planning, decision, problem-solving. In order to access the internal information and background information of his/her behavior, the verbal protocol analysis is applied. The impact factors on the team performance are derived from the state of the art for team performance, and it is found that the communication is a common key for all impact factors. And, in turn, the impact factors for the communication are accesses and the more detailed analysis is performed. The recorded data for the operator training for emergency situation of nuclear power plant training center are analyzed according to the verbal protocol analysis that are being generally utilized in cognitive psychology, educational psychology, and cognitive science. Two aspects, external (syntax) and internal (symantic) aspects of communication are reviewed. From the syntax analysis, it is found that the task of each step in EOP is separated according to each corresponding operator and the ordinary training is important, and the weak-points for a sentence presentation can be found team-by-team. And, from the symantic analysis for the diagnostic procedure of EOP is performed and the communication errors due to different situation awareness by operators could be found, and it lead to a diagnosis failure. The factors for different symantic cognition for a situation are analyzed and the affecting factors

  14. Implementing healthy lifestyle promotion in primary care: a quasi-experimental cross-sectional study evaluating a team initiative

    OpenAIRE

    Andersson, Kristin; Krevers, Barbro; Bendtsen, Preben

    2015-01-01

    Background: Non-communicable diseases are a leading cause of death and can largely be prevented by healthy lifestyles. Health care organizations are encouraged to integrate healthy lifestyle promotion in routine care. This study evaluates the impact of a team initiative on healthy lifestyle promotion in primary care. Methods: A quasi-experimental, cross-sectional design compared three intervention centres that had implemented lifestyle teams with three control centres that used a traditional ...

  15. Knowledge of lymphoedema among primary health care teams: a questionnaire survey.

    OpenAIRE

    Logan, V; Barclay, S; Caan, W.; McCabe, J; Reid, M.

    1996-01-01

    Lymphoedema usually develops following surgery or radiotherapy for cancer, but can also occur in advanced malignant disease or be primary in origin. Lower limb lymphoedema may present particular difficulties in diagnosis, treatment and management. All types of lymphoedema can seriously impair quality of life for those affected. This study aimed to determine the level of knowledge among primary health care team members concerning the identification and management of patients at risk of develop...

  16. The role of the Intermediate Care Team in detecting and responding to loneliness in older clients

    OpenAIRE

    Chana, R.; Marshall, P.; Harley, C

    2016-01-01

    The Intermediate Care Team (ICT) supports patients in their own homes to manage complex needs. They are ideally placed in the community to identify older adults at risk of loneliness. However, little is known about how ICT professionals perceive, detect, or respond to loneliness in their clients. This study explores ICT professional’s attitudes to loneliness in the context of perceived service priorities and their experiences of managing loneliness in their clients. Eight ICT professionals (n...

  17. Improving patient care through student leadership in team quality improvement projects.

    Science.gov (United States)

    Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

    2015-01-01

    In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.

  18. Communicating with Pet Owners About Obesity: Roles of the Veterinary Health Care Team.

    Science.gov (United States)

    Churchill, Julie; Ward, Ernie

    2016-09-01

    Obesity continues to be the most prevalent nutritional problem of dogs and cats as well as one of the most frustrating conditions to treat successfully. Educating and assigning roles to all members of the health care team will improve staff engagement and the consistency and effectiveness of nutritional counseling for preventive care and weight loss treatment plans. Excellent communication skills can be used to assess the client's ability to change and implement a weight loss plan at the right time in the right way to achieve better adherence and improve patient health. PMID:27264055

  19. A team leadership approach to managing the transition from construction to operations for an environmental project

    International Nuclear Information System (INIS)

    This presentation describes a team approach, at the totalproject level that focused team members with common objectives, for the transition to start-up and operation of the project. The Integrated Management Team (IMT) approach has been successful for this US Department of Energy (DOE) environmental restoration project at the Hanford Site in Richland, Washington. The $53.8-million project will collect, treat, and dispose of low-level mixed waste water discharges from the Hanford Site. Construction is scheduled for completion in September 1994 and facility start-up in June 1995. The project challenge is for leadership that is committed to the transition from construction to operation of the environmental restoration project

  20. Developing professional attributes in critical care nurses using Team-Based Learning.

    Science.gov (United States)

    Currey, Judy; Eustace, Paula; Oldland, Elizabeth; Glanville, David; Story, Ian

    2015-05-01

    Australian nurses prepare for specialty practice by undertaking postgraduate theoretical and clinical education in partnership models between universities and hospitals. In our global healthcare system, nurses require advanced critical thinking and strong communication skills to provide safe, high quality patient care. Yet, few education programs focus on developing these skills. Team-Based Learning (TBL) is a specific educational strategy that encourages and rewards students to think critically and solve clinical problems individually and in teams. The aim of this study was to investigate critical care nursing students' perceptions and experiences of TBL after it was introduced into the second half of their postgraduate specialty course. Following Ethics Committee approval, thirty-two students were invited to participate in an extended response questionnaire on their perceptions of TBL as part of a larger study. Data were analyzed thematically. Postgraduate students perceived their professional growth was accelerated due to the skills and knowledge acquired through TBL. Four themes underpinned the development and accelerated acquisition of specialty nurse attributes due to TBL: Engagement, Learning Effectiveness, Critical Thinking, and Motivation to Participate. Team-Based Learning offered deep and satisfying learning experiences for students. The early acquisition of advanced critical thinking, teamwork and communication skills, and specialty practice knowledge empowered nurses to provide safe patient care with confidence.

  1. Profile of an excellent nurse manager: identifying and developing health care team leaders.

    Science.gov (United States)

    Kallas, Kathryn D

    2014-01-01

    The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams. PMID:24896579

  2. Achieving Continuity of Care: Facilitators and Barriers in Community Mental Health Teams

    Directory of Open Access Journals (Sweden)

    Jones Ian Rees

    2011-03-01

    Full Text Available Abstract Background The integration of mental health and social services for people diagnosed with severe mental illness (SMI has been a key aspect of attempts to reform mental health services in the UK and aims to minimise user and carer distress and confusion arising from service discontinuities. Community mental health teams (CMHTs are a key component of UK policy for integrated service delivery, but implementing this policy has raised considerable organisational challenges. The aim of this study was to identify and explore facilitators and barriers perceived to influence continuity of care by health and social care professionals working in and closely associated with CMHTs. Methods This study employed a survey design utilising in-depth, semi-structured interviews with a proportionate, random sample of 113 health and social care professionals and representatives of voluntary organisations. Participants worked in two NHS Mental Health Trusts in greater London within eight adult CMHTs and their associated acute in-patient wards, six local general practices, and two voluntary organisations. Results Team leadership, decision making, and experiences of teamwork support were facilitators for cross boundary and team continuity; face-to-face communication between teams, managers, general practitioners, and the voluntary sector were facilitators for information continuity. Relational, personal, and longitudinal continuity were facilitated in some local areas by workforce stability. Barriers for cross boundary and team continuity were specific leadership styles and models of decision making, blurred professional role boundaries, generic working, and lack of training for role development. Barriers for relational, personal, and longitudinal continuity were created by inadequate staffing levels, high caseloads, and administrative duties that could limit time spent with users. Incompatibility of information technology systems hindered information

  3. Assessing the Quality and Comparative Effectiveness of Team-Based Care for Heart Failure: Who, What, Where, When, and How.

    Science.gov (United States)

    Cooper, Lauren B; Hernandez, Adrian F

    2015-07-01

    Team-based or multidisciplinary care may be a potential way to positively impact outcomes for heart failure (HF) patients by improving clinical outcomes, managing patient symptoms, and reducing costs. The multidisciplinary team includes the HF cardiologist, HF nurses, clinical pharmacists, dieticians, exercise specialists, mental health providers, social workers, primary care providers, and additional subspecialty providers. The timing and setting of multidisciplinary care depends on the needs of the patient and the resources available. Multidisciplinary HF teams should be evaluated based on their ability to achieve goals, as well as their potential for sustainability over time.

  4. Team Performance and Risk-Adjusted Health Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

    Science.gov (United States)

    Mukamel, Dana B.; Temkin-Greener, Helena; Delavan, Rachel; Peterson, Derick R.; Gross, Diane; Kunitz, Stephen; Williams, T. Franklin

    2006-01-01

    Purpose: The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. The purpose of this study was to examine the…

  5. An evaluation of the 'Designated Research Team' approach to building research capacity in primary care

    Directory of Open Access Journals (Sweden)

    Dyas Jane

    2008-06-01

    Full Text Available Abstract Background This paper describes an evaluation of an initiative to increase the research capability of clinical groups in primary and community care settings in a region of the United Kingdom. The 'designated research team' (DRT approach was evaluated using indicators derived from a framework of six principles for research capacity building (RCB which include: building skills and confidence, relevance to practice, dissemination, linkages and collaborations, sustainability and infrastructure development. Methods Information was collated on the context, activities, experiences, outputs and impacts of six clinical research teams supported by Trent Research Development Support Unit (RDSU as DRTs. Process and outcome data from each of the teams was used to evaluate the extent to which the DRT approach was effective in building research capacity in each of the six principles (as evidenced by twenty possible indicators of research capacity development. Results The DRT approach was found to be well aligned to the principles of RCB and generally effective in developing research capabilities. It proved particularly effective in developing linkages, collaborations and skills. Where research capacity was slow to develop, this was reflected in poor alignment between the principles of RCB and the characteristics of the team, their activities or environment. One team was unable to develop a research project and the funding was withdrawn at an early stage. For at least one individual in each of the remaining five teams, research activity was sustained beyond the funding period through research partnerships and funding successes. An enabling infrastructure, including being freed from clinical duties to undertake research, and support from senior management were found to be important determinants of successful DRT development. Research questions of DRTs were derived from practice issues and several projects generated outputs with potential to change daily

  6. Implementation of an Interdisciplinary, Team-Based Complex Care Support Health Care Model at an Academic Medical Center: Impact on Health Care Utilization and Quality of Life.

    Directory of Open Access Journals (Sweden)

    Christine Ritchie

    Full Text Available The Geriatric Resources for the Assessment and Care of Elders (GRACE program has been shown to decrease acute care utilization and increase patient self-rated health in low-income seniors at community-based health centers.To describe adaptation of the GRACE model to include adults of all ages (named Care Support and to evaluate the process and impact of Care Support implementation at an urban academic medical center.152 high-risk patients (≥5 ED visits or ≥2 hospitalizations in the past 12 months enrolled from four medical clinics from 4/29/2013 to 5/31/2014.Patients received a comprehensive in-home assessment by a nurse practitioner/social worker (NP/SW team, who then met with a larger interdisciplinary team to develop an individualized care plan. In consultation with the primary care team, standardized care protocols were activated to address relevant key issues as needed.A process evaluation based on the Consolidated Framework for Implementation Research identified key adaptations of the original model, which included streamlining of standardized protocols, augmenting mental health interventions and performing some assessments in the clinic. A summative evaluation found a significant decline in the median number of ED visits (5.5 to 0, p = 0.015 and hospitalizations (5.5 to 0, p<0.001 6 months before enrollment in Care Support compared to 6 months after enrollment. In addition, the percent of patients reporting better self-rated health increased from 31% at enrollment to 64% at 9 months (p = 0.002. Semi-structured interviews with Care Support team members identified patients with multiple, complex conditions; little community support; and mild anxiety as those who appeared to benefit the most from the program.It was feasible to implement GRACE/Care Support at an academic medical center by making adaptations based on local needs. Care Support patients experienced significant reductions in acute care utilization and significant improvements

  7. Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?

    NARCIS (Netherlands)

    Freund, T.; Everett, C.; Griffiths, P.; Hudon, C.; Naccarella, L.; Laurant, M.G.H.

    2015-01-01

    World-wide, shortages of primary care physicians and an increased demand for services have provided the impetus for delivering team-based primary care. The diversity of the primary care workforce is increasing to include a wider range of health professionals such as nurse practitioners, registered n

  8. OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

    International Nuclear Information System (INIS)

    The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards; - Integrated approach to the provision for the application of safety standards; and - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices; on the capability and reliability of the commissioning and operating personnel; on comprehensive instructions; and on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and

  9. Changing model of nursing care from individual patient allocation to team nursing in the acute inpatient environment.

    Science.gov (United States)

    Fairbrother, Greg; Jones, Aaron; Rivas, Ketty

    2010-06-01

    Agreement was reached with 12 acute medical and surgical wards/units at Sydney's Prince of Wales Hospital to participate in a trial of team nursing (TN). Six units employed action research principles to undertake a change to a team nursing model and six remained with the pre-existing individual patient allocation (IPA) model. Task-based teaming was widely discarded by the team nursing units in favour of allocating patients within the team and introducing more supportive and communicative processes aimed at fostering responsibility sharing. Localised team-based models of care arose in the change wards and were outlined, implemented and refined using social action research principles. A 12-month prospective experimental comparison of job satisfaction and staff retention between the TN and IPA groups indicated statistically significant job satisfaction benefits and practically important staff retention benefits associated with moving away from an IPA model of nursing care delivery towards a team-based model of care delivery. Perhaps not surprisingly, job satisfaction gains were most marked among new graduate nurses, who reported real benefits from a teaming inspired shift in model of care in the acute inpatient environment. PMID:20950201

  10. Is the job satisfaction of primary care team members associated with patient satisfaction?

    Science.gov (United States)

    Szecsenyi, Joachim; Goetz, Katja; Campbell, Stephen; Broge, Bjoern; Reuschenbach, Bernd; Wensing, Michel

    2011-06-01

    BACKGROUND Previous research has shown a correlation between physician job satisfaction and patient satisfaction with quality of care, but the connection between job satisfaction of other primary care team members and patient satisfaction is yet unclear. OBJECTIVE To evaluate whether there is an association between patient satisfaction and job satisfaction of the members of patient care teams. DESIGN The study was based on data from the European Practice Assessment and used an observational design. SETTING 676 primary care practices in Germany. PARTICIPANTS 47 168 patients, 676 general practitioners (practice principals), 305 physician colleagues (trainees and permanently employed physicians) and 3011 non-physician practice members (nurses, secretaries). MAIN OUTCOME MEASURES Patient evaluation was measured using the 23-item EUROPEP questionnaire. Job satisfaction was measured using the 10-item Warr-Cook-Wall job satisfaction scale and further items relating to practice structure. Bivariate correlations were applied in which factors of patient satisfaction and practice structure were compared with physicians and non-physicians satisfaction. RESULTS Patient satisfaction correlates positively with the general job satisfaction of the non-physician (r=0.25, p<0.01) and no significant correlation was found for the general job satisfaction of practice principals and physician colleagues. Patients' satisfaction with the practice organisation correlates positively with the general job satisfaction of the non-physicians (r=0.30, p<0.01) and their view of practice structure (r=0.29, p<0.01). CONCLUSIONS The correlation between non-physician team member satisfaction and patient satisfaction was higher than the correlation between satisfaction of physicians and patients. Patients seem to be sensitive to aspects of practice structure.

  11. Nursing Team Leader handover in the intensive care unit contains diverse information and lacks structure: An observational study

    OpenAIRE

    Spooner, A. J.; Aitken, L. M.; Corley, A.; Fraser, J. F.; Chaboyer, W.

    2016-01-01

    Background: Despite a proliferation of evidence and the development of standardised tools to improve communication at handover, evidence to guide the handover of critical patient information between nursing team leaders in the intensive care unit is limited. Objective: The study aim was to determine the content of information handed over during intensive care nursing team leader shift-to-shift handover. Design: A prospective observational study. Setting: A 21-bed medical/s...

  12. Integrated Hatchery Operations Team: Policies and Procedures for Columbia Basin Anadromous Salmonid Hatcheries, 1994 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Integrated Hatchery Operations Team (Northwest Power Planning Council, Portland, OR)

    1995-01-01

    This document outlines regional policies and procedures for hatchery operations in the Columbia River Basin. The purpose of these policies is to provide regional guidelines by which all anadromous fish hatcheries will be operated. These policies will be adopted by the fisheries co-managers, and will provide guidance to operate hatcheries in an efficient and biologically sound manner. The hatchery policies presented in this manual are not intended to establish production priorities. Rather, the intent is to guide hatchery operations once production numbers are established. Hatchery operations discussed in this report include broodstock collection, spawning, incubation of eggs, fish rearing and feeding, fish release, equipment maintenance and operations, and personnel training. Decisions regarding production priorities must be provided by fishery managers through a comprehensive plan that addresses both natural and hatchery fish production. The Integrated Hatchery Operations Team is a multi-agency group called for by the Northwest Power Planning Council. This team was directed to develop new basinwide policies for managing and operating all existing and future anadromous fish hatcheries in the Columbia River Basin. The parties pledge to confer with each other and to use their authorities and resources to accomplish these mutually acceptable hatchery practices.

  13. Complex Care Management to Decrease Emergency Department Utilization: A Case Study of the Homeless Patient Aligned Care Team Demonstration Project at VA Greater Los Angeles Healthcare System

    OpenAIRE

    Patel, Beena Ishwar

    2013-01-01

    This quality improvement (QI) dissertation is a case study of the homeless-oriented Patient Centered Medical Home demonstration program, referred to as the Homeless Patient Aligned Care Team (HPACT) at West Los Angeles VA Medical Center (WLA). The WLA HPACT program was implemented to address the complex needs of the homeless and at-risk for homelessness population using the Patient Centered Medical Home model (PCMH) - a multi-disciplinary, team-based approach to primary care. Unlike tradition...

  14. Complication avoidance with pre-operative screening: insights from the Seattle spine team.

    Science.gov (United States)

    Buchlak, Quinlan D; Yanamadala, Vijay; Leveque, Jean-Christophe; Sethi, Rajiv

    2016-09-01

    Complication rates for complex adult lumbar scoliosis surgery are unacceptably high. Standardized preoperative evaluation protocols have been shown to significantly reduce the likelihood of a spectrum of negative outcomes associated with complex adult lumbar scoliosis surgery. To increase patient safety and reduce complication risk, an entire medical and surgical team should work together to care for adult lumbar scoliosis patients. This article describes preoperative patient evaluation strategies with a particular focus on adult lumbar scoliosis surgery involving six or more levels of spinal fusion. Domains considered include recent preoperative evaluation literature, predictive risk modeling, the appropriate management of medical conditions, and the composition and activities of a multidisciplinary conference review team. An evidence-based comprehensive systematic preoperative surgical evaluation process is described. PMID:27260267

  15. Gravity Plant Physiology Facility (GPPF) Team in the Spacelab Payload Operations Control Center (SL

    Science.gov (United States)

    1992-01-01

    The primary payload for Space Shuttle Mission STS-42, launched January 22, 1992, was the International Microgravity Laboratory-1 (IML-1), a pressurized manned Spacelab module. The goal of IML-1 was to explore in depth the complex effects of weightlessness of living organisms and materials processing. Around-the-clock research was performed on the human nervous system's adaptation to low gravity and effects of microgravity on other life forms such as shrimp eggs, lentil seedlings, fruit fly eggs, and bacteria. Materials processing experiments were also conducted, including crystal growth from a variety of substances such as enzymes, mercury iodide, and a virus. The Huntsville Operations Support Center (HOSC) Spacelab Payload Operations Control Center (SL POCC) at the Marshall Space Flight Center (MSFC) was the air/ground communication channel used between the astronauts and ground control teams during the Spacelab missions. Featured is the Gravity Plant Physiology Facility (GPPF) team in the SL POCC during the IML-1 mission.

  16. Diarrhoea control: the experience of a health team in a primary care unit, Algeria.

    Science.gov (United States)

    Belhocine, Z; Mahiout, B; Laraba, A; Grangaud, J P

    1985-01-01

    This article reports the experiences of a primary health care unit located in Algeria's Zeralda district in the control of diarrhea. Curative and preventive care is provided to the adult and child populations of the district by a medical and paramedical team. The overall goal of the diarrheal control program, initiated in 1980, is to combat mortality from diarrhea in children under 2 years of age. Intermediate goals include improvement of care provided to infants with diarrhea, early hospitalization of cases of diarrhea, improvement of contacts between the primary care unit and the hospital, and prevention of diarrhea. Children in the target group are located through use of a register of children living in the district, and their families are sent cards containing information on diarrhea and its control. Children are followed from the 1st day of consultation for diarrhea until the 30th day after the episode. Record keeping and careful follow-up are stressed. In 1983, 335 children 18 months of age or younger (47% of the target population) consulted health structures in Zeralda for diarrhea. About 1/3 of children fail to return for follow-up visits. This is attributed both to long waits in the clinic and the fact that children are usually cured by the time of this visit. The number of children hospitalized for acute dehydration has declined from 33 in 1980 to 18 in 1983; the number of deaths from dehydration declined from 16 to 8 in this same period.

  17. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

    Directory of Open Access Journals (Sweden)

    Nombeko Mshunqane

    2012-02-01

    Full Text Available Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10 explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8 explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

  18. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

    Directory of Open Access Journals (Sweden)

    Nombeko Mshunqane

    2012-10-01

    Full Text Available Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive thatpatients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10 explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8 explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

  19. The effect of interprofessional education on interprofessional performance and diabetes care knowledge of health care teams at the level one of health service providing

    Directory of Open Access Journals (Sweden)

    Nikoo Yamani

    2014-01-01

    Conclusion: It seems that inter-professional education can improve the quality of health care to some extent through influencing knowledge and collaborative performance of health care teams. It also can make the health-related messages provided to the covered population more consistent in addition to enhancing self-confidence of the personnel.

  20. Development and validation of a heuristic model for evaluation of the team performance of operators in nuclear power plants

    International Nuclear Information System (INIS)

    Highlights: → We develop an estimation model for evaluation of the team performance of MCR. → To build the model, we extract team performance factors through reviewing literatures and identifying behavior markers. → We validate that the model is adaptable to the advanced MCR of nuclear power plants. → As a result, we find that the model is a systematic and objective to measure team performance. - Abstract: The global concerns about safety in the digital technology of the main control room (MCR) are growing as domestic and foreign nuclear power plants are developed with computerized control facilities and human-system interfaces. In a narrow space, the digital technology contributes to a control room environment, which can facilitate the acquisition of all the information needed for operation. Thus, although an individual performance of the advanced MCR can be further improved; there is a limit in expecting an improvement in team performance. The team performance depends on organic coherence as a whole team rather than on the knowledge and skill of an individual operator. Moreover, a good team performance improves communication between and within teams in an efficient manner, and then it can be conducive to addressing unsafe conditions. Respecting this, it is important and necessary to develop methodological technology for the evaluation of operators' teamwork or collaboration, thus enhancing operational performance in nuclear power plant at the MCR. The objectives of this research are twofold: to develop a systematic methodology for evaluation of the team performance of MCR operators in consideration of advanced MCR characteristics, and to validate that the methodology is adaptable to the advanced MCR of nuclear power plants. In order to achieve these two objectives, first, team performance factors were extracted through literature reviews and methodological study concerning team performance theories. Second, the team performance factors were identified and

  1. Physician - nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.

    Science.gov (United States)

    Litaker, David; Mion, Lorraine; Planavsky, Loretta; Kippes, Christopher; Mehta, Neil; Frolkis, Joseph

    2003-08-01

    Increasing demand to deliver and document therapeutic and preventive care sharpens the need for disease management strategies that accomplish these goals efficiently while preserving quality of care. The purpose of this study was to compare selected outcomes for a new chronic disease management program involving a nurse practitioner - physician team with those of an existing model of care. One hundred fifty-seven patients with hypertension and diabetes mellitus were randomly assigned to their primary care physician and a nurse practitioner or their primary care physician alone. Costs for personnel directly involved in patient management, calculated from hourly rates and encounter time with patients, and pre- and post-study glycosylated hemoglobin (HbA(1c)), high-density lipoprotein cholesterol (HDL-c), satisfaction with care and health-related quality of life (HRQoL) were assessed. Although 1-year costs for personnel were higher in the team-treated group, participants experienced significant improvements in mean HbA(1c) ( - 0.7%, p = 0.02) and HDL-c ( + 2.6 mg dL( - 1), p = 0.02). Additionally, satisfaction with care improved significantly for team-treated subjects in several sub-scales whereas the mean change over time in HRQoL did not differ significantly between groups. This study demonstrates the value of a complementary team approach to chronic disease management in improving patient-derived and clinical outcomes at modest incremental costs.

  2. Population-centered Risk- and Evidence-based Dental Interprofessional Care Team (PREDICT): study protocol for a randomized controlled trial

    OpenAIRE

    Cunha-Cruz, Joana; Milgrom, Peter; Shirtcliff, R. Michael; Bailit, Howard L.; Huebner, Colleen E; Conrad, Douglas; Ludwig, Sharity; Mitchell, Melissa; Dysert, Jeanne; Allen, Gary; Scott, JoAnna; Mancl, Lloyd

    2015-01-01

    Background To improve the oral health of low-income children, innovations in dental delivery systems are needed, including community-based care, the use of expanded duty auxiliary dental personnel, capitation payments, and global budgets. This paper describes the protocol for PREDICT (Population-centered Risk- and Evidence-based Dental Interprofessional Care Team), an evaluation project to test the effectiveness of new delivery and payment systems for improving dental care and oral health. Me...

  3. Collaboration and entanglement: An actor-network theory analysis of team-based intraprofessional care for patients with advanced heart failure.

    Science.gov (United States)

    McDougall, A; Goldszmidt, M; Kinsella, E A; Smith, S; Lingard, L

    2016-09-01

    Despite calls for more interprofessional and intraprofessional team-based approaches in healthcare, we lack sufficient understanding of how this happens in the context of patient care teams. This multi-perspective, team-based interview study examined how medical teams negotiated collaborative tensions. From 2011 to 2013, 50 patients across five sites in three Canadian provinces were interviewed about their care experiences and were asked to identify members of their health care teams. Patient-identified team members were subsequently interviewed to form 50 "Team Sampling Units" (TSUs), consisting of 209 interviews with patients, caregivers and healthcare providers. Results are gathered from a focused analysis of 13 TSUs where intraprofessional collaborative tensions involved treating fluid overload, or edema, a common HF symptom. Drawing on actor-network theory (ANT), the analysis focused on intraprofessional collaboration between specialty care teams in cardiology and nephrology. The study found that despite a shared narrative of common purpose between cardiology teams and nephrology teams, fluid management tools and techniques formed sites of collaborative tension. In particular, care activities involved asynchronous clinical interpretations, geographically distributed specialist care, fragmented forms of communication, and uncertainty due to clinical complexity. Teams 'disentangled' fluid in order to focus on its physiological function and mobilisation. Teams also used distinct 'framings' of fluid management that created perceived collaborative tensions. This study advances collaborative entanglement as a conceptual framework for understanding, teaching, and potentially ameliorating some of the tensions that manifest during intraprofessional care for patients with complex, chronic disease. PMID:27490299

  4. Analyzing health care operations using ABC.

    Science.gov (United States)

    Ross, Thomas K

    2004-01-01

    The evolution of health care created a climate in which cost was subordinate to medical treatment. Current reimbursement constraints have increased the need for providers to be cost conscious, but they have discovered that current accounting practices do not provide the appropriate information to determine the cost of service or make decisions. This article argues that activity-based costing (ABC) can bridge the gap between the medical and financial communities and provide a foundation for performance improvement. PMID:15151193

  5. Creating learning environments for compassionate care: a programme to promote compassionate care by health and social care teams

    OpenAIRE

    Bridges, J.; Fuller, A.

    2014-01-01

    Background The consistent delivery of compassionate health and social care to older people is a matter of global concern to the nursing profession and the public it serves. The development and evaluation of effective interventions to address this concern is of prime importance. Aims and objectives This paper draws on findings from previous research to propose the use of a novel implementation programme designed to improve and support the delivery of compassionate care by health an...

  6. Do not resuscitate: An expanding role for critical care response team

    Directory of Open Access Journals (Sweden)

    Alaa M Gouda

    2016-01-01

    Full Text Available Background: Do not resuscitate (DNR order is an important aspect of medical practice. Since the implementation of critical care response team (CCRT, frequently we have encountered with patients in the wards that should have been made DNR. Initiating DNR became an important part of CCRT activity. We were obliged to extended the role of CCRT - beyond managing seriously ill patients - in addressing the code status for patients after discussion with the managing teams. Purpose: We compare the trend of initiation of DNR orders in the regular ward before and after implementing CCRT. Methods: Our hospital is 1200 bed tertiary care center. CCRT has been launched in January 1, 2008. The CCRT is 24/7 service led by in-house North American certified intensivists. Cohort analysis of prospectively collected data of 5406 CCRT activation from January 1, 2008, to September 30, 2013. Data before implementation of CCRT was available for 299 patients from the period of June 1, 2007, to December 31, 2007. A comparison made between the two groups (before and after implementation of CCRT for demographic data and percentage of patients in whom DNR order initiated. Results: Before CCRT implementation, 299 patients were attended by Intensive Care Unit physician for regular consultation, 41.1% were females and 52.4% were males with mean of age 58.44 ± 18.47 standard deviation (SD. DNR was initiated in 2.7% of patients. After CCRT implementation, 5904 CCRT activations, 47.6% females and 52.4% males with mean of age 59.17 ± 20.07 SD DNR initiated in 468 (7.9% of cases. There was 5.2% increase in DNR orders initiation and completion after CCRT introduced to our institute. Conclusion: CCRT plays an important role in addressing and initiating DNR.

  7. [Work as a source of pleasure: evaluating a Psychosocial Care Center team].

    Science.gov (United States)

    Glanzner, Cecília Helena; Olschowsky, Agnes; Kantorski, Luciane Prado

    2011-06-01

    The objective of this study was to evaluate the pleasure at work felt by the members of a Psychosocial Care Center team. This qualitative case study used Forth Generation Evaluation. This study was performed in Foz do Iguaçu, Parana, Brazil, in November and December 2006. Participants were 10 tem members. Data collection was performed through observation and individual interviews. The analysis was initiated at the same time as the data collection, and the final analysis was performed as per the following steps: data ordering, classification and final analysis. The following analysis themes were developed: work characteristics at the psychological care center, suffering and coping with suffering at work. During the evaluation, the participants showed pleasure and fulfillment with their work by expressing pride, fulfillment and appreciation of what they deliver. Pleasure occurs during the development of psychosocial care, because they always have the freedom to rearrange their manner of working, making possible to develop activities and attitudes capable of giving them pleasure.

  8. Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training

    OpenAIRE

    Ballangrud, Randi

    2013-01-01

    Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven I...

  9. Co-producing knowledge through dialogue in an interdisciplinary team in “person-centred” care for people with dementia

    DEFF Research Database (Denmark)

    Phillips, Louise Jane

    How does dialogue generate knowledge by harnessing “difference” as a transformative force? This paper examines this question through an analysis of the collaborative practices of an interdisciplinary social and health care team who provide an advisory service for residential care homes in relation...... to residents with dementia. Drawing on Bakhtinian dialogic communication theory, an empirical analysis is presented of how knowledge is co-produced collaboratively in team case meetings. The focus is on the shifting relations between different voices, articulating different knowledge forms and professional...... identities, and on the relational construction of ”person-centred care” and the collective identity of the team in opposition to the practices and identities of residential care workers and relatives of residents. In conclusion, the paper discusses the implications of the empirical results in relation...

  10. A robust and novel dynamic-ID-based authentication scheme for care team collaboration with smart cards.

    Science.gov (United States)

    Chang, Ya-Fen; Chen, Chia-Chen; Chang, Pei-Yu

    2013-04-01

    Nowadays, users/patients may gain desired medical services on-line because of the rapid development of computer network technologies. Conventional healthcare services are provided by a single server. However, care team collaboration by integrating services is the key to improve financial and clinical performance. How a user/patient accesses desired medical services provided by multiple servers becomes a challenge to realize care team collaboration. User authentication plays an important role to protect resources or services from being accessed by unauthorized users. In this paper, we first discuss the perceived security drawbacks of pervasive smart-card-based remote user authentication schemes. Then, we propose a novel dynamic-ID-based user authentication scheme based on elliptic curve cryptosystem (ECC) for multi-server environment with smart cards. The proposed scheme ensures user anonymity and computational efficiency and complies with essential requirements of a secure smart-card-based authentication scheme for multi-server environment to enable care team collaboration.

  11. Clinical Space Medicine Products as Developed by the Medical Operations Support Team (MOST)

    Science.gov (United States)

    Polk, James D.; Doerr, Harold K.; Hurst, Victor W., IV; Schmid, Josef

    2007-01-01

    Medical Operations Support Team (MOST) is introducing/integrating teaching practices associated with high fidelity human patient simulation into the NASA culture, in particular, into medical training sessions and medical procedure evaluations. Current/Future Products iclude: a) Development of Sub-optimal Airway Protocols for the International Space Station (ISS) using the ILMA; b) Clinical Core Competency Training for NASA Flight Surgeons (FS); c) Post-Soyuz Landing Clinical Training for NASA FS; d) Experimental Integrated Training for Astronaut Crew Medical Officers and NASA FS; and e) Private Clinical Refresher Training.

  12. The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients

    NARCIS (Netherlands)

    J.M. Hartgerink (Jacqueline); J.M. Cramm (Jane); T.J.E.M. Bakker (Ton); A.M. van Eijsden (A.); J.P. Mackenbach (Johan); A.P. Nieboer (Anna)

    2013-01-01

    textabstractAim: To identify predictors of relational coordination among professionals delivering care to older patients. Background: Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood. Design: This cross-sectional s

  13. Optimizing patient care in radiology through team-working: a case study from the United Kingdom

    International Nuclear Information System (INIS)

    Full text: Improving patient care should be the primary focus of all healthcare providers, regardless of country, setting or department; radiology is no exception. Roles within radiology have evolved and professional boundaries blurred; assistant practitioners contribute to image acquisition and advanced and consultant radiographers undertake tasks historically performed by medical professionals. Team working and appropriate use of skill mix has been highlighted as a way of managing ever increasing imaging workloads.In the United Kingdom, trained radiographers have developed their roles to include tasks historically performed by medical practitioners, including definitive clinical reporting and interventional procedures. The aim of this study was to demonstrate how a radiology department within an acute district general hospital optimizes imaging services to improve access for patients and support for referrers through a strong emphasis on team-working. Data about service delivery was analyzed across three consecutive years and interrogated by modality, referral source and reporting practitioner to determine how workload had evolved. Feedback from referring clinicians was sought. Overall trend was for increased activity (13%) with significant reductions (p<0.001) in waiting and reporting times, with some modality variation. Radiographers interpreted >50% of x-ray and ultrasound examinations. Novel services and patient pathway redesigns were implemented with high clinician satisfaction. Radiologists and radiographers, working together, can deliver an effective service. Innovation, staff development and redesigned patient pathwayshave produced significant improvements

  14. [Recommendations on the relationship between surgeons and anesthesiologists as part of the health care team].

    Science.gov (United States)

    Daher, Michel

    2007-01-01

    Surgeon and anesthesiologist work as a team. Physicians of different but complementary specialties, they work jointly in the management of the patient during the pre, per and postoperative periods, with the main objective of ensuring the best quality of care and the greatest safety. However, the unprecedented development of new technologies during the last decades, deeply modified the conditions of exercise of these two specialities. Thus, the practice of anaesthesia is not only necessary for performing the surgical act, but also for diagnostic and therapeutic techniques using high technologies. So, from a traditional partner of the surgeon, the anesthetist became the privileged collaborator of a great number of specialists. Within these teams, the anesthetist must achieve his/her task in all independence, as stated in the Lebanese Code of Ethics. I will try in this message to point out the responsibilities of each of the two partners in this joint practice. The practice of a shared activity, in the same place, for the benefit of the patient, requires a preliminary definition of roles, in the mutual respect of competencies and responsibilities of each specialist, based on the respect of the rules edicted in the Code of Ethics. PMID:17685116

  15. Accuracy of prognosis estimates by four palliative care teams: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Costantini Massimo

    2002-03-01

    Full Text Available Abstract Background Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. Methods and measurements A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum – maximum at referral, patient characteristics, were recorded by staff, and later compared with actual survival. Results Minimum survival estimates ranged Conclusions Offering a prognosis range has higher levels of accuracy (about double than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

  16. Effectiveness of simulation with team-based learning in newborn nursing care.

    Science.gov (United States)

    Kang, Kyung-Ah; Kim, Shin-Jeong; Oh, Jina; Kim, Sunghee; Lee, Myung-Nam

    2016-06-01

    This study determines the effect of simulation with team-based learning (TBL) on newborn nursing care. This randomized controlled trial included 74 nursing students from one university located in Seoul, South Korea. Participants were categorized into two groups according to educational modality: one group involved both simulation and TBL, and the other involved simulation alone. Learning attitudes, academic achievement, and simulation performance were examined to assess effectiveness. The mean difference in learning attitudes between the two groups was non-significant. Low academic achievement differed significantly between the two groups (t = 3.445, P = 0.002). There was no significant difference in mean scores for simulation performance between the two groups. In this study, simulation with TBL was effective in improving learning outcomes. In current nursing education, various learning methods are employed within complex nursing situations and require flexibility and problem-solving approaches.

  17. Fusion of ranging data from robot teams operating in confined areas

    Science.gov (United States)

    Lyons, Damian M.; Shrestha, Karma; Liu, Tsung-Ming

    2013-05-01

    We address the problem of fusing laser ranging data from multiple mobile robots that are surveying an area as part of a robot search and rescue or area surveillance mission. We are specifically interested in the case where members of the robot team are working in close proximity to each other. The advantage of this teamwork is that it greatly speeds up the surveying process; the area can be quickly covered even when the robots use a random motion exploration approach. However, the disadvantage of the close proximity is that it is possible, and even likely, that the laser ranging data from one robot include many depth readings caused by another robot. We refer to this as mutual interference. Using a team of two Pioneer 3-AT robots with tilted SICK LMS-200 laser sensors, we evaluate several techniques for fusing the laser ranging information so as to eliminate the mutual interference. There is an extensive literature on the mapping and localization aspect of this problem. Recent work on mapping has begun to address dynamic or transient objects. Our problem differs from the dynamic map problem in that we look at one kind of transient map feature, other robots, and we know that we wish to completely eliminate the feature. We present and evaluate three different approaches to the map fusion problem: a robot-centric approach, based on estimating team member locations; a map-centric approach, based on inspecting local regions of the map, and a combination of both approaches. We show results for these approaches for several experiments for a two robot team operating in a confined indoor environment .

  18. Do Patient-Centered Medical Home Access and Care Coordination Measures Reflect the Contribution of All Team Members? A Systematic Review.

    Science.gov (United States)

    Annis, Ann M; Harris, Marcelline; Robinson, Claire H; Krein, Sarah L

    2016-01-01

    Patient-Centered Medical Home (PCMH) evaluations have primarily focused on primary care providers and not on the primary care team. This systematic literature review examined the extent to which access and care coordination measures in PCMH reflect the involvement of associate care providers (ACPs), which include registered and licensed practical nurses, nursing and medical assistants, clerks, pharmacists, social workers, and dietitians. Among 42 studies, few measures specified ACP roles or linked ACP care to outcomes. Increasing attention on team-based care emphasizes a vital need to reframe measures within a team context. PMID:27219827

  19. Real-time support of pediatric diabetes self-care by a transport team.

    Science.gov (United States)

    Franklin, Brandi E; Crisler, S Crile; Shappley, Rebekah; Armour, Meri M; McCommon, Dana T; Ferry, Robert J

    2014-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. RESULTS Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P < 0.0001), their visits were less likely to lead to inpatient admissions (odds ratio 0.58; P < 0.02). More than half (n = 587) of all calls to the pager were resolved without need for further referral. Estimates suggest that 439 ED visits and 115 admissions were avoided at a potential cost savings exceeding 760,000 USD. CONCLUSIONS Integration of a transport service provides a novel, cost-effective approach to reduce disparities in diabetes care. Advantages include scalability, applicability to other disease areas and settings, and low added costs. These findings enrich an emerging evidence base for telephonic care-management models supported by allied health personnel. PMID:23959568

  20. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

    Science.gov (United States)

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

    2013-10-01

    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care.

  1. The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients

    OpenAIRE

    Hartgerink, J. M.; Cramm, J.M.; Bakker, T.J.E.M.; Eijsden, A.M. van; Mackenbach, J. P.; Nieboer, A.P.

    2013-01-01

    Aim To identify predictors of relational coordination among professionals delivering care to older patients. Background Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood. Design This cross-sectional study was part of a larger evaluation study examining the opportunity to prevent loss of function in older patients due to hospitalization in the Netherlands. Methods This study was performed in spring 2010 among ...

  2. Teaming up

    DEFF Research Database (Denmark)

    Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah;

    Questions we care about (Objectives): When students have to work on challenging tasks, as it is often the case in entrepreneurship classrooms that leverage experiential learning, team success becomes central to the students learning. Yet, the formation of teams is often left up to the students...... functioning entrepreneurial student teams as most teams lack personal chemistry which makes them anchor their work too much in a pre-defined project. In contrast, we find that students that can form their own teams aim for less diverse teams than what is achieved by random assignment. However, the homophily...... the students are seeking with regards to ‘personal chemistry’ seems to be favourable for entrepreneurial student teams because it enables them to have team relationships as the anchor for their work. In this way the team becomes an important enabler to endure the pressure and volatility of an entrepreneurial...

  3. How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory.

    Science.gov (United States)

    Kent, Fiona; Francis-Cracknell, Alison; McDonald, Rachael; Newton, Jennifer M; Keating, Jennifer L; Dodic, Miodrag

    2016-10-01

    Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients' health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding 'shared contribution', 'patient as key information source' and 'time constraints' were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients' voice in clinical and education processes.

  4. Reducing turnover and improving health care in nursing homes: the potential effects of self-managed work teams.

    Science.gov (United States)

    Yeatts, D E; Seward, R R

    2000-06-01

    This article describes the use of self-managed work teams (SMWTs) in a nursing home, their potential impacts on the provision of health care and employee satisfaction and turnover, and the factors reported to be important to SMWT effectiveness. Three SMWTs in a midsized nursing home in Wisconsin provide examples. Steps for implementing SMWTs are described.

  5. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction

    Directory of Open Access Journals (Sweden)

    Gausvik C

    2015-01-01

    Full Text Available Christian Gausvik,1 Ashley Lautar,2 Lisa Miller,2 Harini Pallerla,3 Jeffrey Schlaudecker4,5 1University of Cincinnati College of Medicine, 2The Christ Hospital, Cincinnati, OH, USA; 3Department of Family and Community Medicine, 4Division of Geriatric Medicine, University of Cincinnati, Cincinnati, OH, USA; 5Geriatric Medicine Fellowship Program, University of Cincinnati/The Christ Hospital, Cincinnati, OH, USA Abstract: Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR on an acute care for the elderly (ACE unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer

  6. Comparison of patients’ age receiving therapeutic services in a cleft care team in Isfahan

    Science.gov (United States)

    Soheilipour, Saeed; Soheilipour, Fatemeh; Derakhshandeh, Fatemeh; Hashemi, Hedieh; Memarzadeh, Mehrdad; Salehiniya, Hamid; Soheilipour, Fahimeh

    2016-01-01

    Background: Due to numerous difficulties in patients suffering from varieties of cleft lip and palate, their therapeutic management involves interdisciplinary teamwork. This study was conducted to compare the age of commencing treatments such as speech therapy, secondary palate and alveolar bone grafting and orthodontics between those who sought treatment early and late. Materials and Methods: In this retrospective study, 260 files of patients with cleft lip and palate based on their age at the time of admission to a cleft care team were divided into two groups: The early admission and late admission. Both groups compared based on four variables including the mean age of beginning speech therapy, palatal secondary surgery, alveolar bone grafting, and receiving orthodontics using t-test. Results: Based on the results, among 134 patients admitted for speech therapy, the mean age of initiating speech therapy in early clients was 3.3 years, and in the late ones was 9 years. Among 47 patients with secondary surgery, the mean age in early clients was 3.88 years, and in the late clients was 15.7 years. Among 17 patients with alveolar bone grafting, the mean age in the first group was 9 years, and in the other was 16.69 years. Among 24 patients receiving orthodontic services, the mean age in early clients was 7.66 years, and in the second group was 17.05 years. Conclusion: There was a significant difference between the age of performing secondary surgery and alveolar bone grafting and the age of beginning speech therapy and receiving orthodontic services in early references and late references to the team. PMID:27274350

  7. The Creation and Operation of Internal High Performance Modern Enterprises Team

    Institute of Scientific and Technical Information of China (English)

    Shengyu WANG

    2015-01-01

    The future of enterprises mainly depends on product research and development. For the modern enterprises, high performance project team is the most important means of R & D projects. According to the interviews and survey found of a plurality of enterprise project R & D team. the internal high performance team of modern business is good or bad, its key lies in whether the team managers for the team creation and management is in place, this is the most difficult place for the high performance team management system, especially the team leadership. Based on this, this paper discusses on the creation and management of high performance modern enterprise team, aiming to provide valuable reference for the enterprise team management.

  8. Knowledge systems, health care teams, and clinical practice: a study of successful change

    OpenAIRE

    Olson, Curtis A.; Tooman, Tricia R.; Alvarado, Carla J.

    2010-01-01

    Clinical teams are of growing importance to healthcare delivery, but little is known about how teams learn and change their clinical practice. We examined how teams in three US hospitals succeeded in making significant practice improvements in the area of antimicrobial resistance. This was a qualitative cross-case study employing Soft Knowledge Systems as a conceptual framework. The purpose was to describe how teams produced, obtained, and used knowledge and information to bring about success...

  9. Knowledge Systems, Health Care Teams, and Clinical Practice: A Study of Successful Change

    Science.gov (United States)

    Olson, Curtis A.; Tooman, Tricia R.; Alvarado, Carla J.

    2010-01-01

    Clinical teams are of growing importance to healthcare delivery, but little is known about how teams learn and change their clinical practice. We examined how teams in three US hospitals succeeded in making significant practice improvements in the area of antimicrobial resistance. This was a qualitative cross-case study employing Soft Knowledge…

  10. Large Molecule Specific Assay Operation: Recommendation for Best Practices and Harmonization from the Global Bioanalysis Consortium Harmonization Team

    OpenAIRE

    Stevenson, Lauren; Kelley, Marian; Gorovits, Boris; Kingsley, Clare; Myler, Heather; Österlund, Karolina; Muruganandam, Arumugam; Minamide, Yoshiyuki; Dominguez, Mario

    2013-01-01

    The L2 Global Harmonization Team on large molecule specific assay operation for protein bioanalysis in support of pharmacokinetics focused on the following topics: setting up a balanced validation design, specificity testing, selectivity testing, dilutional linearity, hook effect, parallelism, and testing of robustness and ruggedness. The team additionally considered the impact of lipemia, hemolysis, and the presence of endogenous analyte on selectivity assessments as well as the occurrence o...

  11. Improving Trauma Care in India: the Potential Role of the Rural Trauma Team Development Course (RTTDC).

    Science.gov (United States)

    Ali, Jameel; Kumar, Subodh; Gautam, Subash; Sorvari, Anne; Misra, Mahesh C

    2015-12-01

    The Rural Trauma Team Development Course (RTTDC) was devised to optimize trauma resuscitation training in under-resourced rural institutions. This program appears ideal for India because of its dense traffic, large population, and high frequency of rural trauma. We report on the feasibility and desirability of introducing RTTDC in India. An instructor course for 20 faculties and a provider course for 23 were conducted in New Delhi, India. The courses were evaluated by multiple choice question (MCQ) performance, by rating the modules on a three-point scale (1 = very relevant, 2 = relevant, and 3 = not relevant) for communication skills, principles of performance improvement and patient safety (PIPS), and clinical scenarios. Evaluation questionnaires including desirability of promulgation in India were completed using a five-point Likert Scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). Overall written comments were also provided. Both faculty and providers improved post-course MCQ scores (p < 0.05) with lower scores in the provider group. Seventy-eight percent faculty and 74 % providers rated the communication module very relevant. PIPS was rated very relevant by 72 % faculty and 65 % providers. There were over 150 comments, generally positive with over 90 % of both faculty and providers rating strongly agree to agree that the course be promulgated widely in India. The RTTDC including plans for promulgation was enthusiastically received in India, and its potential for improving trauma care including communication skills and PIPS appears excellent. PMID:26729998

  12. Mental health care: how can Family Health teams integrate it into Primary Healthcare?

    Science.gov (United States)

    Gryschek, Guilherme; Pinto, Adriana Avanzi Marques

    2015-10-01

    Mental health is one of the responsibilities of Brazil's Family Health system. This review of literature sought to understand what position Mental Health occupies in the practice of the Family Health Strategy. A search was made of the scientific literature in the database of the Virtual Health Library (Biblioteca Virtual de Saúde), for the keywords: 'Mental Health'; 'Family Health'; 'Primary Healthcare'. The criteria for inclusion were: Brazilian studies from 2009 through 2012 that contributed to understanding of the following question: "How to insert Mental health care into the routine of the Family Health Strategy?" A total of 11 articles were found, which identified difficulties and strategies of the professionals in Primary Healthcare in relation to mental health. Referral, and medicalization, were common practices. Matrix Support is the strategy of training and skill acquisition for teams that enables new approaches in mental health in the context of Primary healthcare. It is necessary for Management of the Health System to take an active role in the construction of healthcare networks in mental health.

  13. Training the 21st-Century Health Care Team: Maximizing Interprofessional Education Through Medical-Legal Partnership.

    Science.gov (United States)

    Tobin-Tyler, Elizabeth; Teitelbaum, Joel

    2016-06-01

    For too long, many stakeholders in the health care delivery system have ignored the extent to which social determinants of health (SDH) are inextricably woven into and affect individual and population health. The health care system is undergoing a relatively rapid transformation, which has included in part an increasing recognition of SDH's effects. This recognition, in turn, has led to renewed calls for changing the way that physicians are trained and has accelerated medical education curricular reforms. This Perspective focuses on one such innovative method of team-based care and the opportunities for its integration into medical education: medical-legal partnership, a health care delivery model that embeds civil legal services into the spectrum of health care services provided to low-income or otherwise vulnerable patients and communities. PMID:26445082

  14. Training the 21st-Century Health Care Team: Maximizing Interprofessional Education Through Medical-Legal Partnership.

    Science.gov (United States)

    Tobin-Tyler, Elizabeth; Teitelbaum, Joel

    2016-06-01

    For too long, many stakeholders in the health care delivery system have ignored the extent to which social determinants of health (SDH) are inextricably woven into and affect individual and population health. The health care system is undergoing a relatively rapid transformation, which has included in part an increasing recognition of SDH's effects. This recognition, in turn, has led to renewed calls for changing the way that physicians are trained and has accelerated medical education curricular reforms. This Perspective focuses on one such innovative method of team-based care and the opportunities for its integration into medical education: medical-legal partnership, a health care delivery model that embeds civil legal services into the spectrum of health care services provided to low-income or otherwise vulnerable patients and communities.

  15. Management of type 2 diabetes mellitus in the elderly: role of the pharmacist in a multidisciplinary health care team

    Directory of Open Access Journals (Sweden)

    Grossman S

    2011-05-01

    Full Text Available Samuel GrossmanDepartment of Veterans Affairs, New York Harbor Healthcare System, New York, NY, USA; Diabetes Care On-The-Go Inc, Brooklyn, NY, USA; Hunter-Bellevue School of Nursing, Hunter College, City University of New York, New York, NY, USA; Arnold and Marie Schwartz College of Pharmacy of Long Island University, Brooklyn, NY, USA; Garden State Association of Diabetes Educators, Edison, NJ, USAAbstract: Intensive glycemic control using insulin therapy may be appropriate for many healthy older adults to reduce premature mortality and morbidity, improve quality of life, and reduce health care costs. However, frail elderly people are more prone to develop complications from hypoglycemia, such as confusion and dementia. Overall, older persons with type 2 diabetes mellitus are at greater risk of death from cardiovascular disease (CVD than from intermittent hyperglycemia; therefore, diabetes management should always include CVD prevention and treatment in this patient population. Pharmacists can provide a comprehensive medication review with subsequent recommendations to individualize therapy based on medical and cognitive status. As part of the patient’s health care team, pharmacists can provide continuity of care and communication with other members of the patient’s health care team. In addition, pharmacists can act as educators and patient advocates and establish patient-specific goals to increase medication effectiveness, adherence to a medication regimen, and minimize the likelihood of adverse events.Keywords: glycemic control, hyperglycemia, continuity of care, hypertension and cardiovascular disease, elderly, type 2 diabetes, pharmacist

  16. Online Dementia Care Training for Healthcare Teams in Continuing and Long-Term Care Homes: A Viable Solution for Improving Quality of Care and Quality of Life for Residents

    Science.gov (United States)

    MacDonald, Colla J.; Stodel, Emma J.; Casimiro, Lynn

    2006-01-01

    The purpose of this research was to design, develop, deliver, and evaluate an online dementia care program aimed at enabling healthcare teams deliver better service to residents with dementia in continuing (CC) and long-term care (LTC) facilities. A Community-Based Participatory Research (CBPR) orientation (Minkler & Wallerstein, 2003) was adopted…

  17. Language and Culture in Health Literacy for People Living with HIV: Perspectives of Health Care Providers and Professional Care Team Members

    Directory of Open Access Journals (Sweden)

    Keitshokile Dintle Mogobe

    2016-01-01

    Full Text Available Low health literacy has been linked to inadequate engagement in care and may serve as a contributor to poor health outcomes among people living with HIV and AIDS. The purpose of this paper was to examine the perspectives of health care providers and professional care team members regarding health literacy in HIV disease. A secondary data analysis was conducted from a qualitative study aimed at understanding factors that help an HIV positive person to manage their HIV disease. Data were collected from sites in Botswana, the US, and Puerto Rico. In the parent study, data were collected through focus group discussions with 135 people living with HIV, 32 HIV health care providers (HCPs, and 39 HIV professional care team members (PCTMs. SPSS was used to analyze quantitative data while ATLAS.ti was used to analyze qualitative data. The findings from analyses of the perspectives of HCPs/PCTMs suggested that linguistic and cultural factors were important themes in the exchange of HIV information between health care providers and PLHIV. These themes included ineffective communication, health seeking behavior, cultural facilitators, and complementary and alternative/traditional healing methods. Thus, this study suggests that language and culture have a major role in health literacy for PLHIV.

  18. The multidisciplinary health care team in the management of stenosis in Crohn's disease

    Directory of Open Access Journals (Sweden)

    Gasparetto M

    2015-03-01

    Full Text Available Marco Gasparetto,1 Imerio Angriman,2 Graziella Guariso1 1Department of Women and Children's Health, Paediatric Gastroenterology Unit, Padua University Hospital, Padova, Italy; 2Department of Surgery, Gastroenterology and Oncology, Padua University, Padova, Italy Background: Stricture formation is a common complication of Crohn's disease (CD, occurring in approximately one-third of all patients with this condition. Our aim was to summarize the available epidemiology data on strictures in patients with CD, to outline the principal evidence on diagnostic imaging, and to provide an overview of the current knowledge on treatment strategies, including surgical and endoscopic options. Overall, the unifying theme of this narrative review is the multidisciplinary approach in the clinical management of patients with stricturing CD. Methods: A Medline search was performed, using “Inflammatory Bowel Disease”, “stricture”, “Crohn's Disease”, “Ulcerative Colitis”, “endoscopic balloon dilatation” and “strictureplasty” as keywords. A selection of clinical cohort studies and systematic reviews were reviewed. Results: Strictures in CD are described as either inflammatory or fibrotic. They can occur de novo, at sites of bowel anastomosis or in the ileal pouch. CD-related strictures generally show a poor response to medical therapies, and surgical bowel resection or surgical strictureplasty are often required. Over the last three decades, the potential role of endoscopic balloon dilatation has grown in importance, and nowadays this technique is a valid option, complementary to surgery. Conclusion: Patients with stricturing CD require complex clinical management, which benefits from a multidisciplinary approach: gastroenterologists, pediatricians, radiologists, surgeons, specialist nurses, and dieticians are among the health care providers involved in supporting these patients throughout diagnosis, prevention of complications, and treatment

  19. New Stoma Patients' Experiences During Post - Operative Nursing Care

    OpenAIRE

    Gao, Ying

    2012-01-01

    The purpose of this study was to find out the essential concerns for stoma patients and the core information that patient are eager to know concerning stoma care. The aim of this study was to provide information that can help improve stoma patient’s’ education resulting in a better psychological support in the post – operative stage. Not all, another aim was to find out the most useful method in patients’ education process concerning stoma care. Qualitative method was used to implement t...

  20. Caring and Fun: Fostering an Adolescent-Centered Community within an Interdisciplinary Team

    Science.gov (United States)

    Kiefer, Sarah M.; Ellerbrock, Cheryl R.

    2012-01-01

    This qualitative case study analyzed how one interdisciplinary team within a large middle school fostered a responsive adolescent-centered community for eighth-grade team students. Data were collected during the spring semester of the 2009 school year via observations, individual interviews, and focus group interviews with nine participants,…

  1. [Team work and interdiciplinarity: challenges facing the implementation of comprehensive outpatient care for people with HIV/Aids in Pernambuco].

    Science.gov (United States)

    Borges, Maria Jucineide Lopes; Sampaio, Aletheia Soares; Gurgel, Idê Gomes Dantas

    2012-01-01

    The complexity of providing healthcare to people with HIV/Aids requires investment in comprehensive action and care, constituting a challenge for the multidisciplinary work teams to build an interdisciplinary practice. This study sought to analyze comprehensive healthcare in the Specialized Assistance Services for HIV/Aids (SAE-HIV/Aids) in Recife, in the State of Pernambuco, starting with the process and organization of team work. This is a case study developed in three SAE-HIV/Aids units, based on a qualitative approach using different research techniques. The results show that SAE-HIV/Aids have complied with most of the Brazilian Health Ministry recommendations in terms of basic infrastructure, though none of them had a team of appropriate size. These services have shown signs of fragmentation and difficulty in establishing a systematic intersectorial and interdisciplinary practice, with failings in ensuring the reference and counter-reference flow. It was seen that there was little appreciation of the role of the manager as team leader. The need to perceive the user as a whole was identified, as well as for the team to work in a coordinated manner in order to ensure communicative and relational activities.

  2. Change in attitudes and performance of critical care teams after a multi-disciplinary simulation-based intervention

    OpenAIRE

    Jennifer Weller; Robert Frengley; Jane Torrie; Webster, Craig S.; Susan Tomlinson; Kaylene Henderson

    2012-01-01

    Objectives: To conduct an in-depth exploration of the self-reported long-term change in attitudes and performance after a full-day multidisciplinary simulation-based course focussed on team management of emergency events in the Critical Care Unit. To address the current lack of knowledge of factors which can lead to improved teamwork performance and their measurement through identification of measurable markers of behaviour and attitude change. Methods: A purposive sample of course participan...

  3. How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory.

    Science.gov (United States)

    Kent, Fiona; Francis-Cracknell, Alison; McDonald, Rachael; Newton, Jennifer M; Keating, Jennifer L; Dodic, Miodrag

    2016-10-01

    Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients' health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding 'shared contribution', 'patient as key information source' and 'time constraints' were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients' voice in clinical and education processes. PMID:26781698

  4. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    Science.gov (United States)

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation. PMID:27305428

  5. A case study of a team-based, quality-focused compensation model for primary care providers.

    Science.gov (United States)

    Greene, Jessica; Hibbard, Judith H; Overton, Valerie

    2014-06-01

    In 2011, Fairview Health Services began replacing their fee-for-service compensation model for primary care providers (PCPs), which included an annual pay-for-performance bonus, with a team-based model designed to improve quality of care, patient experience, and (eventually) cost containment. In-depth interviews and an online survey of PCPs early after implementation of the new model suggest that it quickly changed the way many PCPs practiced. Most PCPs reported a shift in orientation toward quality of care, working more collaboratively with their colleagues and focusing on their full panel of patients. The majority reported that their quality of care had improved because of the model and that their colleagues' quality had to. The comprehensive change did, however, result in lower fee-for-service billing and reductions in PCP satisfaction. While Fairview's compensation model is still a work in progress, their early experiences can provide lessons for other delivery systems seeking to reform PCP compensation.

  6. A robust and novel dynamic-ID-based authentication scheme for care team collaboration with smart cards.

    Science.gov (United States)

    Chang, Ya-Fen; Chen, Chia-Chen; Chang, Pei-Yu

    2013-04-01

    Nowadays, users/patients may gain desired medical services on-line because of the rapid development of computer network technologies. Conventional healthcare services are provided by a single server. However, care team collaboration by integrating services is the key to improve financial and clinical performance. How a user/patient accesses desired medical services provided by multiple servers becomes a challenge to realize care team collaboration. User authentication plays an important role to protect resources or services from being accessed by unauthorized users. In this paper, we first discuss the perceived security drawbacks of pervasive smart-card-based remote user authentication schemes. Then, we propose a novel dynamic-ID-based user authentication scheme based on elliptic curve cryptosystem (ECC) for multi-server environment with smart cards. The proposed scheme ensures user anonymity and computational efficiency and complies with essential requirements of a secure smart-card-based authentication scheme for multi-server environment to enable care team collaboration. PMID:23355184

  7. Action Learning, Team Learning and Co-Operation in the Czech Republic

    Science.gov (United States)

    Kubatova, Slava

    2012-01-01

    This account of practice presents two cases of the application of Action Learning (AL) communication methodology as described by Marquardt [2004. "Optimising the power of action learning". Mountain View, CA: Davies-Black Publishing]. The teams were Czech and international top management teams. The AL methodology was used to improve cooperation and…

  8. Implementation of operational meteorological information service for CARE REMDAS

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Sung Nam; Nam, Jae Cheol; Choi, Jae Chun [Meteorological Reaearch Institute, Seoul (Korea, Republic of); Lee, Byong Lyol; Lee, Bo Ram; Shin, Hyun Cheol; Park, Nan Ah [Korea Meteorological Administration, Seoul (Korea, Republic of); Song, Chang Keun; Park, Sang Jong [Seoul National Univ., Seoul (Korea, Republic of)

    1999-12-15

    The scope of this study consists of : improve of CARE REMDAS - identification of meteorolgical information required for nuclear emergency response and their efficient use on a real-time basis, review of the production and operation of KMA NWP nodels and their applications. Suggestions on the improvements in nuclear emergency response systme from the care studies of both domestic and foreign countries - case study of a domestic model for radioactivity T/D in terms of model dynamics and operation, investigation of promising support systems by reviewing the current status of T/D model in UK. Recommendations on a promising meteorological information sevices based on foreign cases - examinations of DWD system, including EU for nuclear emergency response, review on the meteorogical information support by DWD for NERS.

  9. Implementation of operational meteorological information service for CARE REMDAS

    International Nuclear Information System (INIS)

    The scope of this study consists of : improve of CARE REMDAS - identification of meteorolgical information required for nuclear emergency response and their efficient use on a real-time basis, review of the production and operation of KMA NWP nodels and their applications. Suggestions on the improvements in nuclear emergency response systme from the care studies of both domestic and foreign countries - case study of a domestic model for radioactivity T/D in terms of model dynamics and operation, investigation of promising support systems by reviewing the current status of T/D model in UK. Recommendations on a promising meteorological information sevices based on foreign cases - examinations of DWD system, including EU for nuclear emergency response, review on the meteorogical information support by DWD for NERS

  10. Planning an eLearning Dementia Care Program for Healthcare Teams in Long-Term Care Facilities: The Learners' Perspectives

    Science.gov (United States)

    MacDonald, Colla J.; Stodel, Emma J.; Coulson, Irene

    2004-01-01

    This paper presents a needs analysis conducted to obtain information concerning online dementia care training of healthcare workers in long-term care (LTC) facilities. The resulting information was used to guide the development of an online dementia care training program designed to facilitate the acquisition of skills and knowledge necessary for…

  11. Comparison of patients′ age receiving therapeutic services in a cleft care team in Isfahan

    Directory of Open Access Journals (Sweden)

    Saeed Soheilipour

    2016-01-01

    Conclusion: There was a significant difference between the age of performing secondary surgery and alveolar bone grafting and the age of beginning speech therapy and receiving orthodontic services in early references and late references to the team.

  12. Effectiveness of the Rural Trauma Team Development Course for Educating Nurses and Other Health Care Providers at Rural Community Hospitals.

    Science.gov (United States)

    Zhu, Thein Hlaing; Hollister, Lisa; Scheumann, Christopher; Konger, Jennifer; Opoku, Dazar

    2016-01-01

    The study evaluates (1) health care provider perception of the Rural Trauma Team Development Course (RTTDC); (2) improvement in acute trauma emergency care knowledge; and (3) early transfer of trauma patients from rural emergency departments (EDs) to a verified trauma center. A 1-day, 8-hour RTTDC was given to 101 nurses and other health care providers from nine rural community hospitals from 2011 to 2013. RTTDC participants completed questionnaires to address objectives (1) and (2). ED and trauma registry data were queried to achieve objective (3) for assessing reduction in ED time (EDT), from patient arrival to decision to transfer and ED length of stay (LOS). The RTTDC was positively perceived by health care providers (96.3% of them completed the program). Significant improvement in 13 of the 19 knowledge items was observed in nurses. Education intervention was an independent predictor in reducing EDT by 28 minutes and 95% confidence interval (CI) [-57, -0.1] at 6 months post-RTTDC, and 29 minutes and 95% CI [-53, -6] at 12 months post-RTTDC. Similar results were observed with ED LOS. The RTTDC is well-perceived as an education program. It improves acute trauma emergency care knowledge in rural health care providers. It promotes early transfer of severely injured patients to a higher level of care.

  13. Staying Alive! Training High-Risk Teams for Self Correction

    Science.gov (United States)

    Slack, Kelley; Noe, Raymond; Weaver, Sallie

    2011-01-01

    Research examining teams working in high-risk operations has been lacking. The present symposium showcases research on team training that helps to optimize team performance in environments characterized by life or death situations arising spontaneously after long periods of mundane activity by pulling experts from diverse areas of industry: space flight, health care, and medical simulation.

  14. Development of Sub-optimal Airway Protocols for the International Space Station (ISS) by the Medical Operation Support Team (MOST)

    Science.gov (United States)

    Polk, James D.; Parazynski, Scott; Kelly, Scott; Hurst, Victor, IV; Doerr, Harold K.

    2007-01-01

    Airway management techniques are necessary to establish and maintain a patent airway while treating a patient undergoing respiratory distress. There are situations where such settings are suboptimal, thus causing the caregiver to adapt to these suboptimal conditions. Such occurrences are no exception aboard the International Space Station (ISS). As a result, the NASA flight surgeon (FS) and NASA astronaut cohorts must be ready to adapt their optimal airway management techniques for suboptimal situations. Based on previous work conducted by the Medical Operation Support Team (MOST) and other investigators, the MOST had members of both the FS and astronaut cohorts evaluate two oral airway insertion techniques for the Intubating Laryngeal Mask Airway (ILMA) to determine whether either technique is sufficient to perform in suboptimal conditions within a microgravity environment. Methods All experiments were conducted in a simulated microgravity environment provided by parabolic flight aboard DC-9 aircraft. Each participant acted as a caregiver and was directed to attempt both suboptimal ILMA insertion techniques following a preflight instruction session on the day of the flight and a demonstration of the technique by an anesthesiologist physician in the simulated microgravity environment aboard the aircraft. Results Fourteen participants conducted 46 trials of the suboptimal ILMA insertion techniques. Overall, 43 of 46 trials (94%) conducted were properly performed based on criteria developed by the MOST and other investigators. Discussion The study demonstrated the use of airway management techniques in suboptimal conditions relating to space flight. Use of these techniques will provide a crew with options for using the ILMA to manage airway issues aboard the ISS. Although it is understood that the optimal method for patient care during space flight is to have both patient and caregiver restrained, these techniques provide a needed backup should conditions not present

  15. Introduction of a team-based care model in a general medical unit

    OpenAIRE

    Hastings, Stephanie E.; Suter, Esther; Bloom, Judy; Sharma, Krishna

    2016-01-01

    Background Alberta Health Services is a provincial health authority responsible for healthcare for more than four million people. The organization recognized a need to change its care delivery model to make care more patient- and family-centred and use its health human resources more effectively by enhancing collaborative practice. A new care model including changes to how providers deliver care and skill mix changes to support the new processes was piloted on a medical unit in a large urban ...

  16. Improving outcomes in lung cancer: the value of the multidisciplinary health care team.

    Science.gov (United States)

    Denton, Eve; Conron, Matthew

    2016-01-01

    Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed. PMID:27099511

  17. Team-based education in a palliative approach for rural nurses and unlicensed care providers.

    Science.gov (United States)

    Potter, Gail; Pesut, Barbara; Hooper, Brenda Pherne; Erbacker, Lynnelle

    2015-06-01

    This article describes the preparation and delivery of an educational intervention designed to improve rural nurses and unlicensed care providers' confidence in a palliative approach to care. A palliative approach takes the principles of supportive palliative care and adapts them for application earlier in nonspecialized palliative contexts for individuals living with life-limiting chronic illness. Curriculum in a palliative approach was constructed for nurses and unlicensed care providers (care aides and home health workers) and was delivered through a workshop and monthly follow-up sessions offered through distance technology. Participants valued the joint interactive education and came away with greater appreciation for one another's contributions to care. Insights were gained into common challenges when attempting to apply a palliative approach in rural areas. Important lessons were learned about educating nurses and unlicensed care providers together, about the use of technology for this group, and about teaching the concept of a palliative approach.

  18. Maintaining connections: some thoughts on the value of intensive care unit rounding for general medicine ward teams.

    Science.gov (United States)

    Howell, Joel D

    2011-09-01

    When established ward patients are unexpectedly transferred to an intensive care unit (ICU), the ward team should continue to follow them. Although there may be reasons not to do so, the advantages outweigh the obstacles. Great pedagogic value can be gained from following patients after acute decompensation, but a more important reason is that by following patients into the ICU, the ward team can enact for both patients and their families the twin virtues of caring and continuity. Doing so also demonstrates the highest ideals of medicine-that we are focused not on defined areas of turf, but on our patient's well-being. It shows that we are not merely doing narrowly defined "shift work," but that we truly care about our patients. Rounding on established patients who have been transferred into the ICU is the sort of behavior that undergirds the fundamental bases of professionalism. It takes a few minutes from a busy day, but it can be incredibly beneficial for families, patients, and the ideals of medicine.

  19. Quality of care using a multidisciplinary team in the emergency room

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Maaløe, Rikke; Jensen, Nanna Martin;

    2011-01-01

    Bispebjerg Hospital has implemented a multidisciplinary team reception of critically ill and severely injured patients at the Emergency Department (ED), termed emergency call (EC) and trauma call (TC). The aim of this study was to describe the course, medical treatment and outcome for patients...

  20. Interprofessional team management in pediatric critical care: some challenges and possible solutions

    OpenAIRE

    Stocker M.; Pilgrim SB; Burmester M.; Allen ML; Gijselaers WH

    2016-01-01

    Martin Stocker,1 Sina B Pilgrim,2 Margarita Burmester,3 Meredith L Allen,4 Wim H Gijselaers5 1Neonatal and Pediatric Intensive Care Unit, Children's Hospital Lucerne, Lucerne, 2Pediatric Intensive Care, University Children's Hospital Berne, Berne, Switzerland; 3Pediatric Intensive Care Unit, Royal Brompton Hospital, London, UK; 4Department of Pediatrics, The Royal Children's Hospital, Victoria, Australia; 5Educational Research and Development, School of Business and Ec...

  1. Comparing the implementation of team approaches for improving diabetes care in community health centers

    OpenAIRE

    Wees, P.J. van der; Friedberg, M.W.; Guzman, E; Ayanian, J.Z.; Rodriguez, H.P.

    2014-01-01

    Background: Patient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. Methods: Mixed methods study with intervi...

  2. Resistance is Futile: STScI's Science Planning and Scheduling Team Switches From VMS to Unix Operations

    Science.gov (United States)

    Adler, D. S.

    2000-12-01

    The Science Planning and Scheduling Team (SPST) of the Space Telescope Science Institute (STScI) has historically operated exclusively under VMS. Due to diminished support for VMS-based platforms at STScI, SPST is in the process of transitioning to Unix operations. In the summer of 1999, SPST selected Python as the primary scripting language for the operational tools and began translation of the VMS DCL code. As of October 2000, SPST has installed a utility library of 16 modules consisting of 8000 lines of code and 80 Python tools consisting of 13000 lines of code. All tasks related to calendar generation have been switched to Unix operations. Current work focuses on translating the tools used to generate the Science Mission Specifications (SMS). The software required to generate the Mission Schedule and Command Loads (PASS), maintained by another team at STScI, will take longer to translate than the rest of the SPST operational code. SPST is planning on creating tools to access PASS from Unix in the short term. We are on schedule to complete the work needed to fully transition SPST to Unix operations (while remotely accessing PASS on VMS) by the fall of 2001.

  3. Prevention, early detection and team management of skin cancer in primary care: contribution to The health of the nation objectives.

    Science.gov (United States)

    Jackson, A

    1995-02-01

    The incidence of all skin cancers is increasing. If The health of the nation targets are to be addressed, incidence figures need to be more accurate. Solar damage is the major causal factor in all skin cancers. Certain individual risk factors also play an important part, especially in the development of malignant melanoma. Prevention and early detection are crucial in reducing morbidity and mortality from skin cancer. This paper considers the role of primary care skin screening clinics and cutaneous surgery facilities in the early detection and management of skin cancer. It also illustrates the value of a team approach in primary care in the prevention and early detection of skin cancer and in the more accurate recording of incidence rates.

  4. Comparing the implementation of team approaches for improving diabetes care in community health centers

    NARCIS (Netherlands)

    Wees, P.J. van der; Friedberg, M.W.; Guzman, E.; Ayanian, J.Z.; Rodriguez, H.P.

    2014-01-01

    BackgroundPatient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating o

  5. Teams and working conditions in mobile pre-hospital care services: an integrative review

    Directory of Open Access Journals (Sweden)

    Daiane Dal Pai

    2015-12-01

    Full Text Available Study to identify, analyze and summarize the findings available in the literature on the composition of teams and working conditions in Mobile  Pre-Hospital Care Services  (PHC.  Integrative review to search the Base  de Dados  de  Enfermagem [Nursing Database] (BDEnf, the Cumulative  Index  to  Nursing  and  Allied  Health  Literature (CINAHL,  the Latin American and Caribbean Health Sciences Literature (LILACS, PubMed,  SCOPUS,  Web  of  Science and the portal of journals from the Scientific  Electronic  Library Online  (SciELO. Eighteen articles met the inclusion criteria and were selected. The composition of the teams for PHC services is diversified on the international stage, with the increase in responsibilities assumed by paramedics and the benefits of the specialized nurse's and doctor's presence in the teams being portrayed, which are scarce in some countries.  Working conditions reveal risky places of work, intense psychological demands, work overload, dissatisfaction and inadequate resources in most services.

  6. A comparison of two different team models for treatment of diabetes mellitus in primary care.

    Science.gov (United States)

    Ovhed, I; Johansson, E; Odeberg, H; Råstam, L

    2000-01-01

    The importance of the nurse's role in the management of patients with type 2 diabetes has long since been emphasized. The aim of this study was to test the hypothesis that a structured organization of type 2 diabetes care, with a diabetes nurse working more independently of the general practitioner, has a significant impact on the patient's self-management and quality of care. The test consisted of 394 registered patients, all with an onset of diabetes mellitus occurring after the age of 34, at two primary health care (PHC) districts in Blekinge county in South Sweden. During one year all consultations for both doctors and nurses were analysed, and a structured telephone survey was carried out involving 364 patients who were 84 years or younger. A comparison between the two PHC centres was made regarding quality of care, frequency of consultation, patients' knowledge of their disease, and patients' self-management. The results showed that organizing care of type 2 diabetes in a structured way encourages better metabolic control in spite of less use of oral medication, and among the patients a greater knowledge of their disease and a more active self-management thus favouring implementation of local guidelines. Also, a difference was found in the patients' choice of contact with doctor or nurse regarding their diabetes and even other causes, which shifted the balance from doctor to nurse. This study provides support for organizing type 2 diabetes care in a structured way to increase the quality of care. PMID:12035216

  7. From the Team to the Table: Nursing Societies and Health Care Organizational Ethics.

    Science.gov (United States)

    Wiencek, Clareen; Lavandero, Ramón; Berlinger, Nancy

    2016-09-01

    Health care work is interprofessional work. Nurses and physicians, members of the professions whose close collaboration is foundational to health care delivery, continue to be educated separately in most academic institutions. Their work also is organized in ways that challenge interprofessional collaboration. Understanding workplace realities faced by nurses and physicians, separately and jointly, is a starting place for exploring how to support ethically sound interprofessional work. In this essay, we look most closely at the work of nurses and physicians who care for seriously ill hospitalized patients, a patient population closely associated with ethical challenges.

  8. From the Team to the Table: Nursing Societies and Health Care Organizational Ethics.

    Science.gov (United States)

    Wiencek, Clareen; Lavandero, Ramón; Berlinger, Nancy

    2016-09-01

    Health care work is interprofessional work. Nurses and physicians, members of the professions whose close collaboration is foundational to health care delivery, continue to be educated separately in most academic institutions. Their work also is organized in ways that challenge interprofessional collaboration. Understanding workplace realities faced by nurses and physicians, separately and jointly, is a starting place for exploring how to support ethically sound interprofessional work. In this essay, we look most closely at the work of nurses and physicians who care for seriously ill hospitalized patients, a patient population closely associated with ethical challenges. PMID:27649917

  9. Effectiveness of Teamwork in an Integrated Care Setting for Patients with COPD: Development and Testing of a Self-Evaluation Instrument for Interprofessional Teams

    Directory of Open Access Journals (Sweden)

    Anneke N Van Dijk-de Vries

    2016-04-01

    Full Text Available Introduction: Teamwork between healthcare providers is conditional for the delivery of integrated care. This study aimed to assess the usefulness of the conceptual framework Integrated Team Effectiveness Model for developing and testing of the Integrated Team Effectiveness Instrument. Theory and methods: Focus groups with healthcare providers in an integrated care setting for people with chronic obstructive pulmonary disease (COPD were conducted to examine the recognisability of the conceptual framework and to explore critical success factors for collaborative COPD practice out of this framework. The resulting items were transposed into a pilot instrument. This was reviewed by expert opinion and completed 153 times by healthcare providers. The underlying structure and internal consistency of the instrument were verified by factor analysis and Cronbach’s alpha. Results: The conceptual framework turned out to be comprehensible for discussing teamwork effectiveness. The pilot instrument measures 25 relevant aspects of teamwork in integrated COPD care. Factor analysis suggested three reliable components: teamwork effectiveness, team processes and team psychosocial traits (Cronbach’s alpha between 0.76 and 0.81. Conclusions and discussion: The conceptual framework Integrated Team Effectiveness Model is relevant in developing a practical full-spectrum instrument to facilitate discussing teamwork effectiveness. The Integrated Team Effectiveness Instrument provides a well-founded basis to self-evaluate teamwork effectiveness in integrated COPD care by healthcare providers. Recommendations are provided for the improvement of the instrument.

  10. Stepped Skills: A team approach towards communication about sexuality and intimacy in cancer and palliative care

    OpenAIRE

    Hilde de Vocht; Amanda Hordern; Joy Notter; Harry van de Wiel

    2011-01-01

    BackgroundCancer often has a profound and enduring impact on sexuality, affecting both patients and their partners. Most healthcare professionals in cancer and palliative care are struggling to address intimate issues with the patients in their care.MethodsStudy 1: An Australian study using semi-structured interviews and documentary data analysis.Study 2: Building on this Australian study, using a hermeneutic phenomenological approach, data were collected in the Netherlands through interviewi...

  11. End of Life Care and the Chaplain's Role on the Medical Team

    OpenAIRE

    Lahaj, Mary

    2012-01-01

    This article depicts a chaplain’s role in various learning and teaching situations, including end-of-life care and cases requiring cultural competency and gender preferences. The cases exemplify and underscore the difference between the role of a chaplain and the imam, as well as the necessity to have imams and both male and female chaplains in the hospital. It also describes the training, education, pastoral formation, pastoral identity, and roots of pastoral care in the Islamic tradition. T...

  12. Systematic review of safety checklists for use by medical care teams in acute hospital settings - limited evidence of effectiveness

    Directory of Open Access Journals (Sweden)

    Ko Henry CH

    2011-09-01

    Full Text Available Abstract Background Patient safety is a fundamental component of good quality health care. Checklists have been proposed as a method of improving patient safety. This systematic review, asked "In acute hospital settings, would the use of safety checklists applied by medical care teams, compared to not using checklists, improve patient safety?" Methods We searched the Cochrane Library, MEDLINE, CINAHL, and EMBASE for randomised controlled trials published in English before September 2009. Studies were selected and appraised by two reviewers independently in consultation with colleagues, using inclusion, exclusion and appraisal criteria established a priori. Results Nine cohort studies with historical controls studies from four hospital care settings were included-intensive care unit, emergency department, surgery, and acute care. The studies used a variety of designs of safety checklists, and implemented them in different ways, however most incorporated an educational component to teach the staff how to use the checklist. The studies assessed outcomes occurring a few weeks to a maximum of 12 months post-implementation, and these outcomes were diverse. The studies were generally of low to moderate quality and of low levels of evidence, with all but one of the studies containing a high risk of bias. The results of these studies suggest some improvements in patient safety arising from use of safety checklists, but these were not consistent across all studies or for all outcomes. Some studies showed no difference in outcomes between checklist use and standard care without a checklist. Due to the variations in setting, checklist design, educational training given, and outcomes measured, it was unfeasible to accurately summarise any trends across all studies. Conclusions The included studies suggest some benefits of using safety checklists to improve protocol adherence and patient safety, but due to the risk of bias in these studies, their results

  13. Palliative radiotherapy with or without additional care by a multidisciplinary palliative care team in patients with newly diagnosed cancer: a retrospective matched pairs comparison

    International Nuclear Information System (INIS)

    To analyze survival after early palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. Retrospective matched pairs analysis. Comparison of two groups of 29 patients each: MPCT versus none. Early RT started within three months after cancer diagnosis. Bone and brain metastases were common RT targets. No significant differences in baseline characteristics were observed between both groups. Twelve patients in each group had non-small cell lung cancer. Median performance status was 2 in each group. Twenty-seven patients in each group had distant metastases. Median survival was not significantly different. In multivariate analysis, MPCT care was not associated with survival, while performance status and liver metastases were. Rate of radiotherapy during the last month of life was comparable. Only one patient in each group failed to complete radiotherapy. MPCT care was not associated with survival in these two matched groups of patients. The impact of MPCT care on other relevant endpoints such as symptom control, side effects and quality of life should be investigated prospectively

  14. COPD Multidisciplinary Team Meetings in the United Kingdom: Health Care Professionals' Perceptions of Aims and Structure.

    Science.gov (United States)

    Kruis, Annemarije L; Soljak, Michael; Chavannes, Niels H; Elkin, Sarah L

    2016-10-01

    Over the last 10 years, community and hospital-based multidisciplinary teams (MDTs) have been set up for the management of patients with chronic obstructive pulmonary disease (COPD) in the UK. Meetings of the MDTs have become a regular occurrence, mostly on healthcare professionals' own initiatives. There are no standardized methods to conduct an MDT meeting, and although cancer MDT meetings are widely implemented, the value and purpose of COPD MDT meetings are less clear. Therefore, the aim of this study was to conduct a cross-sectional descriptive online survey to explore COPD MDT members' perceptions of the purpose and usefulness of MDT meetings, and to identify suggestions or requirements to improve the meetings. In total, we received 68 responses from 10 MDTs; six teams (n = 36 members) were located in London and four (n = 32 members) outside. Analysis of the replies by two independent researchers found that MDT meetings aim to optimise management and improve pathways for respiratory patients by improving communication between providers across settings and disciplines. Education of the MDT members also occurs with the aim of safer practice. Discussed patients are characterised by (multiple) co-morbidities, frequent exacerbations and admissions, social and mental health problems, unclear diagnosis and suboptimal responses to interventions. Members reported participating in a COPD MDT as very useful (74%) or useful (20%). Meetings could be improved by ensuring attendance through requirement in job plans, by clear documentation and sharing of derived plans with a wider audience including general practitioners and patients. PMID:26263193

  15. COPD Multidisciplinary Team Meetings in the United Kingdom: Health Care Professionals' Perceptions of Aims and Structure.

    Science.gov (United States)

    Kruis, Annemarije L; Soljak, Michael; Chavannes, Niels H; Elkin, Sarah L

    2016-10-01

    Over the last 10 years, community and hospital-based multidisciplinary teams (MDTs) have been set up for the management of patients with chronic obstructive pulmonary disease (COPD) in the UK. Meetings of the MDTs have become a regular occurrence, mostly on healthcare professionals' own initiatives. There are no standardized methods to conduct an MDT meeting, and although cancer MDT meetings are widely implemented, the value and purpose of COPD MDT meetings are less clear. Therefore, the aim of this study was to conduct a cross-sectional descriptive online survey to explore COPD MDT members' perceptions of the purpose and usefulness of MDT meetings, and to identify suggestions or requirements to improve the meetings. In total, we received 68 responses from 10 MDTs; six teams (n = 36 members) were located in London and four (n = 32 members) outside. Analysis of the replies by two independent researchers found that MDT meetings aim to optimise management and improve pathways for respiratory patients by improving communication between providers across settings and disciplines. Education of the MDT members also occurs with the aim of safer practice. Discussed patients are characterised by (multiple) co-morbidities, frequent exacerbations and admissions, social and mental health problems, unclear diagnosis and suboptimal responses to interventions. Members reported participating in a COPD MDT as very useful (74%) or useful (20%). Meetings could be improved by ensuring attendance through requirement in job plans, by clear documentation and sharing of derived plans with a wider audience including general practitioners and patients.

  16. Optimizing patient care in radiology through team-working: A case study from the United Kingdom

    International Nuclear Information System (INIS)

    Objectives: To investigate how changes in service delivery within the radiology department of an acute district general hospital optimized imaging services for patients and referrers through a strong emphasis on team-working. Methods: Data related to service delivery was collected for three consecutive years and interrogated by imaging modality and reporting practitioner (radiologist, reporting radiographer, sonographer) to explore how workload had changed over the cycle. Results: Departmental activity demonstrated consistent increases, both overall (13.3%) and for most modalities (MRI 43.7%, CT 22.8%) for the study period (March 2010–March 2013). Overall trend suggested significantly shorter waiting times (CT 0.7 weeks, MRI 1.3 weeks, non-obstetric ultrasound one week; all modalities p = 0.001). Some modality variation in reporting times was apparent, with CT (p = 0.06) and MRI (p = 0.01) decreasing but there was an increase in X-ray reporting times (p = 0.001). Reporting radiographers and sonographers reported the majority of X-ray and non-obstetric ultrasound interpretations (59% and 52%, respectively). A radiographer-led neonatal reporting service was implemented and the urology patient pathway redesigned. Effective team-working produced savings of three full-time consultant radiologist posts. Conclusion: Radiologists and radiographers, working together, can deliver an effective service. Innovation, staff development and redesign of patient pathways, have produced significant improvements

  17. Learning through "huddles" for health care leaders: why do some work teams learn as a result of huddles and others do not?

    Science.gov (United States)

    Little, Johanna

    2014-01-01

    The health care industry embraces the concept that collective learning occurs through group social interactions and has been initiating huddles as an avenue for collaborative learning. During change of shift or prior to beginning daily tasks, a huddle is initiated and facilitated by the manager or frontline supervisor. Given that "shared knowledge is obtained through group-based learning," why are some teams learning and others are not? The phenomenon is perplexing, given that the same resources are provided to all teams. Based on the findings in the literature review on learning in groups, teams learn from huddles and others do not because of the following: communication style and dialogue among the group members, communication style and dialogue facilitated by the leader, team and member perceptions, and team membership. Teams that learn from huddles do so because of the elements within the dialogue between team members (reflexive questioning, redundancy of information, metaphors, analogies, dramatic dialogue, strategic meaning) and because the huddle team exhibits higher levels of collegiality, tenure, heterogeneity, team identification, and collective efficacy. Facilitators must encourage a conversation in order to encourage reframing of cognitive maps that encourage learning by huddle members. PMID:25350023

  18. Organizational Learning in Health Care Organizations

    OpenAIRE

    Savithiri Ratnapalan; Elizabeth Uleryk

    2014-01-01

    The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication...

  19. Ambulatory Diagnosis and Management of Obstructive Sleep Apnea: Screening Questionnaires, Diagnostic Tests, and the Care Team.

    Science.gov (United States)

    McEvoy, R Doug; Chai-Coetzer, Ching Li; Antic, Nick A

    2016-09-01

    Obstructive sleep apnea has increased in prevalence in recent years and despite the expansion in sleep medicine services there is a significant unmet burden of disease. This burden presents a challenge to specialists and requires a reappraisal of service delivery, including a move toward lower-cost, simplified methods of diagnosis and treatment, an expansion of the sleep apnea workforce to include suitably trained and equipped primary care physicians and nurses, and the incorporation of chronic disease management principles that link patients to relevant community resources and empower them through new technologies to engage more fully in their own care. PMID:27542873

  20. Team spirit makes the difference: the interactive effects of team work engagement and organizational constraints during a military operation on psychological outcomes afterwards.

    Science.gov (United States)

    Boermans, S M; Kamphuis, W; Delahaij, R; van den Berg, C; Euwema, M C

    2014-12-01

    This article prospectively explores the effects of collective team work engagement and organizational constraints during military deployment on individual-level psychological outcomes afterwards. Participants were 971 Dutch peacekeepers within 93 teams who were deployed between the end of 2008 and beginning of 2010, for an average of 4 months, in the International Security Assistance Force. Surveys were administered 2 months into deployment and 6 months afterwards. Multi-level regression analyses demonstrated that team work engagement during deployment moderated the relation between organizational constraints and post-deployment fatigue symptoms. Team members reported less fatigue symptoms after deployment if they were part of highly engaged teams during deployment, particularly when concerns about organizational constraints during deployment were high. In contrast, low team work engagement was related to more fatigue symptoms, particularly when concerns about organizational constraints were high. Contrary to expectations, no effects for team work engagement or organizational constraints were found for post-traumatic growth. The present study highlights that investing in team work engagement is important for those working in highly demanding jobs.

  1. Team spirit makes the difference : The interactive effects of team work engagement and organizational constraints during a military operation on psychological outcomes afterwards

    NARCIS (Netherlands)

    Boermans, S.M.; Kamphuis, W.; Delahaij, R.; Berg, C. van den; Euwema, M.C.

    2014-01-01

    This article prospectively explores the effects of collective team work engagement and organizational constraints during military deployment on individual-level psychological outcomes afterwards. Participants were 971 Dutch peacekeepers within 93 teams who were deployed between the end of 2008 and b

  2. Multidisciplinary team care for CKD-MBD. Achieving KDIGO guideline recommendations in the bundling era.

    Science.gov (United States)

    McCann, Linda; Hoefs, Meghan

    2014-04-01

    The increasing prevalence of end-stage renal disease and planned expansion of the Medicare bundled payment system will place a greater financial burden on dialysis providers. Management of chronic kidney disease mineral and bone disorder (CKD-MBD) is dependent on interdisciplinary team (IDT) interventions such as dietary modification, medication, and adequate dialysis therapy. Optimizing adherence to diet and medications requires an educated and motivated IDT, patient, and patient support system. The financial constraints of bundling will increase the roles of social workers and dietitians in promoting therapy adherence. Innovative and relevant tactics provide opportunity to overcome monotonous routines, encourage adherence to diet and complex polypharmacy regimens, and achieve recommended biochemical targets as outlined in Kidney Disease Improving Global Outcomes Guideline for Chronic Kidney Disease (KDIGO) - CKD-MBD.

  3. Development of new taxonomy of inappropriate communication and its application to operating teams in nuclear power plants

    International Nuclear Information System (INIS)

    Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.

  4. Change in attitudes and performance of critical care teams after a multi-disciplinary simulation-based intervention

    Directory of Open Access Journals (Sweden)

    Jennifer Weller

    2012-07-01

    Full Text Available Objectives: To conduct an in-depth exploration of the self-reported long-term change in attitudes and performance after a full-day multidisciplinary simulation-based course focussed on team management of emergency events in the Critical Care Unit. To address the current lack of knowledge of factors which can lead to improved teamwork performance and their measurement through identification of measurable markers of behaviour and attitude change. Methods: A purposive sample of course participants underwent semi-structured interviews one to five months after course completion. Responses were coded using grounded theory to identify instances of learning, changes in attitudes or clinical performance, and measurable behavioural and attitudinal markers for such change. Interviews continued until data saturation was achieved. Results: Twenty nine participants (15 doctors and 14 nurses were interviewed. Doctors became more confident in delegating and including nurses in decision making, and nurses became more confident and aware of the need for effective communication. Doctors reported that their ability to assign team roles improved over the day and that they made more frequent use of closed-loop communication. Both professional groups reported improvement in communication in the clinical setting after participation, including better vocalising of thoughts and use of colleagues' names. Attitudes to communication also improved and persisted in the clinical setting. Conclusions: Addressing gaps in current medical education knowledge, self-reported improvements in behaviour and attitudes translated to clinical performance after a simulation course. Measurable behavioural and attitudinal markers were identified that may assist with the development of evidence-based measurement tools in future team training work.

  5. One tool - one team: the marriage of test and operations in a low-budget spacecraft development

    Science.gov (United States)

    Finley, Charles J.

    2006-05-01

    The Air Force Research Laboratory's Space Vehicles Directorate (AFRL/VS) and the Department of Defense Space Test Program (STP) are two organizations that have partnered on more than 85 missions since 1968 to develop, launch, and operate Research and Development, Test and Evaluation space missions. As valuable as these missions have been to the follow-on generation of Operational systems, they are consistently under-funded and forced to execute on excessively ambitious development schedules. Due to these constraints, space mission development teams that serve the RDT&E community are faced with a number of unique technical and programmatic challenges. AFRL and STP have taken various approaches throughout the mission lifecycle to accelerate their development schedules, without sacrificing cost or system reliability. In the areas of test and operations, they currently employ one of two strategies. Historically, they have sought to avoid the added cost and complexity associated with coupled development schedules and segregated the spacecraft development and test effort from the ground operations system development and test effort. However, because these efforts have far more in common than they have differences, they have more recently attempted to pursue parallel I&T and Operations development and readiness efforts. This paper seeks to compare and contrast the "decoupled test and operations" approach, used by such missions as C/NOFS and Coriolis, with the "coupled test and operations" approach, adopted by the XSS-11 and TacSat-2 missions.

  6. [Importance of Anesthesiologists in the Work of a Palliative Care Team].

    Science.gov (United States)

    Hozumi, Jun; Sumitani, Masahiko

    2016-03-01

    World Health Organization has proposed that palliative medicine should be applied early in the course of the malignant diseases. Regrettably, however, palliative care has been usually provided to patients with the advanced stage of cancer, as terminal care. Recently, palliative medicine begins at the time when patients are diagnosed with cancer. In response to changes in clinical settings of palliative medicine, anesthesiologists, with substantial experience in interdisciplinary pain management, can utilize their advantages in providing palliative medicine to cancer patients: 1) use of opioid analgesics; 2) considering the biopsychosocial model of pain; 3) helping patients live as actively as possible until death; and 4) helping the family cope with the patient's illness and their own bereavement.

  7. The communication of the nursing team with patients in palliative care

    OpenAIRE

    Alves, Everton Fernando

    2013-01-01

    The article consists of a contextualized reflection on the communication in palliative care with the purpose of explaining strategies used for effective communication among the nursing, terminally ill and his family. In that sense, it was observed that for the nurse to assist the terminally ill is a difficult task, which raises sensation of sadness, frustration, impotence and even failure in the rendered attendance. This way, many professionals use denial, escaping, and the ...

  8. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

    OpenAIRE

    Nombeko Mshunqane; Aimee V. Stewart; Allan D. Rothberg

    2012-01-01

    Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care tea...

  9. A Delicate Balance - Adaptive Design and Team Learning in the Operating Theatre

    NARCIS (Netherlands)

    Dekker-van Doorn, C.M.

    2014-01-01

    Since the publication of the Institute of Medicine (IOM) study “To Err is human”, followed by “Crossing the Quality Chasm” two years later, patient safety has become an important concern for all involved: patients, professionals and health care organisations (Bleich, 2005; Kohn, 2000). Over the last

  10. A Delicate Balance - Adaptive Design and Team Learning in the Operating Theatre

    NARCIS (Netherlands)

    C.M. Dekker-van Doorn (Connie)

    2014-01-01

    markdownabstract__Abstract__ Since the publication of the Institute of Medicine (IOM) study “To Err is human”, followed by “Crossing the Quality Chasm” two years later, patient safety has become an important concern for all involved: patients, professionals and health care organisations (Bleich, 20

  11. Team interaction skills evaluation criteria for nuclear power plant control room operators

    International Nuclear Information System (INIS)

    Previous research has shown the value of good team interaction skills to group performance, yet little progress has been made on in terms of how such skills can be measured. In this study rating scales developed previously (Montgomery, et al., 1990) were extensively revised and cast into a Behaviorally Anchored Rating Scale (BARS) and a Behavioral Frequency format. Rating data were collected using 13 training instructors at the Diablo Canyon Nuclear Plant, who rated three videotapes of simulator scenario performance during a day-long training session and later evaluated control room crews during requalification training. High levels of interrater agreement on both rating scales were found. However, the factor structure of the ratings was generally inconsistent with that hypothesized. Analysis of training ratings using Cronbach's components of accuracy (Cronbach, 1955) indicated that BARS ratings generally exhibited less error than did the Behavioral Frequency ratings. The results are discussed in terms of both field and research implications

  12. Application of Human-Autonomy Teaming (HAT) Patterns to Reduce Crew Operations (RCO)

    Science.gov (United States)

    Shively, R. Jay; Brandt, Summer L.; Lachter, Joel; Matessa, Mike; Sadler, Garrett; Battiste, Henri

    2016-01-01

    Unmanned aerial systems, robotics, advanced cockpits, and air traffic management are all examples of domains that are seeing dramatic increases in automation. While automation may take on some tasks previously performed by humans, humans will still be required, for the foreseeable future, to remain in the system. The collaboration with humans and these increasingly autonomous systems will begin to resemble cooperation between teammates, rather than simple task allocation. It is critical to understand this human-autonomy teaming (HAT) to optimize these systems in the future. One methodology to understand HAT is by identifying recurring patterns of HAT that have similar characteristics and solutions. This paper applies a methodology for identifying HAT patterns to an advanced cockpit project.

  13. Four C: Community Coordinated Child Care: Concept, Goals, Operation.

    Science.gov (United States)

    Office of Child Development (DHEW), Washington, DC.

    This document reports on a day care program for children of working mothers, the 4-C program. This program is a federally sponsored effort conducted through community cooperation. Its goals include: (1) more and better child care, (2) mobilization of community resources and coordination of existing and new child care programs, (3) ensuring the…

  14. Person-Centered Care in the Home Setting for Parkinson’s Disease: Operation House Call Quality of Care Pilot Study

    Directory of Open Access Journals (Sweden)

    Nawaz Hack

    2015-01-01

    Full Text Available Objective. (1 To evaluate the feasibility of implementing and evaluating a home visit program for persons with Parkinson’s disease (PD in a rural setting. (2 To have movement disorders fellows coordinate and manage health care delivery. Background. The University of Florida, Center for Movement Disorders and Neurorestoration established Operation House Call to serve patients with PD who could not otherwise afford to travel to an expert center or to pay for medical care. PD is known to lead to significant disability, frequent hospitalization, early nursing home placement, and morbidity. Methods. This was designed as a quality improvement project. Movement disorders fellows travelled to the home(s of underserved PD patients and coordinated their clinical care. The diagnosis of Parkinson’s disease was confirmed using standardized criteria, and the Unified Parkinson’s Disease Rating Scale was performed and best treatment practices were delivered. Results. All seven patients have been followed up longitudinally every 3 to 6 months in the home setting, and they remain functional and independent. None of the patients have been hospitalized for PD related complications. Each patient has a new updatable electronic medical record. All Operation House Call cases are presented during video rounds for the interdisciplinary PD team to make recommendations for care (neurology, neurosurgery, neuropsychology, psychiatry, physical therapy, occupational therapy, speech therapy, and social work. One Operation House Call patient has successfully received deep brain stimulation (DBS. Conclusion. This program is a pilot program that has demonstrated that it is possible to provide person-centered care in the home setting for PD patients. This program could provide a proof of concept for the construction of a larger visiting physician or nurse program.

  15. The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

    Directory of Open Access Journals (Sweden)

    Ann M. Fugit, Pharm.D., BCPS

    2013-01-01

    Full Text Available Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit. Design: Retrospective, single-centered, chart review. Setting: Free, bilingual clinic in Richmond, VA. Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011. Main Outcome Measure: Types of interventions documented during the patient-pharmacist visit, categorized as medication review, patient education, or adherence monitoring. Results: Total of 32 patients accounted for 55 patient-pharmacist visits and 296 interventions. The most common interventions were medication review (66.9%, patient education (23.3%, and adherence monitoring (9.8%. Post-hoc analysis suggests Hispanic patients are more likely to be diagnosed with Acquired Immune Deficiency Syndrome (AIDS (P = 0.01, have current or history of opportunistic infection (OI (P=0.01, and have current or history of OI prophylaxis (P = 0.03. Adherence monitoring was less common amongst the non-Hispanics (7.1% compared to the Hispanic sub-population (16.5%, (P = 0.04. Conclusion: The role of ambulatory care pharmacists in a free and bilingual clinic goes beyond adherence monitoring. Pharmacists can be a valuable part of the patient care team by providing medication review and patient education for HIV and other co-morbidities within free clinics. Further research is warranted to assess outcomes and to further explore the underlying barriers to early HIV diagnosis and adherence within the Hispanic population.

  16. Safety in the Operating Theatre | a Multi Factor Approach for Patients and Teams

    NARCIS (Netherlands)

    Wauben, L.S.G.L.

    2010-01-01

    Due to the advances in high-tech technology in the operating theatre, the increased number of persons involved, and the increased complexity of surgical procedures, medical errors are inflicted. To answer the main question: How to improve patient safety in the operating theatre during surgery? this

  17. Implementation of an Interdisciplinary, Team-Based Complex Care Support Health Care Model at an Academic Medical Center: Impact on Health Care Utilization and Quality of Life

    OpenAIRE

    Christine Ritchie; Robin Andersen; Jessica Eng; Garrigues, Sarah K.; Gina Intinarelli; Helen Kao; Suzanne Kawahara; Kanan Patel; Lisa Sapiro; Anne Thibault; Erika Tunick; Barnes, Deborah E.

    2016-01-01

    Introduction The Geriatric Resources for the Assessment and Care of Elders (GRACE) program has been shown to decrease acute care utilization and increase patient self-rated health in low-income seniors at community-based health centers. Aims To describe adaptation of the GRACE model to include adults of all ages (named Care Support) and to evaluate the process and impact of Care Support implementation at an urban academic medical center. Setting 152 high-risk patients (≥5 ED visits or ≥2 hosp...

  18. A Delicate Balance - Adaptive Design and Team Learning in the Operating Theatre

    OpenAIRE

    Dekker-van Doorn, Connie

    2014-01-01

    markdownabstract__Abstract__ Since the publication of the Institute of Medicine (IOM) study “To Err is human”, followed by “Crossing the Quality Chasm” two years later, patient safety has become an important concern for all involved: patients, professionals and health care organisations (Bleich, 2005; Kohn, 2000). Over the last 10 years, significant improvements have been made and many innovative initiatives resulted in enhanced patient safety. At both national and international level checkli...

  19. Planning intensive care unit design using computer simulation modeling: optimizing integration of clinical, operational, and architectural requirements.

    Science.gov (United States)

    OʼHara, Susan

    2014-01-01

    Nurses have increasingly been regarded as critical members of the planning team as architects recognize their knowledge and value. But the nurses' role as knowledge experts can be expanded to leading efforts to integrate the clinical, operational, and architectural expertise through simulation modeling. Simulation modeling allows for the optimal merge of multifactorial data to understand the current state of the intensive care unit and predict future states. Nurses can champion the simulation modeling process and reap the benefits of a cost-effective way to test new designs, processes, staffing models, and future programming trends prior to implementation. Simulation modeling is an evidence-based planning approach, a standard, for integrating the sciences with real client data, to offer solutions for improving patient care.

  20. Community-based, interdisciplinary geriatric care team satisfaction with an electronic health record: a multimethod study.

    Science.gov (United States)

    Sockolow, Paulina S; Bowles, Kathryn H; Lehmann, Harold P; Abbott, Patricia A; Weiner, Jonathan P

    2012-06-01

    This multimethod study measured the impact of an electronic health record (EHR) on clinician satisfaction with clinical process. Subjects were 39 clinicians at a Program of All-inclusive Care for Elders (PACE) site in Philadelphia utilizing an EHR. Methods included the evidence-based evaluation framework, Health Information Technology Research-Based Evaluation Framework, which guided assessment of clinician satisfaction with surveys, observations, follow-up interviews, and actual EHR use at two points in time. Mixed-methods analysis of findings provided context for interpretation and improved validity. The study found that clinicians were satisfied with the EHR; however, satisfaction declined between time periods. Use of EHR was universal and wide and was differentiated by clinical role. Between time periods, EHR use increased in volume, with increased timeliness and decreased efficiency. As the first EHR evaluation at a PACE site from the perspective of clinicians who use the system, this study provides insights into EHR use in the care of older people in community-based healthcare settings. PMID:22411417

  1. The effect of two cognitive aid designs on team functioning during intra-operative anaphylaxis emergencies: a multi-centre simulation study.

    Science.gov (United States)

    Marshall, S D; Sanderson, P; McIntosh, C A; Kolawole, H

    2016-04-01

    This multi-centre repeated measures study was undertaken to determine how contrasting designs of cognitive aids affect team performance during simulated intra-operative anaphylaxis crises. A total of 24 teams consisting of a consultant anaesthetist, an anaesthetic trainee and anaesthetic assistant managed three simulated intra-operative anaphylaxis emergencies. Each team was assigned at random to a counterbalanced order of: no cognitive aid; a linear cognitive aid; and a branched cognitive aid, and scored for team functioning. Scores were significantly higher with a linear compared with either a branched version of the cognitive aid or no cognitive aid for 'Team Overall Behavioural Performance', difference between study groups (F-value) 5.8, p = 0.01. Aggregate scores were higher with the linear compared with the branched aid design (p = 0.03). Cognitive aids improve co-ordination of the team's activities and support team members to verbalise their actions. A linear design of cognitive aid improves team functioning more than a branched design.

  2. Primary health-care teams as adaptive organizations: exploring and explaining work variation using case studies in rural and urban Scotland.

    Science.gov (United States)

    Farmer, Jane; West, Christina; Whyte, Bruce; Maclean, Margaret

    2005-08-01

    It is acknowledged, internationally, that health-care practitioners' work differs between and urban areas. While several factors affect individual teams' activities, there is little understanding about how patterns of work evolve. Consideration of work in relation to local circumstances is important for training, devising contracts and redesigning services. Six case studies centred on Scottish rural and urban general practices were used to examine, in-depth, the activity of primary health-care teams. Quantitative workload data about patient contacts were collected over 24 months. Interviews and diaries revealed insightful qualitative data. Findings revealed that rural general practitioners and district nurses tended to conduct more consultations per practice patient compared with their urban counterparts. Conditions seen and work tasks varied between case study teams. Qualitative data suggested that the key reasons for variation were: local needs and circumstances; choices made about deployment of available time, team composition and the extent of access to other services. Primary care teams might be viewed as adaptive organization, with co-evolution of services produced by health professionals and local people. The study highlights limitations in the application of workload data and suggests that understanding the nature of work in relation to local circumstances is important in service redesign.

  3. [The implementation of interdisciplinarity in the work routine of the family health care team].

    Science.gov (United States)

    Scherer, Magda Duarte dos Anjos; de Pires, Denise Elvira Pires; Jean, Rémy

    2013-11-01

    Interdisciplinarity in the work routine of professionals of a Residency Course on Family Health in Southern Brazil was investigated in a qualitative study involving 11 residents and 5 supervisors of seven professions. Through interviews, observations and focal groups the existence of interdisciplinarity in practice was analyzed, duly identifying favorable and unfavorable aspects for its implementation. Interdisciplinarity was expressed as a complex process and concrete action, which occurs in the dramatic implications of its usage, in a dialectical relationship with the political and institutional context. The study revealed that working in family health care renders the work more complex and that the professionals experience difficulties in sharing knowledge and making the transition between multidisciplinarity and interdisciplinarity. The study concludes that interdisciplinarity requires the integrated use of knowledge in the multi-professional practice, the crossing of disciplinary boundaries, the development of competencies to address the challenges of the work environment and personal attitude as a basic component for professional action.

  4. [The implementation of interdisciplinarity in the work routine of the family health care team].

    Science.gov (United States)

    Scherer, Magda Duarte dos Anjos; de Pires, Denise Elvira Pires; Jean, Rémy

    2013-11-01

    Interdisciplinarity in the work routine of professionals of a Residency Course on Family Health in Southern Brazil was investigated in a qualitative study involving 11 residents and 5 supervisors of seven professions. Through interviews, observations and focal groups the existence of interdisciplinarity in practice was analyzed, duly identifying favorable and unfavorable aspects for its implementation. Interdisciplinarity was expressed as a complex process and concrete action, which occurs in the dramatic implications of its usage, in a dialectical relationship with the political and institutional context. The study revealed that working in family health care renders the work more complex and that the professionals experience difficulties in sharing knowledge and making the transition between multidisciplinarity and interdisciplinarity. The study concludes that interdisciplinarity requires the integrated use of knowledge in the multi-professional practice, the crossing of disciplinary boundaries, the development of competencies to address the challenges of the work environment and personal attitude as a basic component for professional action. PMID:24196886

  5. What's the buzz about BUZZ? A workshop to enhance communication between patients and their health care teams

    Directory of Open Access Journals (Sweden)

    S Lico

    2012-11-01

    Full Text Available Objective: BUZZ is a workshop designed to enhance communication between patients and health care providers (HCPs and results to date will be described. Background: A study of HIV patients interviewed about their treatment, identified several barriers to communication with their health care teams. Another study called BEAHIV, demonstrated low levels of agreement between patients and HCPs surrounding bothersome symptoms of ARV treatment. With a grant from Janssen, a workshop was designed by a faculty of HIV clinicians from across Canada, in conjunction with a behavioural specialist. The workshop covered several topics: identifying barriers to communication for HIV patients, learning about one's own preferred communication style, how to determine a patient's communication style, and ways to uncover issues associated with the patient's treatment, such as ARV-associated side effects. To date, 15 workshops have been conducted across the country. Results: At the end of the workshop, 85% of participants said they would start or continue to identify barriers to communication. At the start of each workshop, several before/after questions were asked. Only 45% of HCPs felt comfortable in adapting their communication towards patients with different behavioural styles prior to participating in the workshop. This increased to 84% after the workshop. Prior to the workshop, 68% of HCPs said they currently engage patients in proactive discussions surrounding ARV-associated side effects, increasing to 82% post-workshop. Prior to the workshop, 60% proactively engaged patients on the impact of ARV side effects on quality of life, which increased to 80% post-workshop. Several weeks after each workshop, a follow up with participants was conducted and it was found that many implemented changes in their practices as a result of what they learned. Conclusion: A workshop designed to enhance communication may have a beneficial effect on reducing communication barriers and

  6. Effect of a vascular access team on central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit : a systematic review

    NARCIS (Netherlands)

    Legemaat, Monique M; Jongerden, IP; van Rens, Roland M F P T; Zielman, Marjanne; van den Hoogen, Agnes

    2015-01-01

    OBJECTIVE: To review the effect of a vascular access team on the incidence of central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit. DATA SOURCES: MEDLINE, CINAHL, Embase, Web-of-Science and the Cochrane Library were searched until December 2013. STUDY

  7. Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams.

    Directory of Open Access Journals (Sweden)

    Patrick Hoek

    Full Text Available Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation.We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations. We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations.Of the 44,443 initial consultations, most were requested by general practitioners (73% and most concerned patients with cancer (86%. Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12 or COPD (OR 1.39; 95% CI: 1.15-1.69 than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40, agitation/delirium (OR 1.57; 95% CI: 1.47-1.68, exhaustion (OR 2.89; 95% CI: 2.61-3.20, euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96 or existential issues (OR 1.55; 95% CI: 1.31-1.83.In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.

  8. Effects of crew resource management training on the team performance of operators in an advanced nuclear power plant

    International Nuclear Information System (INIS)

    The objectives of the study are twofold: the development of a CRM training program appropriate to Korean NPPs and the evaluation of CRM training effectiveness. Firstly, the CRM program was developed with a focus on nontechnical skills - such as leadership, situational awareness, teamwork, and communication - which have been widely known to be critical for improving operational performance. Secondly, the effectiveness tests were conducted for two different crews of operators, performing six different emergency operation scenarios during a four-week period. All the crews (crews A and B) participated in the training program for the technical knowledge and skills, which were required to operate the simulator of the MCR during the first week. However, for the verification of the effectiveness of the CRM training program, only crew A was randomly selected to attend the CRM training after the technical knowledge and skills training. The results of the experiments showed that the CRM training program improved the individual attitudes of crew A with a statistical significance. The team skills of crew A were found to be significantly more advanced than those of crew B. However, the CRM training did not have a positive effect on enhancing the individual performance of crew A, as compared with that of crew B. (author)

  9. The Volcanic Ash Strategic Initiative Team (VAST) - operational testing activities and exercises

    Science.gov (United States)

    Wotawa, Gerhard; Arnold, Delia; Eckhardt, Sabine; Kristiansen, Nina; Maurer, Christian; Prata, Fred; Stohl, Andreas; Zehner, Claus

    2013-04-01

    The project VAST performs its activities within an ESA (European Space Agency) initiative to enhance the use of Earth Observation (EO) data in volcanic ash monitoring and forecasting. The VAST project aims at further exploring the suitability of EO data for such activities and to improve volcanic ash atmospheric transport forecasting services through exercises and demonstration activities in operational environments. Previous to the in-house deployment of the demonstration service, several exercises on operations and communication exchange are needed and first results are presented here. These exercises include technical in-house settings and conceptual planning of the operations with procedure development, volcanic eruptions drills that trigger the acquiring of data and dispersion/forecasting calculations with preliminary estimates of source terms and finally, an international exercise that provides a test case volcanic event to evaluate response times and the usefulness of the different products obtained. Products also include ensemble dispersion forecasts, on one hand multi-input ensembles utilizing the ECMWF EPS system, and on the other hand multi-model ensembles based on different dispersion models driven with different input data. As part of the work, socio-economic aspects need to be taken into account as well. This includes also the identification of best practices on how results can be presented to the stakeholders, including national authorities and policy makers, and the general public.

  10. What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

    Directory of Open Access Journals (Sweden)

    Désirée A. Lie

    2016-08-01

    Full Text Available Background: The student-run clinic (SRC has the potential to address interprofessional learning among health professions students. Purpose: To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. Methods: The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Results: Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50. Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Discussion: Interprofessional SRC participation promotes learning ‘with, from, and about’ each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal

  11. Analog Testing of Operations Concepts for Integration of an Earth-Based Science Team During Human Exploration of Mars

    Science.gov (United States)

    Chappell, Steven P.; Beaton, Kara H.; Graff, Trevor; Newton, Carolyn; Abercromby, Andrew F.; Gernhardt, Michael L.

    2017-01-01

    NASA Extreme Environment Mission Operations (NEEMO) is an underwater spaceflight analog that allows a true mission-like operational environment and uses buoyancy effects and added weight to simulate different gravity levels. A mission was undertaken in 2016, NEEMO 21. The mission was performed at the Aquarius undersea research habitat. During the mission, the effects of varying operations concepts on representative communication latencies associated with Mars missions were studied. Six subjects were weighed out to simulate near-zero or partial gravity and evaluated different operations concepts for integration and management of a simulated Earth-based science team (ST) to provide input and direction during exploration activities. Exploration traverses were planned in advance based on precursor data collected. Subjects completed science-related tasks including pre-sampling surveys and marine science-based sampling as a portion of their tasks on saturation dives up to 4 hours in duration that were to simulate extravehicular activity (EVA) on Mars. A one-way communication latency of 15 minutes between space and mission control was simulated throughout the missions. Objective data included task completion times, total EVA times, crew idle time, translation time, SBT assimilation time (defined as time available for ST to discuss data/imagery after it has been collected, in addition to the time taken to watch imagery and listen to audio streaming over latency). Subjective data included acceptability, simulation quality, capability assessment ratings, and comments. Results were collected and will be presented on the acceptability of the operations concepts studied and which capabilities are the most enabling/enhancing in the operations concept. Discussion is presented on the importance of designing EVA timelines to account for the length of the task, level of interaction with the ground that is required/desired, and communication latency.

  12. Study on team evaluation. Team process model for team evaluation

    International Nuclear Information System (INIS)

    Several studies have been done to evaluate or improve team performance in nuclear and aviation industries. Crew resource management is the typical example. In addition, team evaluation recently gathers interests in other teams of lawyers, medical staff, accountants, psychiatrics, executive, etc. However, the most evaluation methods focus on the results of team behavior that can be observed through training or actual business situations. What is expected team is not only resolving problems but also training younger members being destined to lead the next generation. Therefore, the authors set the final goal of this study establishing a series of methods to evaluate and improve teams inclusively such as decision making, motivation, staffing, etc. As the first step, this study develops team process model describing viewpoints for the evaluation. The team process is defined as some kinds of power that activate or inactivate competency of individuals that is the components of team's competency. To find the team process, the authors discussed the merits of team behavior with the experienced training instructors and shift supervisors of nuclear/thermal power plants. The discussion finds four team merits and many components to realize those team merits. Classifying those components into eight groups of team processes such as 'Orientation', 'Decision Making', 'Power and Responsibility', 'Workload Management', 'Professional Trust', 'Motivation', 'Training' and 'staffing', the authors propose Team Process Model with two to four sub processes in each team process. In the future, the authors will develop methods to evaluate some of the team processes for nuclear/thermal power plant operation teams. (author)

  13. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals.

    Science.gov (United States)

    Rodriguez, Annabelle; Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-08-01

    Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1-5 years and served 90-100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40-45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals and specific

  14. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals

    Science.gov (United States)

    Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-01-01

    Abstract Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1–5 years and served 90–100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40–45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals

  15. Morbidity in users of family health teams in the northeast of Minas Gerais based on the International Classification of Primary Care.

    Science.gov (United States)

    Silva, Valquiria M; Pereira, Ivelisa V S; Rocha, Maria de Jesus L; Caldeira, Antônio P

    2014-12-01

    This study aimed to characterize the profile of morbidity among users of family health teams in the northeastern macroregion of Minas Gerais, Brazil. This is a cross-sectional population-based study, developed with the teams of the Family Health Strategy (FHS). It was conducted by data collection, using semi-structured questionnaires with specific instruments adjusted for three categories of professional teams of the FHS: physicians, nurses and community health agents (CHA). We used the International Classification of Primary Care, second edition (ICPC-2) to encode morbidity. Information was collected from 17,988 people, and 10,855 (60.3%) were females; 1,662 (9.2%) questionnaires were related to care by the physician; 2,530 (14.1%) were related to care by nurses and 13,796 (76.7%) corresponded to visits by and meetings with the CHA. The main health problems were: circulatory diseases (especially hypertension), musculoskeletal problems (especially back pain) and diseases of the digestive tract (especially intestinal parasites), which accounted for more than 40% of the medical consultations. Nonspecific complaints and visits related to women's health were the most prevalent in the care by nurses. In meetings with CHA, complaints about respiratory, musculoskeletal and cardiovascular diseases were the most pointed. The morbidity profile observed does not differ substantially from the results of other studies. Small differences can be attributed to regional particularities. PMID:25388494

  16. Morbidity in users of Family Health teams in the northeast of Minas Gerais based on the International Classification of Primary Care

    Directory of Open Access Journals (Sweden)

    Valquiria M. Silva

    2014-12-01

    Full Text Available This study aimed to characterize the profile of morbidity among users of family health teams in the northeastern macroregion of Minas Gerais, Brazil. This is a cross-sectional population-based study, developed with the teams of the Family Health Strategy (FHS. It was conducted by data collection, using semi-structured questionnaires with specific instruments adjusted for three categories of professional teams of the FHS: physicians, nurses and community health agents (CHA. We used the International Classification of Primary Care, second edition (ICPC-2 to encode morbidity. Information was collected from 17,988 people, and 10,855 (60.3% were females; 1,662 (9.2% questionnaires were related to care by the physician; 2,530 (14.1% were related to care by nurses and 13,796 (76.7% corresponded to visits by and meetings with the CHA. The main health problems were: circulatory diseases (especially hypertension, musculoskeletal problems (especially back pain and diseases of the digestive tract (especially intestinal parasites, which accounted for more than 40% of the medical consultations. Nonspecific complaints and visits related to women's health were the most prevalent in the care by nurses. In meetings with CHA, complaints about respiratory, musculoskeletal and cardiovascular diseases were the most pointed. The morbidity profile observed does not differ substantially from the results of other studies. Small differences can be attributed to regional particularities.

  17. Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety.

    Science.gov (United States)

    Papaspyros, Sotiris C; Javangula, Kalyana C; Adluri, Rajeshwara Krishna Prasad; O'Regan, David J

    2010-01-01

    Error in health services delivery has long been recognised as a significant cause of inpatient morbidity and mortality. Root-cause analyses have cited communication failure as one of the contributing factors in adverse events. The formalised fighter pilot mission brief and debrief formed the basis of the National Aeronautics and Space Administration (NASA) crew resource management (CRM) concept produced in 1979. This is a qualitative analysis of our experience with the briefing-debriefing process applied to cardiac theatres. We instituted a policy of formal operating room (OR) briefing and debriefing in all cardiac theatre sessions. The first 118 cases were reviewed. A trouble-free operation was noted in only 28 (23.7%) cases. We experienced multiple problems in 38 (32.2%) cases. A gap was identified in the second order problem solving in relation to instrument repair and maintenance. Theatre team members were interviewed and their comments were subjected to qualitative analysis. The collaborative feeling is that communication has improved. The health industry may benefit from embracing the briefing-debriefing technique as an adjunct to continuous improvement through reflective learning, deliberate practice and immediate feedback. This may be the initial step toward a substantive and sustainable organizational transformation.

  18. Development of a Novel Nuclear Safety Culture Evaluation Method for an Operating Team Using Probabilistic Safety Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sangmin; Lee, Seung Min; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2015-05-15

    IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea.

  19. Development of a Novel Nuclear Safety Culture Evaluation Method for an Operating Team Using Probabilistic Safety Analysis

    International Nuclear Information System (INIS)

    IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea

  20. Controlled trial of a collaborative primary care team model for patients with diabetes and depression: Rationale and design for a comprehensive evaluation

    Directory of Open Access Journals (Sweden)

    Johnson Jeffrey A

    2012-08-01

    Full Text Available Abstract Background When depression accompanies diabetes, it complicates treatment, portends worse outcomes and increases health care costs. A collaborative care case-management model, previously tested in an urban managed care organization in the US, achieved significant reduction of depressive symptoms, improved diabetes disease control and patient-reported outcomes, and saved money. While impressive, these findings need to be replicated and extended to other healthcare settings. Our objective is to comprehensively evaluate a collaborative care model for comorbid depression and type 2 diabetes within a Canadian primary care setting. Methods/design We initiated the TeamCare model in four Primary Care Networks in Northern Alberta. The intervention involves a nurse care manager guiding patient-centered care with family physicians and consultant physician specialists to monitor progress and develop tailored care plans. Patients eligible for the intervention will be identified using the Patient Health Questionnaire-9 as a screen for depressive symptoms. Care managers will then guide patients through three phases: 1 improving depressive symptoms, 2 improving blood glucose, blood pressure and cholesterol, and 3 improving lifestyle behaviors. We will employ the RE-AIM framework for a comprehensive and mixed-methods approach to our evaluation. Effectiveness will be assessed using a controlled “on-off” trial design, whereby eligible patients would be alternately enrolled in the TeamCare intervention or usual care on a monthly basis. All patients will be assessed at baseline, 6 and 12 months. Our primary analyses will be based on changes in two outcomes: depressive symptoms, and a multivariable, scaled marginal model for the combined outcome of global disease control (i.e., A1c, systolic blood pressure, LDL cholesterol. Our planned enrolment of 168 patients will provide greater than 80% power to observe clinically important improvements in all

  1. Your Health Care Team

    Science.gov (United States)

    ... blood sugar and blood fat levels to balance food with medications and activity to read food labels to make ... little or no alcohol to avoid any possible interaction between the two medications. Dentist People with diabetes are at somewhat greater ...

  2. Co-operative bidding of SMEs in health care sector.

    Science.gov (United States)

    Mezgár, István; Kovács, György; Bonfatti, Fabio

    2002-01-01

    Tendering become an important process for customers in the health care sector to select products and services from the market for the lowest price, with the highest quality and with the shortest delivery time. The number of SMEs (Small and Medium-sized Enterprises) delivering products or services for the health care sector is increasing, but they have usually limited capital and expertise to participate in tenders. The paper introduces a possible solution for this problem, when SMEs form special groups, so called Smart Bidding Organisations (SBO), to prepare a bid for the tender jointly. The SBO appears for the customer (tender issuer) as a single enterprise and the bidding procedure will be faster and less expensive in this way. PMID:15460809

  3. Health Care International

    OpenAIRE

    2006-01-01

    This is an interactive quiz for the team representing the Health Care International (HCI) in an educational game to clarify its role and relationship with other provincial reconstruction teams (PRTs), non-governmental organizations (NGOs), and international organizations (IOs) involved in the broad area of humanitarian assistance, relief operations, development and reconstruction in Afghanistan. The educational game involves the following organizations: Health Care International (HCI), Afghan...

  4. The meaning of care for operating room nursing

    OpenAIRE

    Cléton Salbego; Carla da Silveira Dornelles; Patrícia Bitencourt Toscani Greco; Vânia Marta Pradebon; Gabriela Fávero Alberti

    2016-01-01

    Objective: to understand the meaning of care for nursing technicians who work in the Surgical Center of a general hospital in the western border of Rio Grande do Sul/Brazil. Methods: this is a qualitative research, with an exploratory and descriptive approach. The technique used for data collection was a semi-structured interview and notes from the field diary were available for support. The respondents were eight nursing technicians of the Surgical Center. Results: it can be emphasized that ...

  5. The influence of individual and team cognitive ability on operators' task and safety performance: a multilevel field study in nuclear power plants.

    Science.gov (United States)

    Zhang, Jingyu; Li, Yongjuan; Wu, Changxu

    2013-01-01

    While much research has investigated the predictors of operators' performance such as personality, attitudes and motivation in high-risk industries, its cognitive antecedents and boundary conditions have not been fully investigated. Based on a multilevel investigation of 312 nuclear power plant main control room operators from 50 shift teams, the present study investigated how general mental ability (GMA) at both individual and team level can influence task and safety performance. At the individual level, operators' GMA was predictive of their task and safety performance and this trend became more significant as they accumulated more experience. At the team level, we found team GMA had positive influences on all three performance criteria. However, we also found a "big-fish-little-pond" effect insofar as team GMA had a relatively smaller effect and inhibited the contribution of individual GMA to workers' extra-role behaviors (safety participation) compared to its clear beneficial influence on in-role behaviors (task performance and safety compliance). The possible mechanisms related to learning and social comparison processes are discussed.

  6. The influence of individual and team cognitive ability on operators' task and safety performance: a multilevel field study in nuclear power plants.

    Directory of Open Access Journals (Sweden)

    Jingyu Zhang

    Full Text Available While much research has investigated the predictors of operators' performance such as personality, attitudes and motivation in high-risk industries, its cognitive antecedents and boundary conditions have not been fully investigated. Based on a multilevel investigation of 312 nuclear power plant main control room operators from 50 shift teams, the present study investigated how general mental ability (GMA at both individual and team level can influence task and safety performance. At the individual level, operators' GMA was predictive of their task and safety performance and this trend became more significant as they accumulated more experience. At the team level, we found team GMA had positive influences on all three performance criteria. However, we also found a "big-fish-little-pond" effect insofar as team GMA had a relatively smaller effect and inhibited the contribution of individual GMA to workers' extra-role behaviors (safety participation compared to its clear beneficial influence on in-role behaviors (task performance and safety compliance. The possible mechanisms related to learning and social comparison processes are discussed.

  7. The influence of individual and team cognitive ability on operators' task and safety performance: a multilevel field study in nuclear power plants.

    Science.gov (United States)

    Zhang, Jingyu; Li, Yongjuan; Wu, Changxu

    2013-01-01

    While much research has investigated the predictors of operators' performance such as personality, attitudes and motivation in high-risk industries, its cognitive antecedents and boundary conditions have not been fully investigated. Based on a multilevel investigation of 312 nuclear power plant main control room operators from 50 shift teams, the present study investigated how general mental ability (GMA) at both individual and team level can influence task and safety performance. At the individual level, operators' GMA was predictive of their task and safety performance and this trend became more significant as they accumulated more experience. At the team level, we found team GMA had positive influences on all three performance criteria. However, we also found a "big-fish-little-pond" effect insofar as team GMA had a relatively smaller effect and inhibited the contribution of individual GMA to workers' extra-role behaviors (safety participation) compared to its clear beneficial influence on in-role behaviors (task performance and safety compliance). The possible mechanisms related to learning and social comparison processes are discussed. PMID:24391964

  8. Changes in Perceptions and Attitudes of Healthcare Profession Students Pre and Post Academic Course Experience of Team-Based 'Care for the Critically Ill'.

    Science.gov (United States)

    Clark, Karen; Congdon, Heather Brennan; Macmillan, Kelley; Gonzales, Jeffrey P; Guerra, Adriana

    2015-01-01

    The aim of this study was to describe the development and outcomes of an interprofessional course "Interprofessional Care of the Critically Ill," involving pharmacy, nursing, social work, and respiratory therapy students from two universities. An institutional review board-approved survey was adapted from the TeamSTEPPS surveys investigating clinical practitioners' attitudes and perceptions regarding teamwork, collaboration, and interprofessional engagement. Items applicable to an academic setting were revised and resulted in a 28-statement survey and comments section. Participation was voluntary, and students were requested to participate in the survey on the first and last day of class. There was a significant increase in the perceived understanding of scope of practice of other disciplines from the beginning to end of class (24.4 to 60%, strongly agreed/agreed). Furthermore, students gained appreciation for the complexities associated with working in an interprofessional team with a significant increase in the percent agreeing and strongly agreeing that working on an interdisciplinary team is challenging (66.7 to 81%). Students and faculty gained a greater understanding and appreciation for other disciplines represented in the class and are therefore better prepared to engage in health care teams upon graduation. IPE should be embedded in curriculums and not just an add-on. PMID:26194965

  9. [Montérégie Comprehensive Cancer Care Centre: integrating nurse navigators in Montérégie's oncology teams: the process. Part 2].

    Science.gov (United States)

    Plante, Anne; Joannette, Sonia

    2009-01-01

    Quebec's Oncology Nurse Navigators (or "IPOs" after their French acronym) have been integrated in the entire Montérégie health care region. They have been agents of change mandated with implementing a philosophy of care that centres on the patients and their families, and is delivered by oncology teams. The goal of this second article is to describe the role of IPOs in practice, the problems encountered in the various contexts and the solutions brought forward to facilitate their integration. The training of IPOs, the support they receive from administrators, the deployment of interdisciplinary teams dedicated to oncology, the holding of regular structured interdisciplinary meetings and the training of professionals, and development of standardized work instruments are discussed. The observed impacts of introducing IPOs will also be examined.

  10. A designated centre for people with disabilities operated by Western Care Association, Mayo

    LENUS (Irish Health Repository)

    Whitford, David L

    2007-01-01

    BACKGROUND: There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. METHODS\\/DESIGN: In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. DISCUSSION: The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more

  11. Creating a gold medal Olympic and Paralympics health care team: a satisfaction survey of the mobile medical unit/polyclinic team training for the Vancouver 2010 winter games

    Science.gov (United States)

    2013-01-01

    Background The mobile medical unit/polyclinic (MMU/PC) was an essential part of the medical services to support ill or injured Olympic or Paralympics family during the 2010 Olympic and Paralympics winter games. The objective of this study was to survey the satisfaction of the clinical staff that completed the training programs prior to deployment to the MMU. Methods Medical personnel who participated in at least one of the four training programs, including (1) week-end sessions; (2) web-based modules; (3) just-in-time training; and (4) daily simulation exercises were invited to participate in a web-based survey and comment on their level of satisfaction with training program. Results A total of 64 (out of 94 who were invited) physicians, nurses and respiratory therapists completed the survey. All participants reported favorably that the MMU/PC training positively impacted their knowledge, skills and team functions while deployed at the MMU/PC during the 2010 Olympic Games. However, components of the training program were valued differently depending on clinical job title, years of experience, and prior experience in large scale events. Respondents with little or no experience working in large scale events (45%) rated daily simulations as the most valuable component of the training program for strengthening competencies and knowledge in clinical skills for working in large scale events. Conclusion The multi-phase MMU/PC training was found to be beneficial for preparing the medical team for the 2010 Winter Games. In particular this survey demonstrates the effectiveness of simulation training programs on teamwork competencies in ad hoc groups. PMID:24225074

  12. CARES: Carbonaceous Aerosol and Radiative Effects Study Operations Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zaveri, RA; Shaw, WJ; Cziczo, DJ

    2010-07-12

    The CARES field campaign is motivated by the scientific issues described in the CARES Science Plan. The primary objectives of this field campaign are to investigate the evolution and aging of carbonaceous aerosols and their climate-affecting properties in the urban plume of Sacramento, California, a mid-size, mid-latitude city that is located upwind of a biogenic volatile organic compound (VOC) emission region. Our basic observational strategy is to make comprehensive gas, aerosol, and meteorological measurements upwind, within, and downwind of the urban area with the DOE G-1 aircraft and at strategically located ground sites so as to study the evolution of urban aerosols as they age and mix with biogenic SOA precursors. The NASA B-200 aircraft, equipped with the High Spectral Resolution Lidar (HSRL), digital camera, and the Research Scanning Polarimeter (RSP), will be flown in coordination with the G-1 to characterize the vertical and horizontal distribution of aerosols and aerosol optical properties, and to provide the vertical context for the G-1 and ground in situ measurements.

  13. 77 FR 48007 - Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds...

    Science.gov (United States)

    2012-08-10

    ... care transactions and other administrative simplification issues through the Health Insurance... Transactions In the July 8, 2011 Federal Register (76 FR 40458), we published an IFC titled, ``Administrative... rules (``technical rules'') while other operating rules applied only to the specific...

  14. A Case Study on Collective Cognition and Operation in Team-Based Computer Game Design by Middle-School Children

    Science.gov (United States)

    Ke, Fengfeng; Im, Tami

    2014-01-01

    This case study examined team-based computer-game design efforts by children with diverse abilities to explore the nature of their collective design actions and cognitive processes. Ten teams of middle-school children, with a high percentage of minority students, participated in a 6-weeks, computer-assisted math-game-design program. Essential…

  15. Within-team Patterns of Communication and Referral in Multimodal Treatment of Chronic Low Back Pain Patients by an Integrative Care Team

    OpenAIRE

    O'Connor, Bonnie B.; Eisenberg, David M.; Buring, Julie E.; Liang, Catherine L; Osypiuk, Kamila; Levy, Donald B.; Wayne, Peter M.

    2015-01-01

    Background: Nonspecific chronic low back pain (CLBP) is a highly prevalent and costly public health problem with few treatment options that provide consistent and greater than modest benefits. Treatment of CLBP is shifting from unimodal to multimodal and multidisciplinary approaches, including biopsychosocially-based complementary and integrative care. Multidisciplinary approaches require unique levels of communication and coordination amongst clinicians; however, to date few studies have eva...

  16. Information Sharing for Care Coordination

    OpenAIRE

    Amir, Ofra; Grosz, Barbara J.; Stern, Roni; Sanders, Lee M.

    2013-01-01

    Teamwork and care coordination are of increasing importance to health care delivery and patient safety and health. This paper describes our initial work on developing agents that are able to make intelligent information sharing decisions to support a diverse, evolving team of care providers in constructing and maintaining a shared plan that operates in uncertain environments and over a long time horizon.

  17. Measuring team factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

    OpenAIRE

    Brennan, Sue E; Bosch, Marije; Buchan, Heather; Green, Sally E

    2013-01-01

    Background Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instr...

  18. Review Team Focused Modeling Analysis of Radial Collector Well Operation on the Hypersaline Groundwater Plume beneath the Turkey Point Site near Homestead, Florida

    Energy Technology Data Exchange (ETDEWEB)

    Oostrom, Martinus; Vail, Lance W.

    2016-09-13

    Researchers at Pacific Northwest National Laboratory served as members of a U.S. Nuclear Regulatory Commission review team for the Florida Power & Light Company’s application for two combined construction permits and operating licenses (combined licenses or COLs) for two proposed new reactor units—Turkey Point Units 6 and 7. The review team evaluated the environmental impacts of the proposed action based on the October 29, 2014 revision of the COL application, including the Environmental Report, responses to requests for additional information, and supplemental information. As part of this effort, team members tasked with assessing the environmental effects of proposed construction and operation of Units 6 and 7 at the Turkey Point site reviewed two separate modeling studies that analyzed the interaction between surface water and groundwater that would be altered by the operation of radial collector wells (RCWs) at the site. To further confirm their understanding of the groundwater hydrodynamics and to consider whether certain actions, proposed after the two earlier modeling studies were completed, would alter the earlier conclusions documented by the review team in their draft environmental impact statement (EIS; NRC 2015), a third modeling analysis was performed. The third modeling analysis is discussed in this report.

  19. Review Team Focused Modeling Analysis of Radial Collector Well Operation on the Hypersaline Groundwater Plume beneath the Turkey Point Site near Homestead, Florida

    Energy Technology Data Exchange (ETDEWEB)

    Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vail, Lance W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-08-01

    Researchers at Pacific Northwest National Laboratory served as members of a U.S. Nuclear Regulatory Commission review team for the Florida Power & Light Company’s application for two combined construction permits and operating licenses (combined licenses or COLs) for two proposed new reactor units—Turkey Point Units 6 and 7. The review team evaluated the environmental impacts of the proposed action based on the October 29, 2014 revision of the COL application, including the Environmental Report, responses to requests for additional information, and supplemental information. As part of this effort, team members tasked with assessing the environmental effects of proposed construction and operation of Units 6 and 7 at the Turkey Point site reviewed two separate modeling studies that analyzed the interaction between surface water and groundwater that would be altered by the operation of radial collector wells (RCWs) at the site. To further confirm their understanding of the groundwater hydrodynamics and to consider whether certain actions, proposed after the two earlier modeling studies were completed, would alter the earlier conclusions documented by the review team in their draft environmental impact statement (EIS; NRC 2015), a third modeling analysis was performed. The third modeling analysis is discussed in this report.

  20. [Mobile team of palliative care in a department of neurology: value of two multidisciplinary and professional groups fruit of a joint distribution of the palliative approach and ethical support].

    Science.gov (United States)

    Baudoin, D; Krebs, S

    2013-04-01

    This article describes how a mobile team of palliative care and a department of neurology learned to cope with many complex end-of-life situations. After a brief introduction to inter-team cooperation, clinical work of the mobile team with patients and families and its cooperation with the neurology team are presented. The specificity of supportive care in neurology is also analyzed. Two interdisciplinary and multi-professional tools - the Palliative Care Resource Group and the Ethics Consultation Group - are described, with their activities and their goals. The Palliative Care Resource Group is a specific entity whose identity lies at the crossroads between commonly recognized organizational units: clinic staff, clinical practice, ethical or organizational analysis groups (Balint, 1960), discussion groups (Rusznievski, 1999), training groups. It has several objectives: 1) create a robust conceptual environment enabling the pursuit of palliative care practices without relying on the empty paradigm of stereotypical actions; if suffering cannot be avoided, psychic development and transformation can be promoted; 2) attempt to prevent caregiver burnout; 3) help support and strengthen the collective dimension of the team, learning a mode of care which goes beyond the execution of coded actions; 4) enhance the primary dimension of care, i.e. taking care, especially in clinical situations where conventional wisdom declares that "nothing more can be done."; 5) promote group work so new ideas arising from the different teams influence the behavior of all caregivers. The Ethics Consultation Group organizes its work in several steps. The first step is discernment, clearly identifying the question at hand with the clinical staff. This is followed by a consultation between the clinical team, the patient, the family and the referring physician to arrive at a motivated decision, respecting the competent patient's opinion. The final step is an evaluation of the decision and its

  1. Propositional Team Logics

    OpenAIRE

    Yang, Fan; Väänänen, Jouko

    2016-01-01

    We consider team semantics for propositional logic. In team semantics the truth of a propositional formula is considered in a set of valuations, called a team, rather than in an individual valuation. This offers the possibility to give meaning to concepts such as dependence, independence and inclusion. We define an expressively maximal propositional team logic. This requires going beyond the logical operations of classical propositional logic. We exhibit a hierarchy of logics between the smal...

  2. Development of a quantitative evaluation method for non-technical skills preparedness of operation teams in nuclear power plants to deal with emergency conditions

    International Nuclear Information System (INIS)

    Highlights: ► We selected important non-technical skills for emergency conditions in NPPs. ► We proposed an evaluation method for the selected non-technical skills. ► We conducted two sets of training, 9 experiments each, with real plant operators. ► Teams showed consistent non-technical skills preparedness with changing scenarios. ► Non-technical skills preparedness gives plausible explanations why teams fail tasks. -- Abstract: Many statistical results from safety reports tell that human related errors are the dominant influencing factor on the safe operation of power plants. Fortunately, training operators for the technical and non-technical skills can prevent many types of human errors. In this study, four important non-technical skills in safety critical industries – medical, aviation, and nuclear – were selected to describe behaviors of operation teams in emergency conditions of nuclear power plants (NPPs): communication, leadership, situation awareness, and decision-making skills. Also, preparedness of the non-technical skills was defined, and a quantification method of those skills called NoT-SkiP (Non-Technical Skills Preparedness) was developed to represent ‘how well operation teams are prepared to deal with emergency conditions’ in the non-technical skills aspect by analyzing monitoring-control patterns and a verbal protocol. Two case studies were conducted to validate the method. The first case was applied to Loss of Coolant Accident (LOCA) and Steam Generator Tube Rupture (SGTR) training. Independent variables were scenario, training repetition, and members. Relative values of the NoT-SkiP showed a consistent trend with changing scenarios. However, when training was repeated with the same scenario, NoT-SkiP values of some team were changed. It was supposed that leaders of some teams exerted their knowledge acquired from the previous training and gave up thoroughness of using procedures. When members especially who play a dominant role

  3. Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study; a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mol Ben

    2010-10-01

    Full Text Available Abstract Background There are many avoidable deaths in hospitals because the care team is not well attuned. Training in emergency situations is generally followed on an individual basis. In practice, however, hospital patients are treated by a team composed of various disciplines. To prevent communication errors, it is important to focus the training on the team as a whole, rather than on the individual. Team training appears to be important in contributing toward preventing these errors. Obstetrics lends itself to multidisciplinary team training. It is a field in which nurses, midwives, obstetricians and paediatricians work together and where decisions must be made and actions must be carried out under extreme time pressure. It is attractive to belief that multidisciplinary team training will reduce the number of errors in obstetrics. The other side of the medal is that many hospitals are buying expensive patient simulators without proper evaluation of the training method. In the Netherlands many hospitals have 1,000 or less annual deliveries. In our small country it might therefore be more cost-effective to train obstetric teams in medical simulation centres with well trained personnel, high fidelity patient simulators, and well defined training programmes. Methods/design The aim of the present study is to evaluate the cost-effectiveness of multidisciplinary team training in a medical simulation centre in the Netherlands to reduce the number of medical errors in obstetric emergency situations. We plan a multicentre randomised study with the centre as unit of analysis. Obstetric departments will be randomly assigned to receive multidisciplinary team training in a medical simulation centre or to a control arm without any team training. The composite measure of poor perinatal and maternal outcome in the non training group was thought to be 15%, on the basis of data obtained from the National Dutch Perinatal Registry and the guidelines of the

  4. A designated centre for people with disabilities operated by RehabCare, Donegal

    LENUS (Irish Health Repository)

    Flynn, Maura G

    2012-02-01

    BACKGROUND: Hospital clinicians are increasingly expected to practice evidence-based medicine (EBM) in order to minimize medical errors and ensure quality patient care, but experience obstacles to information-seeking. The introduction of a Clinical Informationist (CI) is explored as a possible solution. AIMS: This paper investigates the self-perceived information needs, behaviour and skill levels of clinicians in two Irish public hospitals. It also explores clinicians\\' perceptions and attitudes to the introduction of a CI into their clinical teams. METHODS: A questionnaire survey approach was utilised for this study, with 22 clinicians in two hospitals. Data analysis was conducted using descriptive statistics. RESULTS: Analysis showed that clinicians experience diverse information needs for patient care, and that barriers such as time constraints and insufficient access to resources hinder their information-seeking. Findings also showed that clinicians struggle to fit information-seeking into their working day, regularly seeking to answer patient-related queries outside of working hours. Attitudes towards the concept of a CI were predominantly positive. CONCLUSION: This paper highlights the factors that characterise and limit hospital clinicians\\' information-seeking, and suggests the CI as a potentially useful addition to the clinical team, to help them to resolve their information needs for patient care.

  5. [Association between coverage by oral health teams in the family health and the increase in dental care output in Brazilian municipalities, 1999 and 2011].

    Science.gov (United States)

    Corrêa, Gabriel Trevizan; Celeste, Roger Keller

    2015-12-01

    The aim of this study was to analyze the association between population coverage by oral health teams under the Family Health Strategy (FHS) and the difference in 1999 and 2011 in rates of use of public dental services in Brazilian municipalities. The sample included all 5,507 municipalities in both years. Data were used from government information systems to perform logistic regression for modeling the increase in procedure rates. By 2011, 85% of Brazil's municipalities had oral health teams under the FHS and there had been an increase in infrastructure, human and financial resources. Dental care output increased 49.5% from 1999 to 2011. Municipalities that incorporated more than 3 oral health teams per 10,000 inhabitants showed higher odds of increasing their rates of community procedures (OR = 1.61, 95%CI: 1.23-2.11), prophylactic procedures (OR = 2.05, CI95%: 1.56-2.69), restorations (OR = 2.07, 95%CI: 1.58-2.71), and extractions (OR = 1.53, 95%CI: 1.19-1.97) after adjusting for socio-demographic factors and variations in physical, human and financial resources. The incorporation of oral health teams into the FHS appears more effective for increasing indicators of the use of dental services.

  6. Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

    Science.gov (United States)

    Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

    2015-12-01

    Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. PMID:26116611

  7. On championship TEAMS.

    Science.gov (United States)

    Jones, Daniel B

    2016-02-01

    Championship teams tap the strengths of the individuals working toward a common goal. Surgery is a team sport, which seeks to provide the very best patient care. For surgeons we seek to cure disease, alleviate suffering, and train the next generation of surgeons. When at our best, we build teamwork with a winning attitude, trust, respect, and love. Together there are no limits to what championship teams can achieve with passion, dedicated practice, mutual respect, and a little luck.

  8. Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study.

    Directory of Open Access Journals (Sweden)

    Chien-Chou Pan

    Full Text Available In Taiwan, cancer is the top cause of death, and the mortality rate of lung cancer is the highest of all cancers. Some studies have demonstrated that multidisciplinary team (MDT care can improve survival rates of non-small cell lung cancer (NSCLC patients. However, no study has discussed the effect of MDT care on different stages of NSCLC. The target population for this study consisted of patients with NSCLC newly diagnosed in the 2005-2010 Cancer Registry. The data was linked with the 2002-2011 National Health Insurance Research Database and the 2005-2011 Cause of Death Statistics Database. The multivariate Cox proportional hazards model was used to explore whether the involvement of MDT care had an effect on survival. This study applied the propensity score as a control variable to reduce selection bias between patients with and without involvement of MDT care. The adjusted hazard ratio (HR of death of MDT participants with stage III & IV NSCLC was significantly lower than that of MDT non-participants (adjusted HR = 0.87, 95% confidence interval = 0.84-0.90. This study revealed that MDT care are significantly associated with higher survival rate of patients with stage III and IV NSCLC, and thus MDT care should be used in the treatment of these patients.

  9. Relationships among Team Trust, Team Cohesion, Team Satisfaction and Project Team Effectiveness as Perceived by Project Managers in Malaysia

    OpenAIRE

    Han-Ping Fung

    2014-01-01

    Today, more and more project teams are formed to achieve organizational objectives as organizations generally recognized the importance and benefits of project teams. There is a compelling reason to study what are the team outcome factors that can predict project team effectiveness as it is unclear whether these team outcome factors can yield the same result in project setting whereby there is resource and time constraint compare to normal work teams which are ongoing and operational in natur...

  10. Assembling the Project Team.

    Science.gov (United States)

    Mills, Donald B.

    2003-01-01

    Although the approval of a project's design and budget typically rests with the campus governing board, a project team determines the configuration, the cost, and the utility of the completed project. Because of the importance of these decisions, colleges and universities must select project team members carefully. (Author)

  11. 地震灾害紧急救援队伍救援行动的规范%Code for Operations for Earthquake Disaster Search and Rescue Team

    Institute of Scientific and Technical Information of China (English)

    吴新燕; 陈虹; 顾建华

    2012-01-01

    介绍了制定地震灾害紧急救援队伍行动规范的背景,阐述了地震灾害紧急救援队伍行动的阶段,给出了地震现场灾害紧急救援队伍行动规范的内容.该规范将有效地规范和协调地震灾害紧急救援队伍的救援行动,提高救援能力与效率,最大限度地减少人员伤亡.%This paper introduced the background of the code for rescue operations for earthquake disaster search and rescue team, expatiated phases of operations and presented contents of code for operations of the team. This code will effectively regulate and coordinate search and rescue operations of the earthquake disaster search and rescue team, improve rescue capabilities and efficiencies and minimize casualties.

  12. A comparison between telephone and bedside consultations given by palliative care consultation teams in the Netherlands: results from a two-year nationwide registration.

    Science.gov (United States)

    Schrijnemaekers, Veron; Courtens, Annemie; Kuin, Annemieke; van der Linden, Barbara; Vernooij-Dassen, Myrra; van Zuylen, Lia; van den Beuken, Marieke

    2005-06-01

    Palliative Care Consultation (PCC) teams in The Netherlands give support to professional caregivers in palliative care. In contrast to many other countries, consultants only give advice. They do not give prescriptions. Most consultations are given by phone; in some, the consultant also visits the patient. For two years, the PCC teams registered all consultations prospectively on a standard registration form in a nationwide database. The aim of this study was to obtain more insight into the possible differences between telephone and bedsides consultations with regard to characteristics of consultants, requesting caregivers, and the patients, as well as the number and kind of problems discussed. The data demonstrate that bedside consultations show more variety in requesting caregivers and are conducted more often for patients. Bedside consultations also addressed a higher number of problems and a wider range of domains (e.g., psychological, spiritual, daily functioning, and support for informal caregivers). These results suggest that bedside consultations have a surplus value compared to telephone consultations. More rigorous study is needed to compare the relative merits of different methods of consultations in palliative care. PMID:15963863

  13. Interdisciplinary Collaboration in Hospice Team Meetings

    OpenAIRE

    Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Regehr, Kelly

    2010-01-01

    Hospice and palliative care teams provide interdisciplinary care to seriously-ill and terminally-ill patients and their families. Care teams are comprised of medical and non-medical disciplines and include volunteers and lay workers in healthcare. The authors explored the perception of collaboration among hospice team members and actual collaborative communication practices in team meetings. The data set consisted of videotaped team meetings, some of which included caregiver participation, an...

  14. Demand and Supply–Based Operating Modes—A Framework for Analyzing Health Care Service Production

    Science.gov (United States)

    Lillrank, Paul; Groop, P Johan; Malmström, Tomi J

    2010-01-01

    Context: The structure of organizations that provide services should reflect the possibilities of and constraints on production that arise from the market segments they serve. Organizational segmentation in health care is based on urgency and severity as well as disease type, bodily function, principal method, or population subgroup. The result is conflicting priorities, goals, and performance metrics. A managerial perspective is needed to identify activities with similar requirements for integration, coordination, and control. Methods: The arguments in this article apply new reasoning to the previous literature. Findings: The method used in this article to classify health care provision distinguishes different types of health problems that share generic constraints of production. Conclusions: The analysis leads to seven different demand-supply combinations, each with its own operational logic. These are labeled demand and supply–based operating modes (DSO modes), and constitute the managerial building blocks of health care organizations. The modes are Prevention, Emergency, One visit, Project, Elective, Cure, and Care. As analytical categories the DSO modes can be used to understand current problems. Several operating modes in one unit create managerial problems of conflicting priorities, goals, and performance metrics. The DSO modes are constructed as managerially homogeneous categories or care platforms responding to general types of demand, and supply constraints. The DSO modes bring methods of industrial management to bear on efforts to improve health care. PMID:21166870

  15. Identifying the key elements of an education package to up-skill multidisciplinary adult specialist palliative care teams caring for young adults with life-limiting conditions: an online Delphi study

    Science.gov (United States)

    Sivell, Stephanie; Lidstone, Victoria; Taubert, Mark; Thompson, Catherine; Nelson, Annmarie

    2015-01-01

    Objectives To collect the views of experts to inform the development of an education package for multidisciplinary adult specialist palliative care (SPC) teams caring for young people with life-limiting conditions. Methods A modified online Delphi process collated expert opinion on format, delivery and content of an education package to up-skill adult SPC teams. Round 1 participants (n=44) answered free-text questions, generating items for Round 2. In Round 2, 68 participants rated the extent to which they agreed/disagreed with the items on 5-point Likert-type scales. Median and mean scores assessed the importance of each item. IQR scores assessed level of consensus for each item; items lacking consensus were rerated by 35 participants in Round 3. Results In the Delphi, consensus was reached on a range of suggested formats, on who should deliver the training, and on several clinical, psychosocial and practical topics. Conclusions Development of a continuous/rolling programme of education, tailored for content and mode of delivery and incorporated into working practice is recommended. As a direct outcome of the results of this study, a series of six linked study days has been established, focusing specifically on the issues around caring for young adults with life-limiting conditions and palliative care needs. PMID:24670554

  16. Consensus statement on advancing research in emergency department operations and its impact on patient care.

    Science.gov (United States)

    Yiadom, Maame Yaa A B; Ward, Michael J; Chang, Anna Marie; Pines, Jesse M; Jouriles, Nick; Yealy, Donald M

    2015-06-01

    The consensus conference on "Advancing Research in Emergency Department (ED) Operations and Its Impact on Patient Care," hosted by The ED Operations Study Group (EDOSG), convened to craft a framework for future investigations in this important but understudied area. The EDOSG is a research consortium dedicated to promoting evidence-based clinical practice in emergency medicine. The consensus process format was a modified version of the NIH Model for Consensus Conference Development. Recommendations provide an action plan for how to improve ED operations study design, create a facilitating research environment, identify data measures of value for process and outcomes research, and disseminate new knowledge in this area. Specifically, we call for eight key initiatives: 1) the development of universal measures for ED patient care processes; 2) attention to patient outcomes, in addition to process efficiency and best practice compliance; 3) the promotion of multisite clinical operations studies to create more generalizable knowledge; 4) encouraging the use of mixed methods to understand the social community and human behavior factors that influence ED operations; 5) the creation of robust ED operations research registries to drive stronger evidence-based research; 6) prioritizing key clinical questions with the input of patients, clinicians, medical leadership, emergency medicine organizations, payers, and other government stakeholders; 7) more consistently defining the functional components of the ED care system, including observation units, fast tracks, waiting rooms, laboratories, and radiology subunits; and 8) maximizing multidisciplinary knowledge dissemination via emergency medicine, public health, general medicine, operations research, and nontraditional publications. PMID:26014365

  17. Team Composition

    OpenAIRE

    Antonio S. Mello

    2006-01-01

    This paper presents a model of team composition. Heterogeneous teams have a greater variety of information sources than homogeneous teams. If information and preferences can be expressed openly, heterogeneous teams reach better decisions. However, members of heterogeneous teams are more likely to diverge in their preferences with respect to courses of action, which is reflected in lower effort. Team leaders who are likely to be either uninformed or well informed about project payoffs prefer t...

  18. Evaluation of community mental health services: comparison of a primary care mental health team and an extended day hospital service.

    Science.gov (United States)

    Secker, J; Gulliver, P; Peck, E; Robinson, J; Bell, R; Hughes, J

    2001-11-01

    Alongside mental health policies emphasising the need to focus on people experiencing serious, long-term problems, recent general healthcare policy is leading to the development in the UK of a primary care-led National Health Service. While most primary care-led mental health initiatives have focused on supporting general practitioners (GPs) in managing milder depression and anxiety, this article describes an evaluation comparing primary care-based and secondary care-based services for people with serious long-term problems. A survey of service users was carried out at three points in time using three measures: the Camberwell Assessment of Need, the Verona Satisfaction with Services Scales and the Lancashire Quality of Life Profile. Staff views were sought at two time intervals and carers' views were obtained towards the end of the 2-year study period. The results indicate that both services reduced overall needs and the users' need for information. The primary care service also reduced the need for help with psychotic symptoms whereas the secondary care service reduced users' need for help with benefits and occupation. There were no major differences in terms of satisfaction or quality of life. Primary care-based services therefore appear to have the potential to be as effective as more traditional secondary care services. However, a more comprehensive range of services is required to address the whole spectrum of needs, a conclusion supported by the views of staff and carers.

  19. Clinical microbiology in the intensive care unit: Strategic and operational characteristics

    Directory of Open Access Journals (Sweden)

    Bhattacharya S

    2010-01-01

    Full Text Available Infection is a major cause of morbidity and mortality among patients admitted in intensive care units (ICUs. The application of the principles and the practice of Clinical Microbiology for ICU patients can significantly improve clinical outcome. The present article is aimed at summarising the strategic and operational characteristics of this unique field where medical microbiology attempts to venture into the domain of direct clinical care of critically ill patients. The close and strategic partnership between clinical microbiologists and intensive care specialists, which is essential for this model of patient care have been emphasized. The article includes discussions on a variety of common clinical-microbiological problems faced in the ICUs such as ventilator-associated pneumonia, blood stream infections, skin and soft tissue infection, UTI, infection control, besides antibiotic management.

  20. The function of Specialist Team Leader in the Management of Operation Room%手术室专科组长在管理中的作用

    Institute of Scientific and Technical Information of China (English)

    张佳明

    2015-01-01

    目的:探讨手术室专科组长在管理中的作用。方法采用回顾性分析法对本院实施手术室专科分组管理情况加以总结和分析,总结专科组长的职责和工作目标,对设立专科组长前后手术备物情况、专科医生对护士的满意度、各指标等加以观察对比。结果相较于设立专科组长前,设立后手术备物情况更加理想、专科医生对护士的满意度更高,护理查房、业务学习等各指标均有明显的改善,前后具有统计学差异(P<0.05)。结论通过设立专科组长协助护士长进行二级管理,可以使手术室的护理管理有很大的提高,不仅可以提高手术配合水平,也可以提高手术室护士整体素质,值得推广和应用。%Objective: to explore the role of specialist team leader of the operation room in management.Methods:a retrospective analysis was used to summarize and analyze the management of specialist in operation room in our hospital, and to sum up the responsibilities and objectives of the specialist team leader.Results: compared to not set up specialist team leader, after the establishment of specialist team leader, surgical preparation items more ideal, a specialist on nurses’ satisfaction higher, nursing rounds, business training and other indexes were significantly improved, with statistical difference (P<0.05).Conclusion: the establishment of specialist team leader to assist the head of the two level management, can make the operation room nursing management has greatly improved, not only can improve the level of operation, but also can improve the overall quality of specialist room nurses, it is worthy of promotion and application.

  1. Integrated community teams – promoting continuity of care for people with long-term neurological conditions (LTNCs)?

    OpenAIRE

    Aspinal, Fiona; Bernard, Sylvia; Gridley, Kate; Parker, Gillian

    2011-01-01

    Purpose The SDO funded study ‘Integrated services for people with long-term neurological conditions: evaluation of the impact of the National Service Framework’ aimed to identify what helps or hinders integrated services and identify models and practice for delivering continuity of care for people with LTNCs. Theory People’s experiences of integrated services were explored by thematically analysing the data using Freeman et al.’s [1, 2] definitions of continuity of care as a conceptual framew...

  2. The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

    OpenAIRE

    Ann M. Fugit, Pharm.D., BCPS; Sallie D. Mayer, Pharm.D., MBA, BCPS, CDE; Radha S. Vanmali, Pharm.D., BCACP

    2013-01-01

    Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV) clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit. Design: Retrospective, single-centered, chart review. Setting: Free, bilingual clinic in Richmond, VA. Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011. Main Outcome Measure: T...

  3. Maritime in transit care.

    Science.gov (United States)

    Bott, G; Barnard, J; Prior, K

    2015-01-01

    Operation GRITROCK saw the first operational deployment of the Maritime In Transit Care team from the Role 2 (Enhanced) (R2(E)) Medical Treatment Facility, which is able to provide Damage Control Surgery and the limited holding of patients, situated on board RFA ARGUS. Whilst the Medical Emergency Response Team demonstrated the capability of advanced military Pre-Hospital Emergency Care (PHEC) on Op HERRICK, the need to provide a similar high level of care on contingency operations was recognised. Op GRITROCK allowed for the continued exploration of a maritime capability from an established R2(E) platform whilst providing medical evacuation capability for a significant population at risk distributed over a large Joint Operation Area. Although the patient load during the operation was low, key lessons were learnt and opportunities identified to further develop the newly recognised sub-speciality of PHEC, both medically and logistically, and these will be discussed in this article. PMID:26867404

  4. A designated centre for people with disabilities operated by RehabCare, Longford

    LENUS (Irish Health Repository)

    Moore, Annamarie

    2013-01-02

    PURPOSE: Testicular cancer occurs at a time in a man\\'s life when major social life changes are occurring and when body image, fertility, sexual desire and performance can be central issues. Oncology nurses, as members of the multidisciplinary team, are in an ideal position to address men\\'s concerns. The aim of this study was to investigate oncology nurses\\' self-perceived knowledge and comfort in relation to discussing sexuality concerns with men diagnosed with testicular cancer and to identify the barriers and facilitators to such discussions. METHODS: This study employed a self-completion, anonymous survey design with a sample of registered nurses working in five, randomly chosen, oncology centres in Ireland. RESULTS: In total, 89 questionnaires (45% response rate) were included for analysis. Findings suggest that although nurses were open to addressing concerns, few informed patients they were available to discuss sexual concerns. Nurses reported lacking knowledge of, and discomfort in, discussing the more intimate aspects of sexuality, including: ejaculatory difficulties, erectile dysfunction, impotence, prosthesis options and testicular self examination. CONCLUSIONS: Findings reinforce the need for more comprehensive education on sexuality issues and testicular cancer. Nurses need to take a more proactive approach to sexuality care, as opposed to the \\'passive waiting stance\\' that permeates the current culture of care. Education programmes need to include specific information on sexual issues associated with testicular cancer, and oncology nurses must subsume sexuality as an essential aspect of their role through changes in policies and nursing care planning.

  5. Designing an Operational Planning Model for Level-one Iranian Primary Health Care Systems

    Directory of Open Access Journals (Sweden)

    Amir-Ashkan Nasiripour

    2008-01-01

    Full Text Available Introduction: This research was performed in 2008 in order to design an operational planning model for Iranian primary health care systems at level one. Methods: In this applied study, which was done in a descriptive and cross-sectional manner, some countries and international organizations which had comprehensive planning systems and some local organizations were studied. The required data from the selected countries were collected through data collection forms, and for local organizations, the data were collected through interview, and the initial model was presented accordingly. The model was tested via Delphi technique and taking the authorities’ views into account, the required changes were made and the ultimate model was prepared. Results: All the studied overseas and indigenous organizations had programming systems. However, none of the level-one Iranian primary health care units had a coherent planning system, and they did not follow any specific models. Since 2008, the model of operational planning has also been utilized by Iranian Ministry of Health, Care and Medical Education at headquarters levels; however, there was no model at lower levels especially in rural and urban health care centers. In all selected countries, the model of programs included title, objectives or expected results, schedule, activities, budget system and evaluation and monitoring indexes. Though these parts existed in the common models in Iran, no scientific basis could be observed in compiling the operational programs. The mechanism of designing the initial suggested operational planning had eight stages, but after three stages of reviewing by authorities, seven stages were ratified. Conclusion: Utilizing the suggested operational planning model can enhance the level-one performance indicators of health care networks in Iran

  6. Fallout: The experiences of a medical team in the care of a Marshallese population accidently exposed to fallout radiation

    International Nuclear Information System (INIS)

    This report presents an historical account of the experiences of the Brookhaven Medical Team in the examination and treatment of the Marshallese people following their accidental exposure to radioactive fallout in 1954. This is the first time that a population has been heavily exposed to radioactive fallout, and even though this was a tragic mishap, the medical findings have provided valuable information for other accidents involving fallout such as the recent reactor accident at Chernobyl. Noteworthy has been the unexpected importance of radioactive iodine in the fallout in producing thyroid abnormalities

  7. Fallout: The experiences of a medical team in the care of a Marshallese population accidentally exposed to fallout radiation

    Energy Technology Data Exchange (ETDEWEB)

    Conard, R.A.

    1991-01-01

    This report presents an historical account of the experiences of the Brookhaven Medical team in the examination and treatment of the Marshallese people following their accidental exposure to radioactive fallout in 1954. This is the first time that a population has been heavily exposed to radioactive fallout, and even though this was a tragic mishap, the medical findings have provided valuable information for other accidents involving fallout such as the recent reactor accident at Chernobyl. Particularly important has been the unexpected importance of radioactive iodine in the fallout in producing thyroid abnormalities.

  8. Fallout: The experiences of a medical team in the care of a Marshallese population accidently exposed to fallout radiation

    Energy Technology Data Exchange (ETDEWEB)

    Conard, R.A.

    1992-09-01

    This report presents an historical account of the experiences of the Brookhaven Medical Team in the examination and treatment of the Marshallese people following their accidental exposure to radioactive fallout in 1954. This is the first time that a population has been heavily exposed to radioactive fallout, and even though this was a tragic mishap, the medical findings have provided valuable information for other accidents involving fallout such as the recent reactor accident at Chernobyl. Noteworthy has been the unexpected importance of radioactive iodine in the fallout in producing thyroid abnormalities.

  9. Fallout: The experiences of a medical team in the care of a Marshallese population accidentally exposed to fallout radiation

    Energy Technology Data Exchange (ETDEWEB)

    Conard, R.A.

    1991-12-31

    This report presents an historical account of the experiences of the Brookhaven Medical team in the examination and treatment of the Marshallese people following their accidental exposure to radioactive fallout in 1954. This is the first time that a population has been heavily exposed to radioactive fallout, and even though this was a tragic mishap, the medical findings have provided valuable information for other accidents involving fallout such as the recent reactor accident at Chernobyl. Particularly important has been the unexpected importance of radioactive iodine in the fallout in producing thyroid abnormalities.

  10. Fallout: The experiences of a medical team in the care of a Marshallese population accidentally exposed to fallout radiation

    International Nuclear Information System (INIS)

    This report presents an historical account of the experiences of the Brookhaven Medical team in the examination and treatment of the Marshallese people following their accidental exposure to radioactive fallout in 1954. This is the first time that a population has been heavily exposed to radioactive fallout, and even though this was a tragic mishap, the medical findings have provided valuable information for other accidents involving fallout such as the recent reactor accident at Chernobyl. Particularly important has been the unexpected importance of radioactive iodine in the fallout in producing thyroid abnormalities

  11. Characteristics and dying trajectories of adult hospital patients from acute care wards who die following review by the rapid response team.

    Science.gov (United States)

    Coombs, M A; Nelson, K; Psirides, A J; Suter, N; Pedersen, A

    2016-03-01

    A third of patients reviewed by rapid response teams (RRT) require end-of-life care. However, little is known about the characteristics and management of these patients following RRT review. This paper presents results of a retrospective, descriptive audit that explored the dying trajectory of adult ward inpatients who died outside of intensive care following RRT review. The study setting was a 430-bed tertiary New Zealand hospital during 2013. RRT, inpatient databases and hospital notes were used to identify 100 consecutive adult inpatients who died subsequent to RRT review. Outcome measures included time from RRT review to death, place of death, pre-existing co-morbidities and frequency of medical review. Results demonstrated that patients were old (median 77 years, IQR 63-85years), emergency admissions (n=100) and admitted under a medical specialty (n=71). All but one of the cohort had pre-existing co-morbidities (mean 3.2, SD 1.7), almost a third (n=31) had cancer and 51% had 1-4 previous inpatient admissions within the previous 12 months. The mean length of stay prior to RRT review was 4.9 days (SD 5.5) during which patients were frequently reviewed by senior medical staff (mean 6.8 times, SD 6.9, range 0-44). Twenty per cent of patients died after their first RRT review with a further 40% receiving treatment limitation/palliation. Fifty-two per cent of patients had a pre-existing DNAR. Eighty per cent of patients died in hospital. Whilst the RRT fulfils an unmet need in decision-making at end of life, there is a need to understand what RRT, instead of ward-based or palliative care teams, offers dying patients. PMID:27029659

  12. Management Teams

    CERN Document Server

    Belbin, R Meredith Meredith

    2012-01-01

    Meredith Belbin's work on teams has become part of everyday language in organizations all over the world. All kinds of teams and team behaviours are covered. At the end of the book is a self-perception inventory so that readers can match their own personalities to particular team roles. Management Teams is required reading for managers concerned with achieving results by getting the best from their key personnel.

  13. Identifying and training non-technical skills for teams in acute medicine

    OpenAIRE

    Flin, R; Maran, N

    2004-01-01

    The aviation domain provides a better analogy for the "temporary" teams that are found in acute medical specialities than industrial or military teamwork research based on established teams. Crew resource management (CRM) training, which emphasises portable skills (for whatever crew a pilot is rostered to on a given flight), has been recognised to have potential application in medicine, especially for teams in the operating theatre, intensive care unit, and emergency room. Drawing on research...

  14. Using operant conditioning and desensitization to facilitate veterinary care with captive reptiles.

    Science.gov (United States)

    Hellmuth, Heidi; Augustine, Lauren; Watkins, Barbara; Hope, Katharine

    2012-09-01

    In addition to being a large component of most zoological collections, reptile species are becoming more popular as family pets. Reptiles have the cognitive ability to be trained to facilitate daily husbandry and veterinary care. Desensitization and operant conditioning can alleviate some of the behavioral and physiological challenges of treating these species. A survey of reptile training programs at zoos in the United States and worldwide reveals that there are many successful training programs to facilitate veterinary care and minimize stress to the animal. Many of the techniques being used to train reptiles in zoological settings are transferable to the exotic pet clinician. PMID:22998960

  15. Hatchery Evaluation Report / Lyons Ferry Hatchery - Fall Chinook : An Independent Audit Based on Integrated Hatchery Operations Teams (IHOT) Performance Measures : Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Montgomery

    1996-05-01

    This report presents the findings of the independent audit of the Lyons Ferry Hatchery (Fall Chinook). The audit is being conducted as a requirement of the Northwest Power Planning Council (NPPC) ``Strategy for Salmon`` and the Columbia River Basin Fish and Wildlife Program. Under the audit, the hatcheries are evaluated against policies and related performance measures developed by the Integrated Hatchery Operations Team (IHOT). IHOT is a multi-agency group established by the NPPC to direct the development of new basinwide standards for managing and operating fish hatcheries. The audit was conducted in April 1996 as part of a two-year effort that will include 67 hatcheries and satellite facilities located on the Columbia and Snake River system in Idaho, Oregon, and Washington. The hatchery operating agencies include the US Fish and Wildlife Service, Idaho Department of Fish and Game, Oregon Department of Fish and Wildlife, and Washington Department of Fish and Wildlife.

  16. ATLAS distributed computing operation shift teams experience during the discovery year and beginning of the long shutdown 1

    International Nuclear Information System (INIS)

    ATLAS Distributed Computing Operation Shifts evolve to meet new requirements. New monitoring tools as well as operational changes lead to modifications in organization of shifts. In this paper we describe the structure of shifts, the roles of different shifts in ATLAS computing grid operation, the influence of a Higgs-like particle discovery on shift operation, the achievements in monitoring and automation that allowed extra focus on the experiment priority tasks, and the influence of the Long Shutdown 1 and operational changes related to the no beam period.

  17. Improving maternity care in the Dominican Republic: a pilot study of a community-based participatory research action plan by an international healthcare team.

    Science.gov (United States)

    Foster, Jennifer; Gossett, Sarah; Burgos, Rosa; Cáceres, Ramona; Tejada, Carmen; Dominguez García, Luis; Ambrosio Rosario, Angel; Almonte, Asela; Perez, Lydia J

    2015-05-01

    This article is a report of the process and results of a feasibility pilot study to improve the quality of maternity care in a sample of 31 women and their newborns delivering in a public, tertiary hospital in the Dominican Republic. The pilot study was the first "action step" taken as a result of a formative, community-based participatory research (CBPR) study conducted between 2008 and 2010 by an interdisciplinary, international partnership of U.S. academic researchers, Dominican medical/nursing personnel, and Dominican community health workers. Health personnel and community health workers separately identified indicators most important to measure quality of antepartum maternity care: laboratory and diagnostic studies and respectful, interpersonal communication. At the midpoint and the completion of data collection, the CBPR team evaluated the change in quality indicators to assess improvement in care. The pilot study supports the idea that joint engagement of community health workers, health personnel, and academic researchers with data creation and patient monitoring is motivating for all to continue to improve services in the cultural context of the Dominican Republic. PMID:24793488

  18. Evaluation of hospital palliative care teams: strengths and weaknesses of the before-after study design and strategies to improve it.

    Science.gov (United States)

    Simon, S; Higginson, I J

    2009-01-01

    Hospital palliative care teams (HPCTs) are well established as multi-professional services to provide palliative care in an acute hospital setting and are increasing in number. However, there is still limited evaluation of them, in terms of efficacy and effectiveness. The gold standard method of evaluation is a randomised control trial, but because of methodological (e.g., randomisation), ethical and practical difficulties such trials are often not possible. HPCT is a complex intervention, and the specific situation in palliative care makes it challenging to evaluate (e.g., distress and cognitive impairment of patients). The quasi-experimental before-after study design has the advantage of enabling an experimental character without randomisation. But this has other weaknesses and is prone to bias, for example, temporal trends and selection bias. As for every study design, avoidance and minimisation of bias is important to improve validity. Therefore, strategies of selecting an appropriate control group or time series and applying valid outcomes and measurement tools help reducing bias and strengthen the methods. Special attention is needed to plan and define the design and applied method.

  19. How Do Interprofessional Student Teams Interact in a Primary Care Clinic? A Qualitative Analysis Using Activity Theory

    Science.gov (United States)

    Kent, Fiona; Francis-Cracknell, Alison; McDonald, Rachael; Newton, Jennifer M.; Keating, Jennifer L.; Dodic, Miodrag

    2016-01-01

    Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from…

  20. Critical Care

    Science.gov (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications from surgery, ... attention by a team of specially-trained health care providers. Critical care usually takes place in an ...

  1. Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

    Science.gov (United States)

    Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

    2016-05-01

    In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record

  2. Dificuldades vivenciadas pela equipe multiprofissional na unidade de terapia intensiva Dificultades vividas por el grupo de atención al paciente en la unidad de tratamiento intensivo Difficulties experienced by the patient care team at the intensive care unit

    Directory of Open Access Journals (Sweden)

    Maria Abadia Leite

    2005-04-01

    debe promover discusiones y reflexionar sobre los aspectos técnico-científicos y éticos de la atención, tanto a los pacientes en estado crítico como de la familia de los pacientes, ante una mejor calidad de la atención y de las relaciones interpersonales.This interpretative case study aimed to identify the difficulties experienced by the patient care team while working at the Intensive Care Unit. Data were collected through participant observation and semistructured interviews with doctors, nurses and nurse's aides. Two major categories emerged from the data analysis: Care delivery in intensive care - "it is difficult to deal with death and inform the patient's family" and care delivery in intensive care - "the lack of material resources and the difficulty to work in a team". The difficulties are related to the contact with family members, dealing with death and the lack of material resources, and particularly with the relation between team members. Therefore, teams need to promote opportunities and discussions to reflect on the technical, scientific and ethic aspects of care for critical patients as well as family members, with a view to better care quality and interpersonal relations.

  3. Estrategias de Autocuidado en Equipos Profesionales que Trabajan en Maltrato Infantil Self care Strategies in Professional Teams That Work in Child Maltreatment

    Directory of Open Access Journals (Sweden)

    Alejandra Isabel Santana

    2007-05-01

    Full Text Available Trabajar profesionalmente en maltrato infantil, implica asumir múltiples impactos, asociados a la temática y a la organización de la tarea. Esto ha llevado a crear Estrategias de Autocuidado para enfrentar esta situación. El objeto del estudio fue identificar las estrategias de los profesionales, a nivel individual y de equipo, y conocer la percepción de efectividad de éstas. Se utilizó una metodología cualitativa. La muestra de este estudio estuvo conformada por equipos interdisciplinarios y profesionales. Se utilizaron entrevistas y el análisis de los datos se realizó según la Grounded Theory. Los participantes han desarrollado las siguientes estrategias: individuales extra-laborales y laborales; de equipo, recreativas y laborales. En la percepción de efectividad, éstas se reconocen efectivas en su mayoría. Aún cuando la percepción de ineficacia se sustenta en la autocrítica de éstas.Working professionally in child maltreatment, implies to assume multiple impacts, associate to the thematic and the organization of the task. This implies the creation of Self-care Strategies to face this situation. The aim of this study was to identify the strategies of professionals of this area, at individual and team level, and to investigate the perception of effectiveness of these. A qualitative methodology was used. The participants were professional teams. Interviews were used and the analysis of the data was carried out according to the Grounded Theory. They have developed the following strategies: individual extra-labor and labor strategies; team, recreational and labor strategies. Most of the strategies used are perceived as effective. However, the perception of inefficiency of these strategies is supported in the self-criticism of those.

  4. A team approach to cost containment.

    Science.gov (United States)

    Williams, Jeni

    2008-04-01

    Strategies for involving clinicians in efforts to reduce labor and supply chain expenses include: Working with nurse managers to develop an operations or productivity report that is truly useful. Establishing biweekly reporting of labor utilization per unit. Adding clinicians to your materials management and finance teams. Helping physicians understand the cost profiles of the products they are using and their impact on cost of care. Being patient while securing buy-in. PMID:18441971

  5. Economics in social care – an introductory presentation on aspects of the economic work for the NCCSC team

    OpenAIRE

    Bauer, Annette; Francis, Jennifer

    2013-01-01

    A wide range of perspectives• Multiple outcomes, some long-term ones and those difficult to quantify or express in monetary form• Difficulty to define routine care• Most studies in this area cannot establish causalities• Resource implications for other parts in the system, often savings for other public services such as health, education or criminal justice• Knock-on effects are typical for social care interventions but difficult to capture• Methods still underdeveloped• I...

  6. Promoters and barriers in hospital team communication

    DEFF Research Database (Denmark)

    Rabøl, Louise Isager; McPhail, Mette Arnsfelt; Østergaard, Doris;

    2012-01-01

    the common characteristics of team communication among multiprofessional teams at four Danish acute care university hospitals. Method: Four focus group interviews with multiprofessional hospital teams (N = 24). Results: Communication is particularly vulnerable during handover of patient information between...... distance, team structure, and hospital organization influence team communication and vary between settings and national cultures. These factors must be accounted for before developing or adapting team communication interventions to improve patient safety....

  7. Respecting as a basic teamwork process in the operating theatre – A qualitative study of theatre nurses who work in interdisciplinary surgical teams of what they see as important factors in this collaboration

    OpenAIRE

    Kaldheim, Hege; Slettebø, Åshild

    2016-01-01

    Background: Studies show that working as a team in the operating theatre can be a challenge, and that surgical teams are not so cohesive as might be expected. Methods: A qualitative approach with exploratory design was used, inspired by grounded theory (GT) as a methodology. The data are from semi–structured, open questions, interviews with eight female theatre nurses from four Norwegian operational units. Results: The study shows that the most important factor in the social process between t...

  8. Delivery of enteral nutrition after the introduction of practice guidelines and participation of dietitians in pediatric critical care clinical teams.

    Science.gov (United States)

    Gentles, Emma; Mara, Jackie; Diamantidi, Krystalia; Alfheeaid, Hani A; Spenceley, Neil; Davidson, Mark; Gerasimidis, Konstantinos

    2014-12-01

    Provision of optimal nutrition is often difficult to achieve in the critically ill child, but can improve with better nutritional support practices. This study evaluated the joint impact of the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds on enteral nutrition (EN) intake and practices in children in intensive care. Nutritional intake and EN practices were audited before (period A) and after (period B) the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds in a pediatric intensive care unit. Information was collected on a daily basis and nutritional intake was compared with predefined targets and the United Kingdom dietary reference values. There were 65 patients and 477 nutritional support days in period A and 65 patients and 410 nutritional support days in period B. Basal metabolic rate (BMR) energy requirements were achieved in a larger proportion of nutritional support days in period B (BMR achieved [% nutritional support days]; period A: 27% vs period B: 48.9%; Pnutritional intake in some patients in critical care, but can have limited benefit for children admitted for corrective heart surgery.

  9. The performance and assessment of hospital trauma teams

    Directory of Open Access Journals (Sweden)

    Lockey David J

    2010-12-01

    Full Text Available Abstract The purpose of the trauma team is to provide advanced simultaneous care from relevant specialists to the seriously injured trauma patient. When functioning well, the outcome of the trauma team performance should be greater than the sum of its parts. Trauma teams have been shown to reduce the time taken for resuscitation, as well as time to CT scan, to emergency department discharge and to the operating room. These benefits are demonstrated by improved survival rates, particularly for the most severely injured patients, both within and outside of dedicated trauma centres. In order to ensure the best possible performance of the team, the leadership skills of the trauma team leader are essential and their non-technical skills have been shown to be particularly important. Team performance can be enhanced through a process of audit and assessment of the workings of the team and the evidence currently available suggests that this is best facilitated through the process of video review of the trauma resuscitation. The use of human patient simulators to train and assess trauma teams is becoming more commonplace and this technique offers a safe environment for the future education of trauma team staff. Trauma teams are a key component of most programmes which set out to improve trauma care. This article reviews the background of trauma teams, the evidence for benefit and potential techniques of performance assessment. The review was written after a PubMed, Ovid, Athens, Cochrane and guideline literature review of English language articles on trauma teams and their performance and hand searching of references from the relevant searched articles.

  10. Critical care issues in cervical cancer management.

    Science.gov (United States)

    Mirhashemi, R; Janicek, M F; Schoell, W M

    1999-01-01

    Radical pelvic surgery in gynecologic oncology patients poses a challenge to the surgeon and the ancillary team in charge of the peri-operative care. The high frequency of medical problems observed in this patient population, in conjunction with the stresses of radical surgery, necessitates careful monitoring of patients' medical status. A comprehensive team approach in the perioperative period is critical to patient care. Early intervention and anticipation of potential problems for the patient at risk in the postoperative period minimizes morbidity and mortality. This article will review the essentials of critical care as it relates to patients undergoing radical pelvic operations. PMID:10225307

  11. Post-operative analgesia for major abdominal surgery and its effectiveness in a tertiary care hospital

    OpenAIRE

    Aliya Ahmed; Naveed Latif; Robyna Khan

    2013-01-01

    Background: Post-operative pain is often inadequately treated. Optimal utilization of the available resources is essential for improving pain management. Aims: The aim of our study was to determine pain management strategies employed after major abdominal surgeries at our institute and their efficacy and safety. Settings and Design: Prospective observational study conducted at a tertiary care hospital. Materials and Methods: Patients undergoing elective major abdominal surgeries w...

  12. Making a team of experts into an expert team.

    Science.gov (United States)

    Charney, Carol

    2011-10-01

    Health care has traditionally been delivered primarily by experts working individually in a decentralized system lacking cohesive organization among professional disciplines. Only recently have the advantages of teamwork training been acknowledged in health care. This article explores the history, benefits, and recommendations for team training in neonatal care. TeamSTEPPS (Rockville, MD) and the revised Neonatal Resuscitation Program are cited as promising models for improved neonatal outcomes through professional teamwork. PMID:22123404

  13. Making a team of experts into an expert team.

    Science.gov (United States)

    Charney, Carol

    2011-10-01

    Health care has traditionally been delivered primarily by experts working individually in a decentralized system lacking cohesive organization among professional disciplines. Only recently have the advantages of teamwork training been acknowledged in health care. This article explores the history, benefits, and recommendations for team training in neonatal care. TeamSTEPPS (Rockville, MD) and the revised Neonatal Resuscitation Program are cited as promising models for improved neonatal outcomes through professional teamwork.

  14. Improved clinical and laboratory skills after team-based, malaria case management training of health care professionals in Uganda

    Directory of Open Access Journals (Sweden)

    Namagembe Allen

    2012-02-01

    Full Text Available Abstract Background Deployment of highly effective artemisinin-based combination therapy for treating uncomplicated malaria calls for better targeting of malaria treatment to improve case management and minimize drug pressure for selecting resistant parasites. The Integrated Management of Malaria curriculum was developed to train multi-disciplinary teams of clinical, laboratory and health information assistants. Methods Evaluation of training was conducted in nine health facilities that were Uganda Malaria Surveillance Programme (UMSP sites. From December 2006 to June 2007, 194 health professionals attended a six-day course. One-hundred and one of 118 (86% clinicians were observed during patient encounters by expert clinicians at baseline and during three follow-up visits approximately six weeks, 12 weeks and one year after the course. Experts used a standardized tool for children less than five years of age and similar tool for patients five or more years of age. Seventeen of 30 laboratory professionals (57% were assessed for preparation of malaria blood smears and ability to interpret smear results of 30 quality control slides. Results Percentage of patients at baseline and first follow-up, respectively, with proper history-taking was 21% and 43%, thorough physical examination 18% and 56%, correct diagnosis 51% and 98%, treatment in compliance with national policy 42% and 86%, and appropriate patient education 17% and 83%. In estimates that adjusted for individual effects and a matched sample, relative risks were 1.86 (95% CI: 1.20,2.88 for history-taking, 2.66 (95%CI: 1.60,4.41 for physical examination, 1.77 (95%CI: 1.41,2.23 for diagnosis, 1.96 (95%CI: 1.46,2.63 for treatment, and 4.47 (95%CI: 2.68,7.46 for patient education. Results were similar for subsequent follow-up and in sub-samples stratified by patient age. Quality of malaria blood smear preparation improved from 21.6% at baseline to 67.3% at first follow-up (p p p p Conclusion A

  15. Exploring the Integration of Field Portable Instrumentation into Real-Time Surface Science Operations with the RIS4E SSERVI Team

    Science.gov (United States)

    Young, K. E.; Bleacher, J. E.; Rogers, D.; Garry, W. B.; McAdam, A.; Scheidt, S. P.; Carter, L. M.; Glotch, T. D.

    2015-12-01

    The Remote, In Situ, and Synchrotron Studies for Science (RIS4E) team represents one node of the Solar System Exploration Research Virtual Institute (SSERVI) program. While the RIS4E team consists of four themes, each dedicated to a different aspect of airless body exploration, this submission details the RIS4E work underway to maximize an astronaut's effectiveness while conducting surface science. The next generation of surface science operations will look quite different than the EVAs (extravehicular activities) conducted during Apollo. Astronauts will possess data of much higher resolution than the Apollo reconnaissance data, and the EVAs will thus be designed to answer targeted science questions. Additionally, technological advancements over the last several decades have made it possible to conduct in situ analyses of a caliber much greater than was achievable during Apollo. For example, lab techniques such as x-ray fluorescence, x-ray diffraction, and multi-spectral imaging are now available in field portable formats, meaning that astronauts can gain real-time geochemical awareness during sample collection. The integration of these instruments into EVA operations, however, has not been widely tested. While these instruments will provide the astronaut with a high-resolution look at regional geochemistry and structure, their implementation could prove costly to the already constrained astronaut EVA timeline. The RIS4E team, through fieldwork at the December 1974 lava flow at Kilauea Volcano, HI, investigates the incorporation of portable technologies into planetary surface exploration and explores the relationship between science value added from these instruments and the cost associated with integrating them into an EVA timeline. We also consider what an appropriate instrumentation suite would be for the exploration of a volcanic terrain using this ideal terrestrial analog (see Rogers et al., Young et al., Bleacher et al., and Yant et al., this meeting).

  16. 糖尿病护理小组对提高糖尿病护理质量的影响研究%The Influence of Diabetes care team to improve the quality of diabetes care

    Institute of Scientific and Technical Information of China (English)

    徐丽萍

    2015-01-01

    目的:分析研究糖尿病护理小组对提高糖尿病护理质量的影响,旨在提高糖尿病患者的护理质量。方法该院于2014年1月开始建立糖尿病护理小组,选取该院2014年1月—8月收治的糖尿病患者85例,作为观察组,进行护理探究。另外,选取去年同期收治的糖尿病患者85例,作为对照组。回顾性分析其临床资料及诊治经过,对比两组患者血糖控制情况及护理满意度。结果糖尿病护理小组成立后,观察组85例患者,各项指标均有很大程度的改善,评分较治疗前比较显著提高,差异有统计学意义(P<0.05)。且组间比较来看,观察组改善情况显著优于对照组,差异有统计学意义(P<0.05)。满意度调查方面,观察组临床总满意度为95.3%,显著高于对照组的80.0%,差异有统计学意义(P<0.05)。结论成立糖尿病护理小组,可有效提高了糖尿病患者的临床护理质量,增加各科室护理人员糖尿病护理知识,改善糖尿病患者生活质量,临床意义重大,应广泛在临床护理中应用。%Objective To analyze the impact of diabetes research diabetes care team to improve the quality of care, aimed at im-proving the quality of care for patients with diabetes. Methods: The hospital in January 2014 to start building diabetes care team, our hospital from January 2014 to August 2014 were treated 85 cases of diabetes, as the observation group, nursing explore. Also, choose the same period last year admitted 85 cases of diabetes [as a control group Given group name], as a control group. A retro-spective analysis of the clinical data and treatment after comparing two groups of patients with blood glucose control and nursing satisfaction. Results Diabetes Care Group was established in the observation group 85 patients, before improving the indicators are to a large extent, the scores improved significantly compared with treatment comparison, the

  17. A managed clinical network for cardiac services: set-up, operation and impact on patient care

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton

    2005-09-01

    Full Text Available Purpose: To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. Methods: This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Results: Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and ‘bed down’. Its primary “modus operand” was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were

  18. Organizational Learning in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Savithiri Ratnapalan

    2014-02-01

    Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.

  19. 电信运营商如何打造优秀的营销团队%How to build Excellent Sales Team for Telecom Operators

    Institute of Scientific and Technical Information of China (English)

    李筱荔

    2011-01-01

    进入3G和全业务运营时代以后,电信运营商之间的竞争日益激烈,要在市场竞争中取得胜利,要获得卓越的经营能力,很大程度上取决于是否有一支素质高,业务能力强的营销团队。如何打造一支优秀的营销团队呢?只有紧密围绕运营商的战略和规划,做好人力资源配置的前瞻性研究,充分利用市场机制,建立目标管理体系,建造人才储备机制,建全绩效管理体制,创建培训管理系统,才能造就一支团结、稳定,与运营商同呼吸共命运,适应未来发展需要的精英团队。%After entering the era of 3G and the entire business operations,the competition between telecom operators are increasing,to get victory in the competition,and get remarkable management ability,is more depended on a high quality,strong professional ability marketing team.How to build an excellent marketing team? Only close around strategy and planning of operators,do human resources configuration of forward sexual research,full use market mechanism,established target management system,construct talent reserves mechanism,built full performance management system,created training management system,to make a elite team of support solidarity,stability,and operators with respiratory total fate,adaptation to future development need.

  20. The prevalence of long QT interval in post-operative intensive care unit patients.

    Science.gov (United States)

    Pham, Julius Cuong; Banks, Michael C; Narotsky, David L; Dorman, Todd; Winters, Bradford D

    2016-08-01

    The severity of patient illnesses and medication complexity in post-operative critically ill patients increase the risk for a prolonged QT interval. We determined the prevalence of prolonged QTc in surgical intensive care unit (SICU) patients. We performed a prospective cross-sectional study over a 15-month period at a major academic center. SICU pre-admission and admission EKGs, patient demographics, and laboratory values were analyzed. QTc was evaluated as both a continuous and dichotomous outcome (prolonged QTc > 440 ms). 281 patients were included in the study: 92 % (n = 257) post-operative and 8 % (n = 24) non-operative. On pre-admission EKGs, 32 % of the post-operative group and 42 % of the non-operative group had prolonged QTc (p = 0.25); on post-admission EKGs, 67 % of the post-operative group but only 33 % of the non-operative group had prolonged QTc (p experience increases the risk for long QTc. PMID:26169292

  1. The Massachusetts General Hospital Pulmonary Embolism Response Team (MGH PERT): creation of a multidisciplinary program to improve care of patients with massive and submassive pulmonary embolism.

    Science.gov (United States)

    Provias, Tim; Dudzinski, David M; Jaff, Michael R; Rosenfield, Kenneth; Channick, Richard; Baker, Joshua; Weinberg, Ido; Donaldson, Cameron; Narayan, Rajeev; Rassi, Andrew N; Kabrhel, Christopher

    2014-02-01

    New and innovative tools have emerged for the treatment of massive and submassive pulmonary embolism (PE). These novel treatments, when considered alongside existing therapy, such as anticoagulation, systemic intravenous thrombolysis, and open surgical pulmonary embolectomy, have the potential to improve patient outcomes. However, data comparing different treatment modalities are sparse, and guidelines provide only general advice for their use. Treatment decisions rest on clinician expertise and institutional resources. Because various medical and surgical specialties offer different perspectives and expertise, a multidisciplinary approach to patients with massive and submassive PE is required. To address this need, we created a novel multidisciplinary program - the Massachusetts General Hospital (MGH) Pulmonary Embolism Response Team (PERT) - which brings together multiple specialists to rapidly evaluate intermediate- and high-risk patients with PE, formulate a treatment plan, and mobilize the necessary resources to provide the highest level of care. Development of a clinical, educational, and research infrastructure, as well as the creation of a national PERT consortium, will make our experience available to other institutions and serve as a platform for future studies to improve the care of complex patients with massive and submassive PE.

  2. 42 CFR 488.314 - Survey teams.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Survey teams. 488.314 Section 488.314 Public Health...-Term Care Facilities § 488.314 Survey teams. (a) Team composition. (1) Surveys must be conducted by an interdisciplinary team of professionals, which must include a registered nurse. (2) Examples of...

  3. Team Development of Virtual Teams

    Science.gov (United States)

    Kim, Sooyoung

    2004-01-01

    Advanced technologies, globalization, the competitiveness of business, flexible working practices, and other rapid changes in the nature of work have all led to the booming of "virtual teams." This paper will provide an overview of virtual teams, including a description of their emergence, a definition and typology of the term "virtual team," an…

  4. Final Report, The Teaching Parents Study: Pan-Britain, mixed methods study of multidisciplinary teams teaching parents, and parents learning to manage, home based care of long-term childhood kidney conditions

    OpenAIRE

    Veronica Swallow, Ruth Nightingale, Davina Allen, Julian Williams, Trish Smith, Jean Crosier, Heather Lambert, Leila Qizalbash, Lucy Wirz, Nicholas JA Webb, Cat Mercer, Laura Crowther.

    2012-01-01

    Background: Care of children and young people (children) in the 12 children’s kidney units in England, Scotland and Wales is managed by multidisciplinary teams (MDTs) comprising professionals such as clinical psychologists, dieticians, doctors, nurses, pharmacists, play workers, social workers, and therapists. Within the constraints of treatment regimens it is in children’s best interests for them to be cared for at home whenever possible1-4. Professionals therefore, spend considerable time ...

  5. Integrated, Team-Based Chronic Pain Management: Bridges from Theory and Research to High Quality Patient Care.

    Science.gov (United States)

    Driscoll, Mary A; Kerns, Robert D

    2016-01-01

    Chronic pain is a significant public health concern. For many, chronic pain is associated with declines in physical functioning and increases in emotional distress. Additionally, the socioeconomic burden associated with costs of care, lost wages and declines in productivity are significant. A large and growing body of research continues to support the biopsychosocial model as the predominant framework for conceptualizing the experience of chronic pain and its multiple negative impacts. The model also informs a widely accepted and empirically supported approach for the optimal management of chronic pain. This chapter briefly articulates the historical foundations of the biopsychosocial model of chronic pain followed by a relatively detailed discussion of an empirically informed, integrated, multimodal and interdisciplinary treatment approach. The role of mental health professionals, especially psychologists, in the management of chronic pain is particularly highlighted. PMID:26900068

  6. Employability Development Teams: Cohesion Factors

    Science.gov (United States)

    Johnson, Douglas W.; Munger, Paul F.

    1972-01-01

    In this study the researchers attempted to analyze the factors of age, sex, racial-ethnic background, operational life of the team, educational status, leader status, team size, caseload size, and the location of program site in terms of their potential effects upon team cohesion. (Author)

  7. How teams use indicators for quality improvement - a multiple-case study on the use of multiple indicators in multidisciplinary breast cancer teams.

    Science.gov (United States)

    Gort, Marjan; Broekhuis, Manda; Regts, Gerdien

    2013-11-01

    A crucial issue in healthcare is how multidisciplinary teams can use indicators for quality improvement. Such teams have increasingly become the core component in both care delivery and in many quality improvement methods. This study aims to investigate the relationships between (1) team factors and the way multidisciplinary teams use indicators for quality improvement, and (2) both team and process factors and the intended results. An in-depth, multiple-case study was conducted in the Netherlands in 2008 involving four breast cancer teams using six structure, process and outcome indicators. The results indicated that the process of using indicators involves several stages and activities. Two teams applied a more intensive, active and interactive approach as they passed through these stages. These teams were perceived to have achieved good results through indicator use compared to the other two teams who applied a simple control approach. All teams experienced some difficulty in integrating the new formal control structure, i.e. measuring and managing performance, in their operational task, and in using their 'new' managerial task to decide as a team what and how to improve. Our findings indicate the presence of a network of relationships between team factors, the controllability and actionability of indicators, the indicator-use process, and the intended results.

  8. Writing for Safety. Facilitating a Team Approach to Writing Operating Instructions. ANTA Leading Edge Training Case Study.

    Science.gov (United States)

    Serle, Oenone

    The Australian engineering company, Jaques, and Swinburne University of Technology conducted a joint project to write more than 190 operating instructions for the company's 77 employees. First, the university's Workplace Skills Unit (WSU) interviewed 75 production workers to identify their language, literacy, and training needs. The WSU negotiated…

  9. Study protocol: a multi-professional team intervention of physical activity referrals in primary care patients with cardiovascular risk factors—the Dalby lifestyle intervention cohort (DALICO study

    Directory of Open Access Journals (Sweden)

    Stenman Emelie

    2012-06-01

    Full Text Available Abstract Background The present study protocol describes the trial design of a primary care intervention cohort study, which examines whether an extended, multi-professional physical activity referral (PAR intervention is more effective in enhancing and maintaining self-reported physical activity than physical activity prescription in usual care. The study targets patients with newly diagnosed hypertension and/or type 2 diabetes. Secondary outcomes include: need of pharmacological therapy; blood pressure/plasma glucose; physical fitness and anthropometric variables; mental health; health related quality of life; and cost-effectiveness. Methods/Design The study is designed as a long-term intervention. Three primary care centres are involved in the study, each constituting one of three treatment groups: 1 Intervention group (IG: multi-professional team intervention with PAR, 2 Control group A (CA: physical activity prescription in usual care and 3 Control group B: treatment as usual (retrospective data collection. The intervention is based on self-determination theory and follows the principles of motivational interviewing. The primary outcome, physical activity, is measured with the International Physical Activity Questionnaire (IPAQ and expressed as metabolic equivalent of task (MET-minutes per week. Physical fitness is estimated with the 6-minute walk test in IG only. Variables such as health behaviours; health-related quality of life; motivation to change; mental health; demographics and socioeconomic characteristics are assessed with an electronic study questionnaire that submits all data to a patient database, which automatically provides feed-back to the health-care providers on the patients’ health status. Cost-effectiveness of the intervention is evaluated continuously and the intermediate outcomes of the intervention are extrapolated by economic modelling. Discussions By helping patients to overcome practical, social and cultural

  10. The Management Team and Survival.

    Science.gov (United States)

    Floratos, Nick; And Others

    1978-01-01

    The team administration model used in the Rio Linda School District is explained, including a definition of the concept, organizational structures, general operations, and problem solving strategies. (SJL)

  11. Point-of-care ultrasonography during rescue operations on board a Polish Medical Air Rescue helicopter.

    Science.gov (United States)

    Darocha, Tomasz; Gałązkowski, Robert; Sobczyk, Dorota; Żyła, Zbigniew; Drwiła, Rafał

    2014-12-01

    Point-of-care ultrasound examination has been increasingly widely used in pre-hospital care. The use of ultrasound in rescue medicine allows for a quick differential diagnosis, identification of the most important medical emergencies and immediate introduction of targeted treatment. Performing and interpreting a pre-hospital ultrasound examination can improve the accuracy of diagnosis and thus reduce mortality. The authors' own experiences are presented in this paper, which consist in using a portable, hand-held ultrasound apparatus during rescue operations on board a Polish Medical Air Rescue helicopter. The possibility of using an ultrasound apparatus during helicopter rescue service allows for a full professional evaluation of the patient's health condition and enables the patient to be brought to a center with the most appropriate facilities for their condition. PMID:26674604

  12. Preparedness of Operation Teams' Non-technical Skills in a Main Control Room of Nuclear Power Plants to Manage Emergency Situations

    International Nuclear Information System (INIS)

    Human reliability is one of the important determinants for the system safety. Nuclear Energy Agency reported that approximately half of events reported by foreign nuclear industry were related with inappropriate human actions. The human error problems can be viewed in two ways: the person approach and the system approach. Other terms to represent each approach are active failures and latent conditions. Active failures are unsafe acts committed by people who are in direct contact with systems whereas latent conditions are the inevitable 'resident pathogens' within the system. To identify what kinds of non-technical skills were needed to cope with emergency conditions, a method to evaluate preparedness of task management in emergency conditions based on monitoring patterns was presented. Five characteristics were suggested to evaluate emergency task management and communication: latent mistake resistibility, latent violation resistibility, thoroughness, communication, and assertiveness. Case study was done by analyzing emergency training of 9 different real operation teams in the reference plant. The result showed that the 9 teams had their own emergency task management skills which resulted in good and bad performances

  13. Preparedness of Operation Teams' Non-technical Skills in a Main Control Room of Nuclear Power Plants to Manage Emergency Situations

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Ho Bin; Kim, Ar Ryum; Seong, Poong Hyun [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    Human reliability is one of the important determinants for the system safety. Nuclear Energy Agency reported that approximately half of events reported by foreign nuclear industry were related with inappropriate human actions. The human error problems can be viewed in two ways: the person approach and the system approach. Other terms to represent each approach are active failures and latent conditions. Active failures are unsafe acts committed by people who are in direct contact with systems whereas latent conditions are the inevitable 'resident pathogens' within the system. To identify what kinds of non-technical skills were needed to cope with emergency conditions, a method to evaluate preparedness of task management in emergency conditions based on monitoring patterns was presented. Five characteristics were suggested to evaluate emergency task management and communication: latent mistake resistibility, latent violation resistibility, thoroughness, communication, and assertiveness. Case study was done by analyzing emergency training of 9 different real operation teams in the reference plant. The result showed that the 9 teams had their own emergency task management skills which resulted in good and bad performances

  14. Professionals' views on interprofessional stroke team functioning

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2011-01-01

    markdownabstractIntroduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals’ perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their e

  15. Moving Young Children from Foster Care to Permanent Homes: Evaluation Findings for the ZERO TO THREE Safe Babies Court Teams Project

    Science.gov (United States)

    McCombs-Thornton, Kimberly

    2012-01-01

    This article summarizes an evaluation of the Safe Babies Court Teams Project. The study compared children in the Court Teams Project at the four initial sites (n = 298) with a nationally representative sample of young child welfare participants (n = 511) from the National Survey of Child and Adolescent Well-Being (NSCAW). The Court Teams Project…

  16. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger

    2008-01-01

    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  17. Essays in Team Economics

    OpenAIRE

    Tumlinson, Justin

    2011-01-01

    This dissertation addresses teamwork with the tools of economics in three specialized settings--I examine (1) how teams form under discrimination, (2) what shareholders can accomplish for themselves and society when operating as group that they cannot as individuals, and (3) ethnicity's role in the performance of pairings between venture capitalists and entrepreneurs.Adverse Selection in Team Formation under DiscriminationThe decision to be an entrepreneur or an employee is among the most con...

  18. Professionals’ views on interprofessional stroke team functioning

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm

    2011-07-01

    Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members.  Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2.  Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion.  Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.        

  19. Professionals’ views on interprofessional stroke team functioning

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm

    2011-07-01

    Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members. Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2. Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion. Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.       

  20. Escalas de satisfação com o atendimento às doenças cardiovasculares: CARDIOSATIS usuário e equipe Satisfaction scales with health care to cardiovascular diseases: CARDIOSATIS patient and team

    Directory of Open Access Journals (Sweden)

    Clareci Silva Cardoso

    2011-01-01

    Full Text Available A satisfação é uma importante medida da qualidade da atenção, da adesão ao tratamento e uso adequado dos serviços de saúde. O objetivo foi construir as escalas para avaliar a satisfação da equipe médica e de usuários com o atendimento às emergências cardiovasculares oferecido por um projeto de telemedicina. A construção das escalas seguiu os padrões internacionais para criação de instrumentos incluindo a definição operacional do construto satisfação e sua dimensionalidade; a operacionalização dos itens; a realização de pré-teste e o estudo piloto. A revisão de literatura, os grupos focais e discussão com especialistas delimitaram as áreas a serem incluídas nas escalas e a elaboração das questões. A escala CARDIOSATIS-Equipe é composta por quinze itens e a escala CARDIOSATIS-Usuário, por onze, pontuados em escala tipo Likert de cinco pontos, incluindo questões abertas. Englobam informações sobre satisfação com a estrutura física, recursos humanos, capacidade de resolutividade, atenção e cuidados oferecidos pelo serviço, além da satisfação com o atendimento recebido/prestado. As escalas CARDIOSATIS têm mostrado fácil compreensão e aceitação pela equipe médica e pacientes. Resultados preliminares mostraram boas características de validade e confiabilidade dos instrumentos.Satisfaction is an important measure of quality care, of adherence to the treatment and adequate use of health services. The objective here is to build two scales which evaluates team' and patients' satisfaction with cardiovascular disease treatment provided through a distance telecardiology project. The procedure followed international standards for development of measure instruments, including operational definition of satisfaction contents and its area for evaluation; item definition; pre-test and pilot study. The literature review, focal groups and discussion with specialists had delimited the domains to be included in

  1. Assessing the feasibility, acceptability and potential effectiveness of Dignity Therapy for people with advanced cancer referred to a hospital-based palliative care team: Study protocol

    Directory of Open Access Journals (Sweden)

    Chochinov Harvey

    2009-05-01

    Full Text Available Abstract Background Loss of dignity for people with advanced cancer is associated with high levels of psychological and spiritual distress and the loss of the will to live. Dignity Therapy is a brief psychotherapy, which has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting in Canada, Australia and the USA, has suggested that Dignity Therapy is beneficial to people with advanced cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in people with advanced cancer who have been referred to hospital-based palliative care teams in the UK, and to pilot the methods for a Phase III RCT. Design A randomised controlled open-label trial. Forty patients with advanced cancer are randomly allocated to one of two groups: (i Intervention (Dignity Therapy offered in addition to any standard care, and (ii Control group (standard care. Recipients of the 'generativity' documents are asked their views on taking part in the study and the therapy. Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline and at approximately one and four weeks after the intervention (equivalent in the control group. The primary outcome is patients' sense of dignity (potential effectiveness assessed by the Patient Dignity Inventory. Secondary outcomes for patients include distress, hopefulness and quality of life. In view of the relatively small sample size, quantitative analyses are mainly descriptive. The qualitative analysis uses the Framework method. Discussion Dignity Therapy is brief, can be delivered at the bedside and may help both patients and their families. This detailed exploratory research shows if it is feasible to offer Dignity Therapy to

  2. Takım Yönetimi ve Takım Etkinliğini Belirleyen Faktörler : Savunma Sanayinde Ar - Ge Yapan Takımlar Üzerinde Bir Saha Araştırması = Team Management and the Determinants of Team Effectiveness : a Field Research on the Team Operating in Research and Development in Defence Industry

    Directory of Open Access Journals (Sweden)

    Mehtap Özşahin

    2008-06-01

    Full Text Available In order to benefit from teams, the effectiveness of teams should be increased. The role and responsibilities should be defined, team members should be educated to improve their skills, performance objectives should be identified, resources should be used at optimum level, team culture and leadership should be established to increase the team effectiveness. In this study, we aim to examine the relationship among the team effectiveness factors - specified as team synergy, use of resources, skills, communication and performance objectives - innovation orientation and quality orientation at teams in defense industry while leadership effect is high, low and absent. Survey is conducted on 15 team producing equipment for defense industry. Questionnaire form employing five - point Likert Scale is used and data are analyzed through the SPSS statistical program packet.

  3. Team-building through sailing: effects on health status, job satisfaction and work performance of health care professionals involved in organ and tissue donation.

    Science.gov (United States)

    Ponzin, Diego; Fasolo, Adriano; Vidale, Enrico; Pozzi, Annalaura; Bottignolo, Elisa; Calabrò, Francesco; Rupolo, Giampietro

    2015-01-01

    The aim of this study was to evaluate the effects of a team-building learning project on job satisfaction, psychological wellbeing, and performance of health care workers involved in the process of organ and tissue donation. The project was conducted between June and September 2011 and consisted of two one-day meetings and a one week sailing, involving 20 staff members. GHQ-12, MBI-HSS, and 25 items taken from the Multidimensional Organizational Health Questionnaire (MOHQ) were used to assess health status, burnout, and job satisfaction. Results of the descriptive analyses were expressed as mean ± SD and as counts and percentages; Chi-square test was used to evaluate statistical significance of differences before and after the initiative. 6 (30,0%) participants showed the likelihood to suffering from anxiety and depression (i.e. recognized as 'cases' by the GHQ-12), 3 (15.0%) of them at baseline and 3 (15.0%), different from the previous ones, in the post-intervention. The presence of stress was revealed in 9 (45.0%) and 12 subjects (60.0%) before and after the experience, respectively (6 subjects showed the presence of stress in both circumstances). We documented 4 burnout cases, 3 (15.0%) at baseline and 1 (5.0%) after the experience. Nevertheless, about 80% of the participants showed a high degree ofjob satisfaction, in terms of positive influence of job in the professional satisfaction and of clear satisfaction for the organization, during both evaluation. In respect to 2010, the number of organ donors and that of ocular tissue donors improved of about 16% and 10%, respectively, during the year of the project and in the following year (mean value). We recognize that our team-building project for personnel involved in the stressful and demanding setting of organ and tissue donation, worthwhile and recompensing at the same time, possibly influenced the personal commitment and the quality of job provided. The high level of stress showed by participants should be

  4. Team-building through sailing: effects on health status, job satisfaction and work performance of health care professionals involved in organ and tissue donation.

    Science.gov (United States)

    Ponzin, Diego; Fasolo, Adriano; Vidale, Enrico; Pozzi, Annalaura; Bottignolo, Elisa; Calabrò, Francesco; Rupolo, Giampietro

    2015-01-01

    The aim of this study was to evaluate the effects of a team-building learning project on job satisfaction, psychological wellbeing, and performance of health care workers involved in the process of organ and tissue donation. The project was conducted between June and September 2011 and consisted of two one-day meetings and a one week sailing, involving 20 staff members. GHQ-12, MBI-HSS, and 25 items taken from the Multidimensional Organizational Health Questionnaire (MOHQ) were used to assess health status, burnout, and job satisfaction. Results of the descriptive analyses were expressed as mean ± SD and as counts and percentages; Chi-square test was used to evaluate statistical significance of differences before and after the initiative. 6 (30,0%) participants showed the likelihood to suffering from anxiety and depression (i.e. recognized as 'cases' by the GHQ-12), 3 (15.0%) of them at baseline and 3 (15.0%), different from the previous ones, in the post-intervention. The presence of stress was revealed in 9 (45.0%) and 12 subjects (60.0%) before and after the experience, respectively (6 subjects showed the presence of stress in both circumstances). We documented 4 burnout cases, 3 (15.0%) at baseline and 1 (5.0%) after the experience. Nevertheless, about 80% of the participants showed a high degree ofjob satisfaction, in terms of positive influence of job in the professional satisfaction and of clear satisfaction for the organization, during both evaluation. In respect to 2010, the number of organ donors and that of ocular tissue donors improved of about 16% and 10%, respectively, during the year of the project and in the following year (mean value). We recognize that our team-building project for personnel involved in the stressful and demanding setting of organ and tissue donation, worthwhile and recompensing at the same time, possibly influenced the personal commitment and the quality of job provided. The high level of stress showed by participants should be

  5. DIFFERENT DIMENSIONS OF TEAMS

    Directory of Open Access Journals (Sweden)

    Goparaju Purna SUDHAKAR

    2014-01-01

    Full Text Available Popularity ofteams is growing in 21st Century. Organizations are getting theirwork done through different types of teams. Teams have proved that thecollective performance is more than the sum of the individual performances.Thus, the teams have got different dimensions such as quantitative dimensionsand qualitative dimensions. The Quantitative dimensions of teams such as teamperformance, team productivity, team innovation, team effectiveness, teamefficiency, team decision making and team conflicts and Qualitative dimensionsof teams such as team communication, team coordination, team cooperation, teamcohesion, team climate, team creativity, team leadership and team conflictshave been discussed in this article.

  6. Teleradiology network to improve patient care in a peacekeeping military operation

    Science.gov (United States)

    Cleary, Kevin R.; Levine, Betty A.; Norton, Gary S.; Mun, Seong K.; Cramer, Timothy J.; de Treville, Robert E.

    1997-05-01

    The Imaging Science and Information Systems (ISIS) Center of the Department of Radiology at Georgetown University Medical Center recently collaborated with the US Army in developing an off-the-shelf teleradiology network for Operation Joint Endeavor, the peace-keeping mission in Bosnia-Herzegovina. The network is part of Operation Primetime III, a project to deploy advanced communications and medical equipment to provide state-of-the-art medical care to the 20,000 US troops stationed there. The network encompasses three major sites: the 212th Mobile Army Surgical Hospital (MASH) near Tuzla, Bosnia-Herzegovina; the 67th Combat Support Hospital (CSH) in Taszar, Hungary; and the Landstuhl Regional Medical Center (LRMC) in Landstuhl, Germany. Planning for the project began in January 1996, and all three sites were operational by April 1996. Since the system was deployed, computed radiography (CR) has been sued almost exclusively at the MASH and CSH for all general x-ray exams. From mid- May to September 1996, over 2700 CR images were acquired at the MASH and over 1600 at the CSH. Since there was not a radiologist a the MASH, the images were transferred to the CSH for primary diagnosis and archiving. In the same time period, over 550 patient folders were sent from the MASH to the CSH.

  7. Increasing Independence in Self-Care Tasks for Children with Autism Using Self-Operated Auditory Prompts

    Science.gov (United States)

    Mays, Nicole McGaha; Heflin, L. Juane

    2011-01-01

    This study was conducted to determine the effects of self-operated auditory prompting systems (SOAPs) on independent self-care task completion of elementary-school-aged children with autism and intellectual disabilities. Prerecorded verbal prompts on a student-operated tape recorder were employed to facilitate independence in washing hands and…

  8. Roles and Responsibilities in Feature Teams

    Science.gov (United States)

    Eckstein, Jutta

    Agile development requires self-organizing teams. The set-up of a (feature) team has to enable self-organization. Special care has to be taken if the project is not only distributed, but also large and more than one feature team is involved. Every feature team needs in such a setting a product owner who ensures the continuous focus on business delivery. The product owners collaborate by working together in a virtual team. Each feature team is supported by a coach who ensures not only the agile process of the individual feature team but also across all feature teams. An architect (or if necessary a team of architects) takes care that the system is technically sound. Contrariwise to small co-located projects, large global projects require a project manager who deals with—among other things—internal and especially external politics.

  9. Wijkteams jeugd en gezin: Hoe teams werken, leren en ontwikkelen integreren in de dagelijkse praktijk

    Directory of Open Access Journals (Sweden)

    Roel van Goor

    2016-03-01

    Full Text Available Neighbourhood support teams: How teams integrate working, learning, and developing in daily practiceOn 1 January 2015, responsibility for the availability and accessibility of all youth care in the Netherlands was decentralized from the national and subnational levels of government to the municipal level. Neighbourhood support teams for youth and family play a pivotal role in the organization of the municipal youth care system. This transition aimed both to transform the way youth care is carried out and to achieve cost savings. Youth workers in these teams have been assigned a new task that demands a new type of professionalism and a different way of working: away from an institution-centred and supply-oriented approach and towards operating proactively in the community and offering integrated support and care that responds to what young people and families really need.How are these professionals handling this transition and how can teams offer young people family care that provides quality and achieves result? This article provides pointers for municipalities and team managers responsible for overseeing this transformational process. The starting point for our practice-based research was Amsterdam, where we investigated how innovative and successful neighbourhood teams in the field of care – community care, psychiatric care, youth care, youth protection – have already made a similar transformation.In the City of Amsterdam, prevention and lighter forms of youth and family support are provided by 27 Parent and Child Teams (PCTs, consisting of Parent and Child Advisors (PCAs who operate throughout the city in neighbourhoods and at schools. During the pilot phase in 2013 and 2014, we examined how the learning processes of the PCTs and PCAs can be organized in such a way that an ongoing process of learning and development is able to occur. We provided an overview of literature, conducted interviews, and held an expert meeting. A crucial part of

  10. Team work load in an English general practice. I.

    Science.gov (United States)

    Marsh, G N; McNay, R A

    1974-02-23

    A survey of the total care provided by a general practitioner and his paramedical team for 3,137 patients in Teesside in 1972 showed that even in this area of high morbidity and mortality the work load was very small. The doctor held an average of 2.3 consultations per patient per year, and the overall average for the team of doctor, nurse, and health visitor was only 3.1. By delegating work to a team of trained paramedical workers, by increasing the proportion of personal medicine, and by engaging the co-operation of his patients, the general practitioner reduced his work load considerably, without any apparent reduction in standard of care.

  11. Designing User Interfaces for Smart-Applications for Operating Rooms and Intensive Care Units

    Science.gov (United States)

    Kindsmüller, Martin Christof; Haar, Maral; Schulz, Hannes; Herczeg, Michael

    Today’s physicians and nurses working in operating rooms and intensive care units have to deal with an ever increasing amount of data. More and more medical devices are delivering information, which has to be perceived and interpreted in regard to patient status and the necessity to adjust therapy. The combination of high information load and insufficient usability creates a severe challenge for the health personnel with respect to proper monitoring of these devices respective to acknowledging alarms and timely reaction to critical incidents. Smart Applications are a new kind of decision support systems that incorporate medical expertise in order to help health personnel in regard to diagnosis and therapy. By means of a User Centered Design process of two Smart Applications (anaesthesia monitor display, diagnosis display), we illustrate which approach should be followed and which processes and methods have been successfully applied in fostering the design of usable medical devices.

  12. Comparison of NASA Team2 and AES-York Ice Concentration Algorithms Against Operational Ice Charts From the Canadian Ice Service

    Science.gov (United States)

    Shokr, Mohammed; Markus, Thorsten

    2006-01-01

    Ice concentration retrieved from spaceborne passive-microwave observations is a prime input to operational sea-ice-monitoring programs, numerical weather prediction models, and global climate models. Atmospheric Environment Service (AES)- York and the Enhanced National Aeronautics and Space Administration Team (NT2) are two algorithms that calculate ice concentration from Special Sensor Microwave/Imager observations. This paper furnishes a comparison between ice concentrations (total, thin, and thick types) output from NT2 and AES-York algorithms against the corresponding estimates from the operational analysis of Radarsat images in the Canadian Ice Service (CIS). A new data fusion technique, which incorporates the actual sensor's footprint, was developed to facilitate this study. Results have shown that the NT2 and AES-York algorithms underestimate total ice concentration by 18.35% and 9.66% concentration counts on average, with 16.8% and 15.35% standard deviation, respectively. However, the retrieved concentrations of thin and thick ice are in much more discrepancy with the operational CIS estimates when either one of these two types dominates the viewing area. This is more likely to occur when the total ice concentration approaches 100%. If thin and thick ice types coexist in comparable concentrations, the algorithms' estimates agree with CIS'S estimates. In terms of ice concentration retrieval, thin ice is more problematic than thick ice. The concept of using a single tie point to represent a thin ice surface is not realistic and provides the largest error source for retrieval accuracy. While AES-York provides total ice concentration in slightly more agreement with CIS'S estimates, NT2 provides better agreement in retrieving thin and thick ice concentrations.

  13. Analysis and development of multiprofessional teams in medical rehabilitation

    OpenAIRE

    Körner, Mirjam

    2008-01-01

    Team analysis and team development are important instruments of organizational development and quality management. They contribute to team optimization in medical rehabilitation. Team analysis allows assessment of strengths and weaknesses of teams, resulting in possible recommendations for team development. So far there are only a few empirical studies and little practical experience analyzing multiprofessional teams in the health care field and inpatient medical rehabilitation in particular....

  14. [The Nutritional Care Experience of a Post-Operative Periampullary Cancer Patient With Cachexia].

    Science.gov (United States)

    Liou, Yan-Ting; Chiang, Pin-Yi; Shun, Shiow-Ching

    2016-04-01

    Cachexia is one of the most widely overlooked of the syndromes that are experienced by cancer patients. This syndrome is especially prevalent among patients with gastroenterology tract cancer. Although the National Comprehensive Cancer Network (NCCN) issued palliative-care practice guidelines for cachexia in 2015, guidelines have yet to be issued for the clinical setting. The authors reviewed the literature and applied their clinical experience to create an approach for identifying the degree of cachexia in a post-operative patient with periampullary cancer. This approach assesses the nutritional status, physical status, laboratory results, and gastrointestinal system functions of the patient using the Cachexia Assessment Scale (CAS) and NCCN Practice Guidelines for Cachexia. The patient improved under nursing care with an increase in nutritional intake and physical activity facilitating their process of post-surgical physical recovery. The authors hope that this experience using the combined CAS-NCCN Practice Guidelines will help clinical caregivers better understand how to apply the relevant guidelines in clinical settings. The developed approach may help nurses assess the comprehensive nutrition status of patients and related factors in order to provide interventions that will decrease the progression of cachexia effectively and promote quality of life. PMID:27026565

  15. Effects of adding a new PCMH block rotation and resident team to existing longitudinal training within a certified PCMH: primary care residents’ attitudes, knowledge, and experience

    Directory of Open Access Journals (Sweden)

    Anandarajah G

    2016-08-01

    Full Text Available Gowri Anandarajah,1,2 Christopher Furey,1 Rabin Chandran,1 Arnold Goldberg,3,4 Fadya El Rayess,1 David Ashley,1 Roberta E Goldman,1,5 1Department of Family Medicine, 2Department of Medical Science, Warren Alpert Medical School of Brown University, Providence, RI, 3Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, 4Department of Family Medicine, Leigh Valley Family Health Network, Allentown, PA, 5Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA Background: Although the patient-centered medical home (PCMH model is considered important for the future of primary care in the USA, it remains unclear how best to prepare trainees for PCMH practice and leadership. Following a baseline study, the authors added a new required PCMH block rotation and resident team to an existing longitudinal PCMH immersion and didactic curriculum within a Level 3-certified PCMH, aiming for “enhanced situated learning”. All 39 residents enrolled in a USA family medicine residency program during the first year of curricular implementation completed this new 4-week rotation. This study examines the effects of this rotation after 1 year. Methods: A total of 39 intervention and 13 comparison residents were eligible participants. This multimethod study included: 1 individual interviews of postgraduate year (PGY 3 intervention vs PGY3 comparison residents, assessing residents’ PCMH attitudes, knowledge, and clinical experience, and 2 routine rotation evaluations. Interviews were audiorecorded, transcribed, and analyzed using immersion/crystallization. Rotation evaluations were analyzed using descriptive statistics and qualitative analysis of free text responses. Results: Authors analyzed 23 interviews (88% and 26 rotation evaluations (67%. Intervention PGY3s’ interviews revealed more nuanced understanding of PCMH concepts and more experience with system-level PCMH

  16. Team skills training

    International Nuclear Information System (INIS)

    Numerous reports and articles have been written recently on the importance of team skills training for nuclear reactor operators, but little has appeared on the practical application of this theoretical guidance. This paper describes the activities of the Training and Education Department at GPU Nuclear (GPUN). In 1987, GPUN undertook a significant initiative in its licensed operator training programs to design and develop initial and requalification team skills training. Prior to that time, human interaction skills training (communication, stress management, supervisory skills, etc.) focused more on the individual rather than a group. Today, GPU Nuclear conducts team training at both its Three Mile Island (YMI), PA and Oyster Creek (OC), NJ generating stations. Videotaped feedback is sued extensively to critique and reinforce targeted behaviors. In fact, the TMI simulator trainer has a built-in, four camera system specifically designed for team training. Evaluations conducted on this training indicated these newly acquired skills are being carried over to the work environment. Team training is now an important and on-going part of GPUN operator training

  17. Diabetes Care Team to Explore the Effect in the Risk Management%糖尿病护理团队在风险管理中的作用探究

    Institute of Scientific and Technical Information of China (English)

    李海霞; 赵伟

    2015-01-01

    糖尿病患者除积极进行治疗外,接受科学、有效的护理干预对稳定其病情和防控疾病进一步恶化具有重要意义。重视糖尿病护理团队在风险管理中的作用,有助于形成群体风险防范意识,使护理人员识别、评估、预防以及处理风险事件的能力增强,从而有利于减少糖尿病患者面临的护理风险因素,以确保其生命安全。该研究主要从合理建立糖尿病护理团队以奠定风险管理基础,糖尿病护理团队明确工作职责以增强风险管理意识以及糖尿病护理团队明确工作内容以提升处理风险能力三个方面,对糖尿病护理团队在风险管理中的作用进行探究。%In addition to active treatment in patients with diabetes, the acceptance of scientific and effective nursing intervention to stabilize their condition and further deterioration of the disease prevention and control is important. Emphasis on diabetes care team in risk management, contribute to the formation of risk awareness groups that nurses identify, assess, prevent and deal with the ability to enhance the risk event, which will help reduce risk factors for diabetes care faced to ensure their lives. This article from the diabetes care team to establish a reasonable risk management in order to lay the foundation, clear job responsibilities dia-betes care team to enhance the awareness of risk management and diabetes care team clear job content to enhance the ability to deal with three aspects of risk for diabetes care team in Risk Management role of inquiry.

  18. [Team management of rheumatoid arthritis].

    Science.gov (United States)

    Le Loët, X; Vittecoq, O

    2001-12-01

    The main objectives of team management of rheumatoid arthritis are to stop structural damage of joints and to reduce functional, psychological, socioprofessional and economic consequences. Team management requires the collaboration, around the patient, of a rheumatologist, a nurse, a psychologist, a physiotherapist, an occupational therapist, an orthopaedic surgeon at the same time, in the same place. More and more patients wish to manage their disease by themselves. Team care should not be proposed to every patient; it must be reserved to patients whose condition required such an approach because of the severity of the disease, comorbidity, psychological or socioprofessionnal difficulties. Team management should be personalized. Utility of team management is now accepted; out-patient administration is as effective as in-patient one. A good educational program is very important. However, search is still needed to define optimal modalities of team management and tools to measure the efficiency of this approach.

  19. [Will inpatient care still be financeable? Effects of the minimum wage to operators].

    Science.gov (United States)

    Meyer, Dirk

    2010-11-01

    Due to demographic and social developments nursing service will continueto be a growth industry in the long run. The requirement for this is the political volition of a sufficient funding. A minimum wage in nursing service tends to increase prices of the offered services. Stated justifications for a minimum wage are wage dumping protection (inter alia against the background of the upcoming opening of the single market in 2011) as well as raising rivals' costs. Protection is focused on the 266,000 non-skilled workers in basic care owing to the strong tightening of the labour market for caregivers. Operative minimum wages will lead to adjustments by optimising operations, intensification of work, and rationalisation of workflow by increased employment of capital as well as technical substitution of relatively expensive non-skilled workers. In addition there will be increased pressure on prices for nursing services and private co-payments. There will be an increased supply and demand for illegal services. Suppliers who had been tied to collective contracts so far will achieve a relative advantage in competition. PMID:21086675

  20. Highlights From the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care

    OpenAIRE

    Kamath, Janine R. A.; Osborn, John B; Roger, Véronique L; Rohleder, Thomas R.

    2011-01-01

    In August 2010, the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care was held. The continuing mission of the conference is to gather a multidisciplinary group of systems engineers, clinicians, administrators, and academic professors to discuss the translation of systems engineering methods to more effective health care delivery. Education, research, and practice were enhanced via a mix of formal presentations, tutorials, and informal gatherings...

  1. The MYRRHA-FASTEF cores design for critical and sub-critical operational modes (EU FP7 Central Design Team project)

    Energy Technology Data Exchange (ETDEWEB)

    Sarotto, Massimo, E-mail: massimo.sarotto@enea.it [ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Via Martiri di Monte Sole 4, 40129 Bologna (Italy); Castelliti, Diego; Fernandez, Rafael; Lamberts, Damien; Malambu, Edouard; Stankovskiy, Alexey [SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol (Belgium); Jaeger, Wadim [KIT, Karlsruhe Institute of Technology, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmotz-Platz 1, 76344, Eggenstein-Leopoldshafen (Germany); Ottolini, Marco [ANSALDO NUCLEARE S.p.A., Corso Perrone 25, 16152 Genova (Italy); Martin-Fuertes, Francisco [CIEMAT, Spanish National Research Centre for Energy, Environment and Technology, Avenida Complutense 40, 28040 Madrid (Spain); Sabathé, Laurent [AREVA-NP, Rue Juliette Récamier 10, 69456 Lyon Cedex 06 (France); Mansani, Luigi [ANSALDO NUCLEARE S.p.A., Corso Perrone 25, 16152 Genova (Italy); Baeten, Peter [SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol (Belgium)

    2013-12-15

    Highlights: • EU FP7 CDT/FASTEF project related to the multi-purpose irradiation facility MYRRHA. • MYRRHA-FASTEF cores design for both critical and sub-critical operational modes. • Detailed neutronic analyses by deterministic and Monte Carlo methods. • Accurate TH studies at the fuel assembly and pin sub-channel level. • Investigation of the potential for the transmutation of minor actinides. -- Abstract: On April 2009, a three-year-project was launched within the 7th Framework Programme (FP) of the European Commission: the Central Design Team (CDT) for a FAst Spectrum Transmutation Experimental Facility (FASTEF). The main goal was to achieve an advanced level of design for an irradiation facility, cooled by lead-bismuth, operating in both critical and sub-critical modes. In continuity with the research studies on fast nuclear systems carried out in the 5–6th FPs, the CDT had the further ambitious objective to define a preliminary design of the MYRRHA reactor, planned to be built at the SCK• CEN research centre in Mol (Belgium). In addition to being a multi-purpose irradiation facility, MYRRHA should be able to demonstrate the Acceleration Driven System concept at ∼100 MW power level and an efficient transmutation of minor actinides, as main contributors to high-level long-lived radioactive wastes. This paper describes the design of cores able to operate the MYRRHA-FASTEF plant in both critical and sub-critical modes. The design studies were performed by detailed neutronic analyses (with deterministic and Monte Carlo methods) and by accurate thermal-hydraulic evaluations (at the fuel assembly and pin sub-channel level), by taking also into account thermo-mechanical and safety constraints. Among the most significant core features, the fast flux level (Φ{sub >0.75} {sub MeV} ∼ 10{sup 15} cm{sup −2} s{sup −1}), the high flexibility for irradiation purposes and the limited overall dimension (impacting on the cost of the plant) can be noticed

  2. DIFFERENT DIMENSIONS OF TEAMS

    OpenAIRE

    Goparaju Purna SUDHAKAR

    2013-01-01

    Popularity of teams is growing in 21st Century. Organizations are getting their work done through different types of teams. Teams have proved that the collective performance is more than the sum of the individual performances. Thus, the teams have got different dimensions such as quantitative dimensions and qualitative dimensions. The Quantitative dimensions of teams such as team performance, team productivity, team innovation, team effectiveness, team efficiency, team decision making and tea...

  3. Innovation in healthcare team feedback.

    Science.gov (United States)

    Plaza, Christine; Beard, Leslie; Fonzo, Anthony Di; Tommaso, Michael Di; Mujawaz, Yaman; Serra-Julia, Marcel; Morra, Dante

    2011-01-01

    Healthcare delivery is evolving from individual, autonomous practice to collaborative team practice. However, barriers such as professional autonomy, time constraints and the perception of error as failure preclude learning behaviours that can facilitate organizational learning and improvement. Although experimentation, engaging in questions and feedback, discussing errors and reflecting on results can facilitate learning and promote effective performance, the cultural barriers within healthcare can prevent or inhibit this type of behaviour among teams. At the University Health Network's Centre for Innovation in Complex Care, we realize the need for a tool that facilitates learning behaviour and is sensitive to the risk-averse nature of the clinical environment. The vehicle for the Team Feedback Tool is a web-based application called Rypple (www.rypple.com), which allows team members to provide anonymous, rapid-fire feedback on team processes and performance. Rypple facilitates communication, elicits feedback and provokes discussion. The process enables follow-up face-to-face team discussions and encourages teams to create actionable solutions for incremental changes to enhance team health and performance. The Team Feedback Tool was implemented and piloted in general internal medicine at the University Health Network's Toronto General Hospital from early May 2009 to July 2009 to address the issues of teamwork and learning behaviour in the clinical environment. This article explores the opportunities and barriers associated with the implementation of the Team Feedback Tool. PMID:21841396

  4. 社区医护团队的自我和谐现状研究%Current Status of Self Consistency and Congruence of Community Health Care Team

    Institute of Scientific and Technical Information of China (English)

    罗春玲; 黄莲; 叶巧如; 吴翠红; 苏芬; 苏春波

    2012-01-01

    To study the present situation of self consistency and congruence of the community health care team, to investigate the factors influencing the self consistency and congruence and how to improve its degree. Methods Self consistency and congruence scale ( SCCS ) was taken to investigate 245 members of the staff in the community health services centers under the Longhua People's Hospital of Bao'an District of Shenzhen. Results There was no difference of SCCS score between the community doctor and the community nurse ( P > 0. 05 ). The average total score of SCCS for community health care staff was ( 99. 96 ± 10. 85 ), of which the score of self - experience inconsistence was ( 48. 84 ± 7. 59 ), the self flexibility score was (41. 98 ±5. 53 ), and the self - stereotypes score was ( 21. 22 ± 3. 75 ), with statistically significant differences as compared with the nom of college students ( P < 0. 05 ) . Conclusion The community health care staffs are of lower self consistency and congruence. They need enhanced mental health education given by relevant management departments.%目的 了解社区医护团队的自我和谐现状,探讨影响社区医护团队自我和谐的因素及采取何种应对方式来提高社区医护团队的自我和谐程度.方法 采用自我和谐量表,对在深圳市宝安区龙华人民医院下属的社区卫生服务中心工作的245名医护人员进行调查.结果 社区医生和护士的自我和谐得分间差异无统计学意义(P>0.05).社区医护团队自我和谐量表总分均值为(99.96±10.85)分,其中自我与经验的不和谐得分为(48.84±7.59)分,自我的灵活性得分为(41.98±5.53)分,自我的刻板性得分为(21.22±3.75)分,与大学生常模比较差异均有统计学意义(P<0.05).结论 社区医护团队的自我和谐程度偏低,管理部门应加强对社区医护团队的心理健康教育.

  5. Team Learning and Team Composition in Nursing

    Science.gov (United States)

    Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Elseviers, Monique; Denekens, Joke

    2011-01-01

    Purpose: This study aims to explore team learning activities in nursing teams and to test the effect of team composition on team learning to extend conceptually an initial model of team learning and to examine empirically a new model of ambidextrous team learning in nursing. Design/methodology/approach: Quantitative research utilising exploratory…

  6. Integrating palliative care into comprehensive cancer care.

    Science.gov (United States)

    Abrahm, Janet L

    2012-10-01

    While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care. PMID:23054873

  7. Multidisciplinary in-hospital teams improve patient outcomes: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2014-01-01

    Full Text Available Background: The use of multidisciplinary in-hospital teams limits adverse events (AE, improves outcomes, and adds to patient and employee satisfaction. Methods: Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses′ aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others. Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality while improving patient and healthcare worker satisfaction. Results: Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs, hospital wards, intensive care units (ICUs, and most critically, operating rooms (ORs. Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS, and yielded greater patient "staff" satisfaction. Conclusion: Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers′ performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.

  8. Ten principles of good interdisciplinary team work

    OpenAIRE

    Nancarrow, S.A.; Booth, A; Ariss, S.; Smith, T; Enderby, P; Roots, A.

    2013-01-01

    Background Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. Method This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team ...

  9. Negotiated knowledge positions : communication in trauma teams

    OpenAIRE

    Härgestam, Maria

    2015-01-01

    Background Within trauma teams, effective communication is necessary to ensure safe and secure care of the patient. Deficiencies in communication are one of the most important factors leading to patient harm. Time is an essential factor for rapid and efficient disposal of trauma teams to increase patients’ survival and prevent morbidity. Trauma team training plays an important role in improving the team’s performance, while the leader of the trauma team faces the challenge of coordinating and...

  10. Professionals' views on interprofessional stroke team functioning

    OpenAIRE

    Cramm, Jane Murray; Nieboer, Anna Petra

    2011-01-01

    markdownabstractIntroduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals’ perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by te...

  11. Administrative simplification: adoption of operating rules for health care electronic funds transfers (EFT) and remittance advice transactions. Interim final rule with comment period.

    Science.gov (United States)

    2012-08-10

    This interim final rule with comment period implements parts of section 1104 of the Affordable Care Act which requires the adoption of operating rules for the health care electronic funds transfers (EFT) and remittance advice transaction. PMID:22888504

  12. Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care

    OpenAIRE

    Mousquès, Julien; Bourgueil, Yann; Le Fur, Philippe; Yilmaz, Engin

    2010-01-01

    Objectives To assess the efficacy and the cost of a French team work experiment between nurses and GPs for managing type 2 diabetes patients. Methods Based on a case control study design we compare the evolution of process (standard follow-up procedures) and final (glycemic control) outcomes, and of cost, between two consecutive periods between type 2 diabetes patients followed within the team work experiment (intervention group) or by “standard” GPs (controlled group). Results After a 11 mon...

  13. TEAM ORGANISERING

    DEFF Research Database (Denmark)

    Levisen, Vinie; Haugaard, Lena

    2004-01-01

    organisation som denne? Når teams i samtiden anses for at være en organisationsform, der fremmer organisatorisk læring, beror det på, at teamet antages at udgøre et ikke-hierarkisk arbejdsfællesskab, hvor erfaringer udveksles og problemer løses. Teamorganisering kan imidlertid udformes på mange forskellige...

  14. Effects of adding a new PCMH block rotation and resident team to existing longitudinal training within a certified PCMH: primary care residents’ attitudes, knowledge, and experience

    Science.gov (United States)

    Anandarajah, Gowri; Furey, Christopher; Chandran, Rabin; Goldberg, Arnold; El Rayess, Fadya; Ashley, David; Goldman, Roberta E

    2016-01-01

    Background Although the patient-centered medical home (PCMH) model is considered important for the future of primary care in the USA, it remains unclear how best to prepare trainees for PCMH practice and leadership. Following a baseline study, the authors added a new required PCMH block rotation and resident team to an existing longitudinal PCMH immersion and didactic curriculum within a Level 3-certified PCMH, aiming for “enhanced situated learning”. All 39 residents enrolled in a USA family medicine residency program during the first year of curricular implementation completed this new 4-week rotation. This study examines the effects of this rotation after 1 year. Methods A total of 39 intervention and 13 comparison residents were eligible participants. This multimethod study included: 1) individual interviews of postgraduate year (PGY) 3 intervention vs PGY3 comparison residents, assessing residents’ PCMH attitudes, knowledge, and clinical experience, and 2) routine rotation evaluations. Interviews were audiorecorded, transcribed, and analyzed using immersion/crystallization. Rotation evaluations were analyzed using descriptive statistics and qualitative analysis of free text responses. Results Authors analyzed 23 interviews (88%) and 26 rotation evaluations (67%). Intervention PGY3s’ interviews revealed more nuanced understanding of PCMH concepts and more experience with system-level PCMH tasks than those of comparison PGY3s. More intervention PGY3s rated themselves “extremely prepared” to implement PCMH than comparison PGY3s; however, most self-rated “somewhat prepared”. Their reflections demonstrated deeper understanding of PCMH implementation and challenges than comparison PGY3s but inadequate experience to directly see the results of successful solutions. Rotation evaluations from PGY1, PGY2, and PGY3s revealed strengths and several areas for improvement. Conclusion Adding one 4-week block rotation to existing longitudinal training appears

  15. Evaluating operational specifications of point-of-care diagnostic tests: a standardized scorecard.

    Directory of Open Access Journals (Sweden)

    Jonathan D Lehe

    Full Text Available The expansion of HIV antiretroviral therapy into decentralized rural settings will increasingly require simple point-of-care (POC diagnostic tests that can be used without laboratory infrastructure and technical skills. New POC test devices are becoming available but decisions around which technologies to deploy may be biased without systematic assessment of their suitability for decentralized healthcare settings. To address this, we developed a standardized, quantitative scorecard tool to objectively evaluate the operational characteristics of POC diagnostic devices. The tool scores devices on a scale of 1-5 across 30 weighted characteristics such as ease of use, quality control, electrical requirements, shelf life, portability, cost and service, and provides a cumulative score that ranks products against a set of ideal POC characteristics. The scorecard was tested on 19 devices for POC CD4 T-lymphocyte cell counting, clinical chemistry or hematology testing. Single and multi-parameter devices were assessed in each of test categories. The scores across all devices ranged from 2.78 to 4.40 out of 5. The tool effectively ranked devices within each category (p0.80; p<0.001. Use of this tool enables the systematic evaluation of diagnostic tests to facilitate product selection and investment in appropriate technology. It is particularly relevant for countries and testing programs considering the adoption of new POC diagnostic tests.

  16. Is fumigation enough for air conditioning units in operation theatres and Intensive care units?

    Directory of Open Access Journals (Sweden)

    Anasua Deb

    2016-05-01

    Full Text Available Background: Strict asepsis is necessary in operating theatres (OT and intensive care units (ICU as the patients undergo invasive procedures. The filters of contaminated air conditioning (AC units provide a niche for proliferation of fungi and production of fungal spores. Methods: The routine procedure for maintenance of sterile atmosphere in our hospital, i.e. fumigation and mopping walls with disinfectants often fail to address these fungal spores of the AC filters. We therefore carried out a surveillance of the ACs in ICUs and OTs to find the level of contamination with fungal spores and also to improvise on intervention strategies to tackle the problem. Over 3 months period, 34 ACs from 7 OTs and 2 ICUs were screened by taking 2 swabs from each AC which were then tested for the presence of fungal spores as per standard methods. Results: The contamination rate was 88.2% before fumigation and 76.9% after fumigation. The fungal spore contamination rate was reduced to 20% (1 out of 5 ACs after servicing of the ACs was done. Aspergillus spp. was the most common fungal isolate. Conclusion: Based on the observations, we recommend regular servicing of the ACs as well as wet mopping of the ducts with sporicidal solution at regular intervals. [Int J Res Med Sci 2016; 4(5.000: 1583-1589

  17. THE ANALYSIS OF TRAINING NEEDS IN PUBLIC INSTITUTIONS OPERATING IN HEALTH CARE SECTOR IN THE PODKARPACIE PROVINCE

    Directory of Open Access Journals (Sweden)

    Tomasz Skica

    2012-04-01

    Full Text Available The article is an attempt at diagnosing training needs of the employees of units operating in health care sector in the Podkarpacie Province. In times of permanent changes affecting each sphere of economy, providers of health care services cannot afford to remain outside this trend. Improving qualifications, adaptability of the offer, influencing its quality, and above all, the awareness of the necessity of these changes, have become an element which is fully integrated also with this sphere of public sector operations. Taking into account the above, the article verifies not only training needs articulated by employees of Health Care Centers (HCC operating in the Podkarpacie Province, but also the way they are perceived by the managers of these centers, the ability to define training needs and their compatibility with characteristic features of analyzed HCCs. Therefore special emphasis has been placed on demonstrating the variety of diagnosed training needs with reference to such criteria as the size of analyzed centers, the market serviced by them, and their location. These determinants allowed us to conduct a complex analysis of conditions and structure of voiced need for subject training, and as a consequence, contributed to diagnosing the expectations of the health care sector concerning initiatives improving the quality of public services in the health care services area.

  18. 糖尿病护理小组应用于糖尿病患者临床护理中的效果探讨%The Application Effect of Diabetes Care Team in Diabetic Patients in Clinical Nursing Discussion

    Institute of Scientific and Technical Information of China (English)

    曹玉梅

    2015-01-01

    Objective Application for diabetes care team in diabetes clinical care results were discussed.MethodsRandomly selected diabetic patients admitted to our hospital 76 cases a year as research subjects, divided into two groups, each of 38 cases. Where the control group with conventional methods of care, nursing care and diabetes team group is applied, compared two groups of patient satisfaction and the indicators score.ResultsIn contrast, patient satisfaction of care group was 94.74% (36/38), signiifcantly higher than the 78.95% (30/38), the differences between the groups were statistically significant (P<0.05). Conclusion The clinical application of diabetes care and diabetes care team model of care can significantly improve patient satisfaction, and enhance the patient's self-management skills to help improve the quality of life of patients.%目的:对糖尿病护理小组应用在糖尿病患者临床护理中的效果进行探讨。方法随机抽取我院1年收治的糖尿病患者76例作为研究对象,平均分为两组,每组各38例。其中对照组采用常规护理方法,护理组则应用糖尿病小组护理,对比两组患者的满意度和各项指标评分。结果经对比,护理组患者的满意度为94.74%(36/38),高于对照组的78.95%(30/38),组间差异均具有统计学意义(P<0.05)。结论在糖尿病的临床护理中应用糖尿病护理小组的护理模式可以提高患者的满意度,增强患者的自我管理能力,有助于改善患者的生活质量。

  19. Temperature and salinity profile data collected by NOAA's Navigation Response Team 5 during operations along the northeast US coast, May 2005 - March 2006 (NODC Accession 0002673)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Temperature profile data were collected using CTD casts in the Northwest Atlantic Ocean and the Northeast US coast from the NAVIGATION RESPONSE TEAM 5 from 03 May...

  20. Temperature and salinity profile data collected by NOAA's Navigation Response Team 5 during operations along the northeast US coast, March 2005 - March 2006 (NODC Accession 0002674)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Temperature profile data were collected using CTD casts in the Northwest Atlantic Ocean and the Northeast US Coast from the NAVIGATION RESPONSE TEAM 5 from 03 March...

  1. The effect of a team strategy discussion on military team performance

    NARCIS (Netherlands)

    S. Dalenberg; A.L.W. Vogelaar; B. Beersma

    2009-01-01

    In modern military operations, people from diverging backgrounds often have to work together in ad hoc teams. These team members are often well trained to perform their own part of the teamwork. However, for optimal performance they should also act as a team. The question is how optimal team perform

  2. 团队护理模式在住院离退休干部护理中的应用%Application of Team Care Model for Inpatient Old Cadres

    Institute of Scientific and Technical Information of China (English)

    杨秀丽; 闫海楠; 于秋影

    2012-01-01

    目的 探讨离退休干部护理服务新模式,提升部队服务保障水平.方法 在科内组建团队护理小组,对住院离退休干部在责任制整体护理的基础上实行团队护理模式,由多学科专业人员对其进行相应的指导和护理.结果 专科护理内涵质量提高,健康促进作用明显,患者和家属满意度提高.结论 团队护理模式在现行护理工作中具有优势,是其他护理模式所不能替代,值得临床推广.%Objective To discuss the new service model for the old cadres and promote service level. Methods The care teams were set. up in the department; the team care model was implemented based on the responsibility system for the old cadre in the hospital; the nursing service was instructed by multi -field professionals. Results The specialized care quality has been improved; the effect of health recovery was obvious; the satisfaction degree were high in patients. Conclusion There are of more advantages of team care model comparing with current nursing service model, and it could be applied in the clinical practices widely.

  3. A Fire Safety Certification System for Board and Care Operators and Staff. SBIR Phase I: Final Report.

    Science.gov (United States)

    Walker, Bonnie L.

    This report describes the development and pilot testing of a fire safety certification system for board and care operators and staff who serve clients with developmental disabilities. During Phase 1, training materials were developed, including a trainer's manual, a participant's coursebook a videotape, an audiotape, and a pre-/post test which was…

  4. Virtual teams

    OpenAIRE

    Sanders, David

    2010-01-01

    This paper describes some early results from observing and interviewing groups working to achieve intellectually complex tasks that required the use of computers, WWW and other research resources. Three groups were virtual (they were working at a distance and rarely meeting face to face) and two groups were simple control groups They were real groups (working in relatively close proximity so that face to face contact was possible most of the time). All five teams completed their tasks but a s...

  5. Virtual teams

    OpenAIRE

    Sichrovský, Jan

    2013-01-01

    Virtual environment is part of the newly forming area, which is becoming more and more attractive for businesses to use its own potential. Even though it is a very dynamic issue, the goals of this work is providing a detailed description of the aspects of team work in these unusual conditions. The result is a material that not only summarizes the current knowledge, but try to move forward, including many practical views and experiences. The first part focuses on the general definition of ...

  6. Continuous improvement and TQM in health care: an emerging operational paradigm becomes a strategic imperative.

    Science.gov (United States)

    Swinehart, K; Green, R F

    1995-01-01

    Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health-care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health-care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health-care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

  7. Team responsibility structure and team performance

    NARCIS (Netherlands)

    Doorewaard, J.A.C.M.; Hootegem, G. van; Huys, R.

    2002-01-01

    The purpose is to analyse the impact of team responsibility (the division of job regulation tasks between team leader and team members) on team performance. It bases an analysis on 36 case studies in The Netherlands which are known to have implemented team-based work. The case studies were executed

  8. A highly sensitive and simply operated protease sensor toward point-of-care testing.

    Science.gov (United States)

    Park, Seonhwa; Shin, Yu Mi; Seo, Jeongwook; Song, Ji-Joon; Yang, Haesik

    2016-04-21

    Protease sensors for point-of-care testing (POCT) require simple operation, a detection period of less than 20 minutes, and a detection limit of less than 1 ng mL(-1). However, it is difficult to meet these requirements with protease sensors that are based on proteolytic cleavage. This paper reports a highly reproducible protease sensor that allows the sensitive and simple electrochemical detection of the botulinum neurotoxin type E light chain (BoNT/E-LC), which is obtained using (i) low nonspecific adsorption, (ii) high signal-to-background ratio, and (iii) one-step solution treatment. The BoNT/E-LC detection is based on two-step proteolytic cleavage using BoNT/E-LC (endopeptidase) and l-leucine-aminopeptidase (LAP, exopeptidase). Indium-tin oxide (ITO) electrodes are modified partially with reduced graphene oxide (rGO) to increase their electrocatalytic activities. Avidin is then adsorbed on the electrodes to minimize the nonspecific adsorption of proteases. Low nonspecific adsorption allows a highly reproducible sensor response. Electrochemical-chemical (EC) redox cycling involving p-aminophenol (AP) and dithiothreitol (DTT) is performed to obtain a high signal-to-background ratio. After adding a C-terminally AP-labeled oligopeptide, DTT, and LAP simultaneously to a sample solution, no further treatment of the solution is necessary during detection. The detection limits of BoNT/E-LC in phosphate-buffered saline are 0.1 ng mL(-1) for an incubation period of 15 min and 5 fg mL(-1) for an incubation period of 4 h. The detection limit in commercial bottled water is 1 ng mL(-1) for an incubation period of 15 min. The developed sensor is selective to BoNT/E-LC among the four types of BoNTs tested. These results indicate that the protease sensor meets the requirements for POCT. PMID:26980003

  9. Concepções dos cuidados em saúde mental por uma equipe de saúde da família, em perspectiva histórico-cultural The concept of mental care of a family health team from a historical-cultural perspective

    Directory of Open Access Journals (Sweden)

    Marcelo Dalla Vecchia

    2009-02-01

    Full Text Available O presente estudo visa a analisar sentidos pessoais e significações sociais das atividades de atenção em saúde mental desenvolvidas por profissionais integrantes de uma equipe de saúde da família. Parte-se, para tal, da perspectiva teórica da psicologia histórico-cultural de Vigotsky (1896-1934. O trabalho é parte de uma pesquisa participante e, portanto, é contextualizado na etapa de inserção no campo. Observou-se que a equipe considera relevante a determinação das condições de vida no processo saúde-doença da população atendida, a necessidade de lançar mão de estratégias diversificadas no cuidado para além da consulta, a importância de se cuidar da saúde mental da própria equipe, bem como dificuldades na abordagem da família. Indica-se a importância, para o trabalho cotidiano das equipes, das possibilidades de superação da exclusividade do núcleo biomédico na determinação do processo saúde-doença apontadas nos princípios operacionais da Estratégia de Saúde da Família, expressas na utilização do acolhimento como recurso de cuidado, a constituição de vínculos e responsabilização e a continuidade da atenção.The present study aims at analyzing the individual senses and social meanings of mental care actions carried out by professionals working in a Family Health Care Team. The study is based on Vigotsky's (1896-1934 theoretical perspective of a historical and cultural psychology. The work is part of a participant research and as such conducted in the context of a field research. It was observed that the team took into consideration the relevance of social determinants for the disease of the target population, the need for making use of diversified care strategies reaching beyond the clinical setting, the importance of taking care of their own mental health, as well as difficulties related to approaching the families of the patients. We emphasize the importance of overcoming the exclusiveness of

  10. The issue of nursing care of patients after thyroid gland operation

    OpenAIRE

    MARŠÁLKOVÁ, Pavla

    2009-01-01

    The developed countries, our Republic not excluded, have a relatively high incidence of thyroid diseases (5 % to 30 % of population). Females develop the diseases five times oftener than males, mostly in their middle or higher age. The thyroid diseases are curable, but they require that proper diagnostics is applied, effective treatment administered by a professional team, and the patients behave responsibly. A nurse at a Surgery Department has to stand ready to cater instantaneously to the n...

  11. Evaluation of students' receptiveness and response to an interprofessional learning activity across health care disciplines: An approach toward team development in healthcare

    OpenAIRE

    M.P. Judge; E.C. Polifroni; A.T. Maruca; M.E. Hobson; A. Leschak; H. Zakewicz

    2015-01-01

    Objective: This investigation evaluated if exposure to interdisciplinary education improves student readiness for interprofessional learning, fundamental to healthcare team development. Methods: A pre-test post-test design was used to evaluate 308 students from dental medicine, dietetics, medicine, nursing, pharmacy and physical therapy. The Readiness for Interprofessional Learning Scale (RIPLS) was used to evaluate student responsiveness to interprofessional education. Results: Nursing...

  12. Narrative Reflection as a Means to Explore Team Effectiveness

    NARCIS (Netherlands)

    Lohuis, Anne Marie; Sools, Anneke; Vuuren, van Mark; Bohlmeijer, Ernst T.

    2016-01-01

    The aim of this article is to explore how teams make sense of their effectiveness over time by telling their team story. We selected five team stories from health care teams perceived by the organization as effective. We analyzed their stories using three-level narrative analysis, which addresses th

  13. Effects of quality control team on nursing care quality of ICU department%质控小组对重症监护科护理服务质量的影响

    Institute of Scientific and Technical Information of China (English)

    李丽珠; 黄海星; 陈秋弟; 方莉莉; 麦雪柔; 程本坤

    2014-01-01

    Objective To explore the relationship between quality control team and quality of nursing care in ICU.Methods We established a quality control team to check up,supervise and guide the work of nursing staffs on duty.The nursing care working indexes before and after the set-up of quality control team were compared.Results After establishing the quality control team,the quality of nursing care was improved.According to the evaluation criteria of continuous quality improvement of the Guangdong province,the score of the primary care increased from originally (92.4 ± 1.5) to (96.1 ± 1.1),and that of the specialty care was from (91.2 ± 1.3) to (95.3 ± 2.2),while nursing documentation quality was from (92.1 ± 1.6) to (97.3 ± 1.5).Safety measures of the patients were critically enhanced,the adverse events in nursing care were statistically significantly reduced by 2.8%.Conclusion The quality control team could improve the quality of nursing care in ICU and effectively reduce the incidence rate of adverse events.%目的 探讨质控小组与重症监护病房的护理质量的关系.方法 科内成立质量控制小组,对当班护理人员的护理工作进行检查、监督、指导,对比质量控制小组成立前后的护理工作指标.结果 成立质控小组后,重症监护病房护理质量得到提高,基础护理得分从(92.4±1.5)分提高到(96.1±1.1),专科护理得分从(91.2±1.3)分提高到(95.3±2.2),护理文书书写得分从(92.1±1.6)分提高到(97.3±1.5).患者安全措施有明显提高,护理不良事件的发生率下降至2.8%,差异有统计学意义(P<0.05).结论 质控小组能有效提高ICU护理质量,减少护理不良事件的发生.

  14. Analysis of application value of quality control team management mode in the operating room nursing management%质量控制小组管理模式在手术室护理管理中的应用价值分析

    Institute of Scientific and Technical Information of China (English)

    李建荣

    2014-01-01

    To analyze the clinical value of quality control team management mode in the operating room nursing management.Methods:The stage of implementation of quality control team management mode in the operating room nursing management from November 2012 to November 2013 was as the experimental group.The stage of no implementation of quality control team management mode in the operating room nursing management before November 2012 was as the reference group. Results:The psychological nursing quality,health care quality,basic nursing quality of the experimental group were higher than those of the reference group,and the two groups had significant difference(P<0.05).The complaint rate and satisfaction rate of the experimental group were superior to those of the reference group,and the two groups had significant difference(P<0.05). Conclusion:The implementation of quality control team management mode in the operating room nursing management has better effect.It not only improves the nursing quality,but also reduces the complaints.%目的:针对手术室护理管理中实施质量控制小组管理模式的临床价值进行分析。方法:2012年11月-2013年11月在手术室护理中开展质量控制小组管理模式的阶段作为试验组,2012年11月之前在手术室护理中未开展质量控制小组管理模式的阶段作为参照组。结果:试验组中心理护理质量、健康护理质量、基础护理质量均高于参照组,两组比较差异具有统计学意义(P<0.05)。试验组中投诉率低于参照组,满意率优于参照组,两组比较差异具有统计学意义(P<0.05)。结论:针对手术室护理管理中实施质量控制小组管理模式具有较好的效果,不仅提高了护理的质量,同时也降低了投诉情况。

  15. 78 FR 39531 - Mine Rescue Teams

    Science.gov (United States)

    2013-07-01

    ... Rescue Teams; CFR Correction #0;#0;Federal Register / Vol. 78 , No. 126 / Monday, July 1, 2013 / Rules... Rescue Teams CFR Correction In Title 30 of the Code of Federal Regulations, Parts 1 to 199, revised as of... Miner Act Requirements for Underground Coal Mine Operators and Mine Rescue Teams Type of mine...

  16. Hospice Care

    Science.gov (United States)

    ... your care. Other team members may include a music therapist, physical therapist, speech therapist or occupational therapist. ... to the Terms and Conditions and Privacy Policy Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium ...

  17. Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg – a project report

    Directory of Open Access Journals (Sweden)

    Berger, Sarah

    2016-04-01

    Full Text Available Introduction: This project report describes the development, “piloting” and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany.Project Description: A five-member interprofessional team collaborated together on this project. Kolb’s concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: Results: The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative, SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP (n=40 and monoprofessional (MP groups (n=34, was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Conclusions: Lessons learnt included: a recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes.

  18. Cammp Team

    Science.gov (United States)

    Evertt, Shonn F.; Collins, Michael; Hahn, William

    2008-01-01

    The International Space Station (ISS) Configuration Analysis Modeling and Mass Properties (CAMMP) Team is presenting a demo of certain CAMMP capabilities at a Booz Allen Hamilton conference in San Antonio. The team will be showing pictures of low fidelity, simplified ISS models, but no dimensions or technical data. The presentation will include a brief description of the contract and task, description and picture of the Topology, description of Generic Ground Rules and Constraints (GGR&C), description of Stage Analysis with constraints applied, and wrap up with description of other tasks such as Special Studies, Cable Routing, etc. The models include conceptual Crew Exploration Vehicle (CEV) and Lunar Lander images and animations created for promotional purposes, which are based entirely on public domain conceptual images from public NASA web sites and publicly available magazine articles and are not based on any actual designs, measurements, or 3D models. Conceptual Mars rover and lander are completely conceptual and are not based on any NASA designs or data. The demonstration includes High Fidelity Computer Aided Design (CAD) models of ISS provided by the ISS 3D CAD Team which will be used in a visual display to demonstrate the capabilities of the Teamcenter Visualization software. The demonstration will include 3D views of the CAD models including random measurements that will be taken to demonstrate the measurement tool. A 3D PDF file will be demonstrated of the Blue Book fidelity assembly complete model with no vehicles attached. The 3D zoom and rotation will be displayed as well as random measurements from the measurement tool. The External Configuration Analysis and Tracking Tool (ExCATT) Microsoft Access Database will be demonstrated to show its capabilities to organize and track hardware on ISS. The data included will be part numbers, serial numbers, historical, current, and future locations, of external hardware components on station. It includes dates of

  19. Bridging gaps to promote networked care between teams and groups in health delivery systems: a systematic review of non-health literature

    OpenAIRE

    Braithwaite, Jeffrey

    2015-01-01

    Objectives To assess non-health literature, identify key strategies in promoting more networked teams and groups, apply external ideas to healthcare, and build a model based on these strategies. Design A systematic review of the literature outside of healthcare. Method Searches guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of ABI/INFORM Global, CINAHL, IBSS, MEDLINE and Psychinfo databases following a mind-mapping exercise generating key terms centred o...

  20. Stereotactic mesencephalotomy for palliative care pain control: A case report, literature review and plea to rediscover this operation.

    Science.gov (United States)

    Ivanishvili, Zurab; Pujara, Shyam; Honey, C Michael; Chang, Stephano; Honey, Christopher R

    2016-08-01

    Introduction Stereotactic mesencephalotomy is an ablative procedure which lesions the pain pathways (spinothalamic and trigeminothalamic tracts) at the midbrain level to treat medically refractory, nociceptive, contralateral pain. Sparsely reported in contemporary English language literature, this operation is at risk of being lost from the modern-day neurosurgical practice. Methods We present a case report and brief review of the literature on stereotactic mesencephalotomy. A 17-year-old girl with cervical cord glioblastoma and medically refractory unilateral head and neck pain was treated with contralateral stereotactic mesencephalotomy. The lesion was placed at the level of the inferior colliculus, half way between the lateral edge of the aqueduct and lateral border of the midbrain. Results The patient had no head and neck pain immediately after the procedure and remained pain-free for the remainder of her life (five months). She was weaned off her pre-operative narcotics and was able to leave hospital, meeting her palliative care goals. Conclusions Cancer-related unilateral head and neck nociceptive pain in the palliative care setting can be successfully treated with stereotactic mesencephalotomy. We believe that stereotactic mesencephalotomy is the treatment of choice for a small number of patients typified by our case. The authors make a plea to the palliative care and neurosurgical communities to rediscover this operation. PMID:26760110