WorldWideScience

Sample records for care teams operating

  1. Your cancer care team

    Science.gov (United States)

    ... gov/ency/patientinstructions/000929.htm Your cancer care team To use the sharing features on this page, ... help your body heal. Working with Your Care Team Each member of your care team plays an ...

  2. Critical Care Team

    Science.gov (United States)

    ... Patients and Families > About Critical Care > Team Tweet Team Page Content ​The critical care team is a group of specially trained caregivers who ... help very ill patients get better. The care team often teach the patient and family strategies that ...

  3. Developing a multidisciplinary team for disorders of sex development: planning, implementation, and operation tools for care providers.

    Science.gov (United States)

    Moran, Mary Elizabeth; Karkazis, Katrina

    2012-01-01

    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.

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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...... from existing systematic reviews was critically appraised and summarized. Study selection: Using the search terms "rehabilitation", "multidisciplinary teams" or "team care", references were identified for existing studies published after 2000 that examined multidisciplinary rehabilitation team care...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...

  9. 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.

  10. 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.

  11. Your Health Care Team

    Science.gov (United States)

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  12. 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...

  13. Evaluation of the five-year operation period of a rapid response team led by an intensive care physician at a university hospital

    Science.gov (United States)

    Mezzaroba, Ana Luiza; Tanita, Marcos Toshiyuki; Festti, Josiane; Carrilho, Claudia Maria Dantas de Maio; Cardoso, Lucienne Tibery Queiroz; Grion, Cintia Magalhães Carvalho

    2016-01-01

    Objective To evaluate the implementation of a multidisciplinary rapid response team led by an intensive care physician at a university hospital. Methods This retrospective cohort study analyzed assessment forms that were completed during the assessments made by the rapid response team of a university hospital between March 2009 and February 2014. Results Data were collected from 1,628 assessments performed by the rapid response team for 1,024 patients and included 1,423 code yellow events and 205 code blue events. The number of assessments was higher in the first year of operation of the rapid response team. The multivariate analysis indicated that age (OR 1.02; 95%CI 1.02 - 1.03; p < 0.001), being male (OR 1.48; 95%CI 1.09 - 2.01; p = 0.01), having more than one assessment (OR 3.31; 95%CI, 2.32 - 4.71; p < 0.001), hospitalization for clinical care (OR 1.77; 95%CI 1.29 - 2.42; p < 0.001), the request of admission to the intensive care unit after the code event (OR 4.75; 95%CI 3.43 - 6.59; p < 0.001), and admission to the intensive care unit before the code event (OR 2.13; 95%CI 1.41 - 3.21; p = 0.001) were risk factors for hospital mortality in patients who were seen for code yellow events. Conclusion The hospital mortality rates were higher than those found in previous studies. The number of assessments was higher in the first year of operation of the rapid response team. Moreover, hospital mortality was higher among patients admitted for clinical care. PMID:27626952

  14. Making surgical missions a joint operation: NGO experiences of visiting surgical teams and the formal health care system in Guatemala.

    Science.gov (United States)

    Roche, Stephanie; Hall-Clifford, Rachel

    2015-01-01

    Each year, thousands of Guatemalans receive non-emergent surgical care from short-term medical missions (STMMs) hosted by local non-governmental organizations (NGOs) and staffed by foreign visiting medical teams (VMTs). The purpose of this study was to explore the perspectives of individuals based in NGOs involved in the coordination of surgical missions to better understand how these missions articulate with the larger Guatemalan health care system. During the summers of 2011 and 2013, in-depth interviews were conducted with 25 representatives from 11 different Guatemalan NGOs with experience with surgical missions. Transcripts were analysed for major themes using an inductive qualitative data analysis process. NGOs made use of the formal health care system but were limited by several factors, including cost, issues of trust and current ministry of health policy. Participants viewed the government health care system as a potential resource and expressed a desire for more collaboration. The current practices of STMMs are not conducive to health system strengthening. The role of STMMs must be defined and widely understood by all stakeholders in order to improve patient safety and effectively utilise health resources. Priority should be placed on aligning the work of VMTs with that of the larger health care system.

  15. The metamorphosis of a collaborative team: from creation to operation.

    Science.gov (United States)

    Adams, Tracey L; Orchard, Carole; Houghton, Pamela; Ogrin, Rajna

    2014-07-01

    This paper reports on the process of developing a community-based interprofessional team to provide diabetes related foot ulcer care. A new interprofessional team was formed in a local community, and the process of building a successful team was examined by the adoption of an exploratory qualitative case study approach that gathered a series of one-on-one interviews with participants at three points in time - prior to the team's formation, two months into the team's operation, and finally seven months later - shortly before the team and its clinic closed. Interviews were also conducted with a small sample of the team's patients. The factors linked to the successes and challenges of building a care team in a community setting are explored. Informants highlighted the value of regular team meetings, role clarity, and a commitment to patient-centered care. However effective collaboration was not sufficient to maintain the team in the face of poor institutional and government support.

  16. Team effectiveness in academic primary health care teams.

    Science.gov (United States)

    Delva, Dianne; Jamieson, Margaret; Lemieux, Melissa

    2008-12-01

    Primary health care is undergoing significant organizational change, including the development of interdisciplinary health care teams. Understanding how teams function effectively in primary care will assist training programs in teaching effective interprofessional practices. This study aimed to explore the views of members of primary health care teams regarding what constitutes a team, team effectiveness and the factors that affect team effectiveness in primary care. Focus group consultations from six teams in the Department of Family Medicine at Queen's University were recorded and transcribed and qualitative analysis was used to identify themes. Twelve themes were identified that related to the impact of dual goals/obligations of education and clinical/patient practice on team relationships and learners; the challenges of determining team membership including nonattendance of allied health professionals except nurses; and facilitators and barriers to effective team function. This study provides insight into some of the challenges of developing effective primary care teams in an academic department of family medicine. Clear goals and attention to teamwork at all levels of collaboration is needed if effective interprofessional education is to be achieved. Future research should clarify how best to support the changes required for increasingly effective teamwork.

  17. Capability enhancement and amputee care in Operation Iraqi Freedom: The role of a rehabilitation and prosthetics assistance team in reconstruction operations.

    Science.gov (United States)

    Scherer, Matthew

    2009-05-01

    Defining the role of the U.S. Army Rehabilitation and Prosthetic Assistance Team in reconstruction operations was a key component of this first of its kind Army Medical Department (AMEDD) mission in a combat theater of operations. In the tradition of civil-military operations, a five-man team trained 11 Iraqi rehabilitation and prosthetic providers on best clinical, technical, and business practices to manage the nation's growing amputee population. The team instructed, assisted, and supervised Iraqi clinicians in the delivery of prosthetic and rehabilitation services to 124 patients over 350 patient clinical visits. After a successful transition from Multi-National Force-Iraq oversight to the Iraqi Ministry of Defense (MoD), the premier prosthetics and rehabilitation clinic in Iraq now provides services to patients from current and past conflicts, including civilians and pediatric patients.

  18. Interprofessional Care and Role of Team Leaders.

    Science.gov (United States)

    Kaini, B K

    2015-01-01

    Interprofessional care is an essential part of the health service delivery system. It helps to achieve improved care and to deliver the optimal and desired health outcomes by working together, sharing and learning skills. Health care organisation is a collective sum of many leaders and followers. Successful delivery of interprofessional care relies on the contribution of interprofessional care team leaders and health care professionals from all groups. The role of the interprofessional care team leader is vital to ensuring continuity and consistency of care and to mobilise and motivate health care professionals for the effective delivery of health services. Medical professionals usually lead interprofessional care teams. Interprofessional care leaders require various skills and competencies for the successful delivery of interprofessional care.

  19. 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.

  20. Can health care teams improve primary care practice?

    Science.gov (United States)

    Grumbach, Kevin; Bodenheimer, Thomas

    2004-03-10

    In health care settings, individuals from different disciplines come together to care for patients. Although these groups of health care personnel are generally called teams, they need to earn true team status by demonstrating teamwork. Developing health care teams requires attention to 2 central questions: who is on the team and how do team members work together? This article chiefly focuses on the second question. Cohesive health care teams have 5 key characteristics: clear goals with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication. Two organizations are described that demonstrate these components: a private primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region primary care sites. Research on patient care teams suggests that teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. In addition, medical settings in which physicians and nonphysician professionals work together as teams can demonstrate improved patient outcomes. A number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. Taking small steps toward team development may improve the work environment in primary care practices.

  1. 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.

  2. Evaluating the effectiveness of health care teams.

    Science.gov (United States)

    Mickan, Sharon M

    2005-05-01

    While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. Organisational benefits of teamwork include reduced hospitalisation time and costs, reduced unanticipated admissions, better accessibility for patients, and improved coordination of care. Team benefits include efficient use of health care services, enhanced communication and professional diversity. Patients report benefits of enhanced satisfaction, acceptance of treatment and improved health outcomes. Finally, team members report enhanced job satisfaction, greater role clarity and enhanced well-being. Due to the inherent complexity of teamwork, a constituency model of team evaluation is supported where key stakeholders identify and measure the intended benefits of a team.

  3. 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.

  4. 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.

  5. 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.

  6. Mental health integration: normalizing team care.

    Science.gov (United States)

    Reiss-Brennan, Brenda

    2014-01-01

    This article examines the impact of integrating mental health into primary health care. Mental Health Integration (MHI) within Intermountain Healthcare has changed the culture of primary health care by standardizing a team-based care process that includes mental health as a normal part of the routine medical encounter. Using a quantitative statistical analysis of qualitative reports (mixed methods study), the study reports on health outcomes associated with MHI for patients and staff. Researchers interviewed 59 patients and 50 staff to evaluate the impact of MHI on depression care. Patients receiving MHI reported an improved relationship with caregivers (P approach to improve outcomes.

  7. 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

  8. 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.

  9. Delivering Coordinated Cancer Care by Building Transactive Memory in a Team of Teams.

    Science.gov (United States)

    Henry, Elizabeth; Silva, Abigail; Tarlov, Elizabeth; Czerlanis, Cheryl; Bernard, Margie; Chauhan, Cynthia; Schalk, Denise; Stewart, Greg

    2016-11-01

    Cancer care delivery is highly complex. Treatment involves coordination within oncology health-care teams and across other teams of referring primary and specialty providers (a team of teams). Each team interfaces with patients and caregivers to offer component parts of comprehensive care. Because patients frequently obtain specialty care from divergent health-care systems resulting in cross-system health-care use, oncology teams need mechanisms to coordinate and collaborate within and across health-care systems to optimize clinical outcomes for all cancer patients. Transactive memory is one potential strategy that can help improve comprehensive patient care delivery. Transactive memory is a process by which two or more team professionals develop a shared system for encoding, storing, and retrieving information. Each professional is responsible for retaining only part of the total information. Applying this concept to a team of teams results in system benefits wherein all teams share an understanding of specialized knowledge held by each component team. The patient's role as the unifying member of the team of teams is central to successful treatment delivery. This clinical case presents a patient who is receiving oral treatment for advanced prostate cancer within two health systems. The case emphasizes the potential for error when multiple teams function without a point team (the team coordinating efforts of all other primary and specialty teams) and when the specialty knowledge of providers and patients is not well integrated into all phases of the care delivery process.

  10. 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=showing that staff had greater 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.

  11. 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...

  12. U.S. Air Force Operational Medicine: Using the Enterprise Estimating Supplies Program to Develop Materiel Solutions for the Operational Requirements of the EMEDS Specialty Care Augmentation Team

    Science.gov (United States)

    2011-06-28

    medical assets since 2004. Air Force medical modeling capabilities currently capture care and treatment of the sick and injured from the first...0.01 $18.67 0.36 0.01 $18.67 A 6505015781669 PENICILLIN G PROCAINE SUSP STER USP 600000 UNITS / ML PG 1 1 0.50 0.12 $135.37 0.50 0.12 $135.37 D...8.76 0.78 0.03 $17.52 A 6630015207423 TUBE BLOOD COLLECTING W/ SERUM SEPARATOR 200S PG 1 1 2.25 0.25 $142.79 2.25 0.25 $142.79 A 6515011562966 TUBE

  13. Collaborative transdisciplinary team approach for dementia care.

    Science.gov (United States)

    Galvin, James E; Valois, Licet; Zweig, Yael

    2014-01-01

    Alzheimer's disease (AD) has high economic impact and places significant burden on patients, caregivers, providers and healthcare delivery systems, fostering the need for an evaluation of alternative approaches to healthcare delivery for dementia. Collaborative care models are team-based, multicomponent interventions that provide a pragmatic strategy to deliver integrated healthcare to patients and families across a wide range of populations and clinical settings. Healthcare reform and national plans for AD goals to integrate quality care, health promotion and preventive services, and reduce the impact of disease on patients and families reinforcing the need for a system-level evaluation of how to best meet the needs of patients and families. We review collaborative care models for AD and offer evidence for improved patient- and family-centered outcomes, quality indicators of care and potential cost savings.

  14. Multiprofessional team approach in palliative care units in Japan.

    Science.gov (United States)

    Maeyama, Etsuko; Kawa, Masako; Miyashita, Mitsunori; Ozawa, Taketoshi; Futami, Noriko; Nakagami, Yuriko; Sugishita, Chieko; Kazuma, Keiko

    2003-08-01

    Health-care providers engaged in palliative care experience difficulty with the practice of team care. However, the details of the difficulties have not been not clarified. To obtain an overview of team care in the Japanese palliative inpatient care setting, a descriptive and cross-sectional study was performed. The participants were physicians, nurses, dietitians, medical social workers (MSWs), and pharmacists. A representative from each discipline was selected. They were asked about their participation in services provided by government-approved palliative care units (PCUs) and the practice of team care. A total of 38 institutions participated in this study. In these institutions, 97% of physicians, 37% of dietitians, 39% of MSWs, 27% of pharmacists, and 13% of physical therapists attended PCU care meetings once a week or more, and 35% of religious workers and 11% of counselors attended. About 70% of institutions held regular care meetings with more than three types of health-care providers. Physicians and nurses had different perceptions regarding the practice of team care. The former had a positive perception of team care and the latter had a negative perception. In addition, nurses' perception of overall team care was related to their perception of care meetings ( P=0.052) and the number of types of professional participating in care meetings ( P=0.054). To promote team care in the Japanese palliative care setting, it is necessary to consider a practical standard of team care, and to conduct effective care meetings.

  15. A nurse practitioner patient care team: implications for pediatric oncology.

    Science.gov (United States)

    Golden, Julia Rose

    2014-01-01

    The role of the pediatric advanced practice registered nurse continues to evolve within the ever-changing field of health care. In response to increased demand for health care services and because of a variety of changes in the health care delivery system, nurse practitioner patient care teams are an emerging trend in acute care settings. Care provided by nurse practitioner teams has been shown to be effective, efficient, and comprehensive. In addition to shorter hospital stays and reduced costs, nurse practitioner teams offer increased quality and continuity of care, and improved patient satisfaction. Nurse practitioner patient care teams are well suited to the field of pediatric oncology, as patients would benefit from care provided by specialized clinicians with a holistic focus. This article provides health care professionals with information about the use of nurse practitioner patient care teams and implications for use in pediatric oncology.

  16. 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...... 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...

  17. 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...

  18. 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.

  19. 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.

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

    Science.gov (United States)

    Burke, Triona; O'Neill, Catherine

    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.

  1. 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.

  2. 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.

  3. Primary care team working in Ireland: a qualitative exploration of team members' experiences in a new primary care service.

    Science.gov (United States)

    Kennedy, Norelee; Armstrong, Claire; Woodward, Oonagh; Cullen, Walter

    2015-07-01

    Team working is an integral aspect of primary care, but barriers to effective team working can limit the effectiveness of a primary care team (PCT). The establishment of new PCTs in Ireland provides an excellent opportunity to explore team working in action. The aim of this qualitative study was to explore the experiences of team members working in a PCT. Team members (n = 19) from two PCTs were interviewed from May to June 2010 using a semi-structured interview guide. All interviews were audio-recorded and transcribed. Data were analysed using NVivo (version 8). Thematic analysis was used to explore the data. We identified five main themes that described the experiences of the team members. The themes were support for primary care, managing change, communication, evolution of roles and benefits of team working. Team members were generally supportive of primary care and had experienced benefits to their practice and to the care of their patients from participation in the team. Regular team meetings enabled communication and discussion of complex cases. Despite the significant scope for role conflict due to the varied employment arrangements of the team members, neither role nor interpersonal conflict was evident in the teams studied. In addition, despite the unusual team structure in Irish PCTs - where there is no formally appointed team leader or manager - general issues around team working and its benefits and challenges were very similar to those found in other international studies. This suggests, in contrast to some studies, that some aspects of the leadership role may not be as important in successful PCT functioning as previously thought. Nonetheless, team leadership was identified as an important issue in the further development of the teams.

  4. [The role of the mobile palliative care team nurse].

    Science.gov (United States)

    Chrétien, Sophie

    2015-11-01

    The mobile palliative care and support team nurse works in different departments within the hospital. The clinical situation of a patient enables the team to identify in what ways she is declining and thereby participate in the care management in order to favour the patient's return home.

  5. The multidisciplinary team in palliative care: A case reflection

    Directory of Open Access Journals (Sweden)

    Liza Bowen

    2014-01-01

    Full Text Available This essay is a reflection on the multidisciplinary team in palliative care, from the perspective of a final year MBBS student from the UK spending one month with an Indian pain and palliative care team at Institute Rotary Cancer Hospital (IRCH, AIIMS, New Delhi.

  6. [Involvement of medical representatives in team medical care].

    Science.gov (United States)

    Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko

    2009-04-01

    In recent years, chemotherapies have been further advanced because of successive launch of new drugs, introduction of molecular targeting, etc., and the concept of so-called Team Medical Care ,the idea of sharing interdisciplinary expertise for collaborative treatment, has steadily penetrated in the Japanese medical society. Dr. Naoto Ueno is a medical oncologist at US MD Anderson Cancer Center, the birthplace of the Team Medical Care. He has advocated the concept of ABC of Team Oncology by positioning pharmaceutical companies as Team C. Under such team practice, we believe that medical representatives of a pharmaceutical company should also play a role as a member of the Team Medical Care by providing appropriate drug use information to healthcare professionals, supporting post-marketing surveillance of treated patients, facilitating drug information sharing among healthcare professionals at medical institutions, etc.

  7. Medical Team Training Programs in Health Care

    Science.gov (United States)

    2005-01-01

    DOM, renamed LifewingsTM), and Geriatric Interdisciplinary Team Training ( GITT )—from a comprehensive review of the literature (refer to Baker et al...response checklist,” which trainees are required to use in the OR. Geriatric Interdisciplinary Team Training ( GITT ) The primary purpose of GITT is to... GITT provides interdisciplinary team training for physicians, nurses, nurse practitioners, social workers, pharmacists, therapists, and

  8. 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.

  9. The palliative care interdisciplinary team: where is the community pharmacist?

    Science.gov (United States)

    O'Connor, Moira; Pugh, Judith; Jiwa, Moyez; Hughes, Jeff; Fisher, Colleen

    2011-01-01

    Palliative care emphasizes an interdisciplinary approach to care to improve quality of life and relieve symptoms. Palliative care is provided in many ways; in hospices, hospital units, and the community. However, the greatest proportion of palliative care is in the community. In hospice and palliative care units in hospitals, clinical pharmacists are part of the interdisciplinary team and work closely with other health care professionals. Their expertise in the therapeutic use of medications is highly regarded, particularly as many palliative care patients have complex medication regimens, involving off-label or off-license prescribing that increases their risk for drug-related problems. However, this active involvement in the palliative care team is not reflected in the community setting, despite the community pharmacist being one of the most accessible professionals in the community, and visiting a community pharmacist is convenient for most people, even those who have limited access to private or public transport. This may be due to a general lack of understanding of skills and knowledge that particular health professionals bring to the interdisciplinary team, a lack of rigorous research supporting the necessity for the community pharmacist's involvement in the team, or it could be due to professional tensions. If these barriers can be overcome, community pharmacists are well positioned to become active members of the community palliative care interdisciplinary team and respond to the palliative care needs of patients with whom they often have a primary relationship.

  10. 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.

  11. Understanding Cleft and Craniofacial Team Care

    Science.gov (United States)

    ... Donor Spotlight Fundraising Ideas Vehicle Donation Volunteer Efforts Cleft Lip/Palate & Craniofacial Specialists in Your Area skip to submenu Parents & Individuals Cleft Lip/Palate & Craniofacial Specialists in Your Area Team Disclaimer States: ...

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. Exploring the concept of a team approach to wound care: MANAGING WOUNDS AS A TEAM.

    Science.gov (United States)

    2014-05-01

    Background The growing prevalence and incidence of nonhealing acute and chronic wounds is a worrying concern. A major challenge is the lack of united services aimed at addressing the complex needs of individuals with wounds. However, the WHO argues that interprofessional collaboration in education and practice is key to providing the best patient care, enhancing clinical and health-related outcomes and strengthening the health system. It is based on this background that the team approach to wound care project was conceptualised. The project was jointly initiated and realised by the Association for the Advancement of Wound Care (AAWC-USA), the Australian Wound Management Association (AWMA) and the European Wound Management Association (EWMA). Aim The aim of this project was to develop a universal model for the adoption of a team approach to wound care. Objective The overarching objective of this project was to provide recommendations for implementing a team approach to wound care within all clinical settings and through this to develop a model for advocating the team approach toward decision makers in national government levels. Method An integrative literature review was conducted. Using this knowledge, the authors arrived at a consensus on the most appropriate model to adopt and realise a team approach to wound care. Results Eighty four articles met the inclusion criteria. Following data extraction, it was evident that none of the articles provided a definition for the terms multidisciplinary, interdisciplinary or transdisciplinary in the context of wound care. Given this lack of clarity within the wound care literature, the authors have here developed a Universal Model for the Team Approach to Wound Care to fill this gap in our current understanding. Conclusion We advocate that the patient should be at the heart of all decision-making, as working with the Universal Model for the Team Approach to Wound Care begins with the needs of the patient. To facilitate this

  19. 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.

  20. 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.…

  1. The role of dentist in palliative care team

    Directory of Open Access Journals (Sweden)

    Rani P Mol

    2010-01-01

    Full Text Available The palliative doctor gives the ′touch of God′ as he/she takes care of the terminally ill patient. The oncologist encounters great difficulties in managing oral cavity problems of these patients. A trained dental doctor can help other doctors in dealing with these situations. But the general dental surgeon does not have enough idea about his part in these treatments. The community is also unaware of the role that a nearby dentist can play. Adequate training programs have to be conducted and awareness has to be created. A trained dentist will be a good team mate for the oncologist or radiotherapist or other doctors of the palliative care team. In this paper, a brief attempt is made to list a few areas in which a palliative care dentist can help other members of the palliative care team and also the patient in leading a better life.

  2. Crossing boundaries, re-defining care: the role of the critical care outreach team.

    Science.gov (United States)

    Coombs, Maureen; Dillon, Ann

    2002-05-01

    There is clear indication that both government and professional policy in the United Kingdom supports a radical change in the role of healthcare practitioners, with a move towards a patient-focused service delivered by clinical teams working effectively together. Recent health service imperatives driving the agenda for flexible clinical teams have occurred simultaneously with an increased public and political awareness of deficits in availability of critical care services. Against this policy backdrop, working across professional and organizational boundaries is fundamental to supporting quality service improvements. In the acute care sector, the development of critical care outreach teams is an innovation that seeks to challenge the traditional support available for sick ward patients. Activity data and observations from the first 6-month evaluation of two critical care outreach teams identify the need for clinical support and education offered by critical care practitioners to ward-based teams. The experiences from such flexible clinical teams provides a foundation from which to explore key issues for intradisciplinary and interdisciplinary working across clinical areas and organizational boundaries. Adopting innovative approaches to care delivery, such as critical care outreach teams, can enable clinical teams and NHS trusts to work together to improve the quality of care for acutely ill patients, support clinical practitioners working with this client group, and develop proactive service planning.

  3. The social worker. A member of the primary care team?

    Science.gov (United States)

    Falloon, D

    1998-12-01

    The primary health care team at present does not include social workers as routine members. If however, we, accept the World Health Organization definition of health, which includes social well being, then it follows that the social worker should be considered as a member of the health team to attend to this aspect of health in the service delivery mix. This paper presents the experience of a social worker assigned to the August Town/Hermitage Type III health centre during the period March 1995 to February 1996 and her contribution to patient welfare. The expected roles of the social worker and his or her contribution to the health team are outlined.

  4. 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.

  5. Evaluating multidisciplinary health care teams: taking the crisis out of CRM.

    Science.gov (United States)

    Sutton, Gigi

    2009-08-01

    High-reliability organisations are those, such as within the aviation industry, which operate in complex, hazardous environments and yet despite this are able to balance safety and effectiveness. Crew resource management (CRM) training is used to improve the non-technical skills of aviation crews and other high-reliability teams. To date, CRM within the health sector has been restricted to use with "crisis teams" and "crisis events". The purpose of this discussion paper is to examine the application of CRM to acute, ward-based multidisciplinary health care teams and more broadly to argue for the repositioning of health-based CRM to address effective everyday function, of which "crisis events" form just one part. It is argued that CRM methodology could be applied to evaluate ward-based health care teams and design non-technical skills training to increase their efficacy, promote better patient outcomes, and facilitate a range of positive personal and organisational level outcomes.

  6. Health care interprofessional education: encouraging technology, teamwork, and team performance.

    Science.gov (United States)

    2014-04-01

    It is critical to prepare nurses for future practice to work in teams by engaging students in interprofessional education (IPE) that fosters positive attitudes toward teamwork. The purpose of this study was to examine the effects of computer-supported IPE on students’ attitudes and perceptions toward health care teamwork and team performance. A hybrid approach to IPE was used to provide students with an educational experience that combined the benefits of traditional face-to-face communication methodology with a computer-mediated platform that focused on reflection and team building. A statistically significant difference was found in students’ perceptions of team performance after engaging in computer-supported IPE. No statistically significant difference in students’ pretest–posttest composite attitude toward teamwork scores was noted; however, there was a positive trend toward improved scores.

  7. Promotion of role clarification in the Health Care Team Challenge.

    Science.gov (United States)

    Hudson, C C; Gauvin, S; Tabanfar, R; Poffenroth, A M; Lee, J S; O'Riordan, A L

    2017-01-31

    Interprofessional collaboration has consistently been associated with positive client-care outcomes. Role clarification is one facet of interprofessional collaboration that is thought to be crucial for effective interprofessional team functioning. Given the positive outcomes associated with interprofessional collaboration, educators have begun to integrate formal interprofessional education events into healthcare curricula. The Health Care Team Challenge (HCTC) is a collaborative competition designed to promote interprofessional competencies among students in healthcare fields. The current study empirically investigated whether this event promoted role clarification among participants. Sixteen participants in five healthcare professions (occupational therapy, physiotherapy, clinical psychology, nursing, and medicine) completed two questionnaires to assess role clarification before and after participating in this event. Results indicate that participants' understanding of their own and other professions' roles improved after participating in this team activity. These results suggest that the HCTC is effective in promoting role clarification and collaboration among healthcare students.

  8. Palliative care team visits. Qualitative study through participant observation

    Directory of Open Access Journals (Sweden)

    María del Mar Alfaya Góngora

    2016-04-01

    Full Text Available Objectives:To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants.Methods:A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed.Results:The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources.Conclusion:Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

  9. [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.

  10. [Information in health care: the use of SIAB by the professional teams of Family Health Care].

    Science.gov (United States)

    Marcolino, Janaína Souza; Scochi, Maria José

    2010-06-01

    The remarkable expansion of Family Health Care Program and the discussion of issues related to the amount of the collected data stimulated the need for designing an information system that embraced the complex organization of basic health care. So, in 1998, the Basic Health Care Information System (SI4B) was founded. This research aimed to investigate the use of SIAB by the professional teams of the Family Health Care. A questionnaire was applied to 75 professionals belonging to 10 teams which were observed, one week each. The study evidenced that the Family Health Care teams that participated in this research have not used the available information for planning or assessing their health care services, and so, they have missed the opportunity of using the available information for health care local needs.

  11. Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work

    Directory of Open Access Journals (Sweden)

    Mazzocato Pamela

    2011-11-01

    Full Text Available Abstract Objective Teamwork has been suggested as a promising approach to improving care processes in emergency departments (ED. However, for teamwork to yield expected results, implementation must involve behavior changes. The aim of this study is to use behavior analysis to qualitatively examine how teamwork plays out in practice and to understand eventual discrepancies between planned and actual behaviors. Methods The study was set in a Swedish university hospital ED during the initial phase of implementation of teamwork. The intervention focused on changing the environment and redesigning the work process to enable teamwork. Each team was responsible for entire care episodes, i.e. from patient arrival to discharge from the ED. Data was collected through 3 days of observations structured around an observation scheme. Behavior analysis was used to pinpoint key teamwork behaviors for consistent implementation of teamwork and to analyze the contingencies that decreased or increased the likelihood of these behaviors. Results We found a great discrepancy between the planned and the observed teamwork processes. 60% of the 44 team patients observed were handled solely by the appointed team members. Only 36% of the observed patient care processes started according to the description in the planned teamwork process, that is, with taking patient history together. Beside this behavior, meeting in a defined team room and communicating with team members were shown to be essential for the consistent implementation of teamwork. Factors that decreased the likelihood of these key behaviors included waiting for other team members or having trouble locating each other. Getting work done without delay and having an overview of the patient care process increased team behaviors. Moreover, explicit instructions on when team members should interact and communicate increased adherence to the planned process. Conclusions This study illustrates how behavior analysis

  12. The effect of multidisciplinary team care on cancer management.

    Science.gov (United States)

    Abdulrahman, Ganiy Opeyemi

    2011-01-01

    Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical oncologist. The report further suggested that a lead clinician with a well established interest in cancer care should be appointed to organise and coordinate the whole range of cancer services provided within the Cancer Unit. Many people have argued that the multidisciplinary team management of patients has resulted in better care and improved survival. However, there are barriers to the optimal effectiveness of the multidisciplinary team. This paper aims to review various studies on the effectiveness of the multidisciplinary team in the management of cancer patients and also discuss some of the barriers to the multidisciplinary team.

  13. 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...

  14. 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.

  15. Team care of type 2 diabetes mellitus in Taiwan.

    Science.gov (United States)

    Wang, Chih-Yuan; Yu, Neng-Chun; Sheu, Wayne Huey-Herng; Tsai, Shih-Tzer; Tai, Tong-Yuan

    2014-12-01

    Type 2 diabetes mellitus (T2DM) is a global health-care and national policy issue. As fluctuating glycemic control in diabetes often results in serious complications, we must encourage the diabetes educators' efforts at long-term follow-up among patients with T2DM. Therefore, certified diabetes educators (CDEs) play the most pivotal roles as life-long protectors for patients with T2DM. In the past 15 years, more than 4,000 CDEs have been trained and qualified, including health professionals such as physicians, nurses, dieticians, and pharmacists. The most important initiation of diabetes share care in Taiwan was originated in I-Lan County. Initiated to provide regional diabetes care, the name of this program is the Lan-Yang Diabetes Shared Care System. In 2006, the Taiwanese Association of Diabetes Educators (TADE) carried out a nationwide survey to evaluate the status of diabetes control in Taiwan, focusing on the "ABC" goal (A: HbA1c Five years later, in 2011, TADE compared two nationwide surveys and found total ABC attainment rates of 4.1% and 8.6%, respectively. The team-care approach to T2DM has been underway for over 20 years in Taiwan. Future interventions and treatment algorithms with team-based education should aim at preventing acute and chronic complications, which remains a long-term challenge in Taiwan.

  16. 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

  17. Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.

    Science.gov (United States)

    Taylor, Erin Fries; Machta, Rachel M; Meyers, David S; Genevro, Janice; Peikes, Deborah N

    2013-01-01

    Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care.

  18. [Neonatal palliative care at home: Contribution of the regional pediatric palliative care team].

    Science.gov (United States)

    Cojean, N; Strub, C; Kuhn, P; Calvel, L

    2017-02-01

    The "patients' rights and end-of-life care" act, known as the Leonetti law, has allowed implementation of palliative care in neonatology as an alternative to unreasonable therapeutic interventions. A palliative care project can be offered to newborns suffering from intractable diseases. It must be focused on the newborn's quality of life and comfort and on family support. Palliative care for newborns can be provided in the delivery room, in the neonatal unit, and also at home. Going home is possible but requires medical support. Here we describe the potential benefits of the intervention of a regional team of pediatric palliative care for newborns, both in the hospital and at home. Two clinical situations of palliative care at home started in the neonatal period and the neonatal unit are presented. They are completed by a retrospective national survey focusing on the type of support to newborns in palliative care in 2014, which was conducted in 22 French regional pediatric palliative care teams. It shows that 26 newborns benefited from this support at home in 2014. Sixteen infants were born after a pregnancy with a palliative care birth plan and ten entered palliative care after a decision to limit life-sustaining treatments. Twelve of them returned home before the 20th day of life. Sixteen infants died, six of them at home. The regional pediatric palliative care team first receives in-hospital interventions: providing support for ethical reflection in the development of the infant's life project, meeting with the child and its family, helping organize the care pathway to return home. When the child is at home, the regional pediatric palliative care team can support the caregiver involved, provide home visits to continue the clinical monitoring of the infant, and accompany the family. The follow-up of the bereavement and the analysis of the practices with caregivers are also part of its tasks.

  19. 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.

  20. 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.

  1. Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.

    Science.gov (United States)

    Sockolow, Paulina S; Bowles, Kathryn H; Rogers, Michelle; Adelsberger, Marguerite C; Chittams, Jesse L; Liao, Cindy

    2013-01-01

    We conducted three health care evaluation studies in community and hospital settings to examine adoption of point-of-care documentation systems among interdisciplinary care team clinicians. Both community studies used a mixed methods design to assess actual system usage and clinician satisfaction. In the hospitals, scenario testing was used. Results indicated clinician adoption of the systems was universal, although not always timely with: (1) a mismatch between system functionality and workflow which was a barrier to clinician system access during patient care and reduced clinician efficiency; (2) no increase in interdisciplinary team communication; and (3) no impact on patient outcomes identified by clinicians. To facilitate adoption, clinicians should see the value of using the system as intended by receiving patient care and patient safety feedback that uses system data.

  2. Practice improvement, part II: collaborative practice and team-based care.

    Science.gov (United States)

    Roett, Michelle A; Coleman, Mary Thoesen

    2013-11-01

    The Institute of Medicine recommends interprofessional teams to address patients' complex needs. Team care should be structured in a way that uses the highest training levels of its members. Team communication is enhanced through regular meetings (eg, team huddles), and office efficiency is improved through identifying and solving underlying system-level issues (ie, second-order problem solving). Inclusive leadership principles are used to strengthen team practices and meet chronic care model goals. Setting clear goals with measurable outcomes, creating clinical and administrative systems, establishing a clear division of labor among team members who have occupational diversity, and providing ongoing training all facilitate team building. Increasing opportunities for team members to work together, such as with group visits, and providing interprofessional education are ways to encourage adoption of interprofessional practice. Reimbursement for team care includes per member per month payments for such services as care management, pay-for-performance benchmark payments, and payment for non-face-to-face services.

  3. 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.

  4. 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...

  5. Opportunities in interdisciplinary care team adoption of electronic point-of-care documentation systems.

    Science.gov (United States)

    Sockolow, Paulina S; Bowles, Kathryn H; Rogers, Michelle; Adelsberger, Marguerite C; Chittams, Jesse L; Liao, Cindy

    2014-01-01

    We conducted three evaluation studies in community and hospital settings to examine point-of-care documentation system adoption among interdisciplinary care team clinicians. In the community settings, quantitative methods included documentation time-to-completion and a clinician satisfaction survey. Qualitative methods included observations and follow-up interviews. Qualitative data and quantitative data were merged comparing findings along themes. In the hospitals, qualitative scenario testing results indicated clinician system adoption was universal, though not always timely. At all sites, mismatch between system functionality and workflow was a barrier to clinician system access during patient care and reduced clinician efficiency. Clinicians at all settings were satisfied with their ability to access other clinicians' notes, without increased interdisciplinary team communication. Clinicians did not identify any systems impact on patient outcomes. To facilitate adoption, clinicians should see the value of using the system as intended by receiving system data feedback that shows improvement of patient care and patient safety.

  6. Defragmenting care: testing an intervention to increase the effectiveness of interdisciplinary health care teams.

    Science.gov (United States)

    Kilgore, Rachel V; Langford, Rae W

    2010-06-01

    Few studies in the literature have examined the outcomes of health care interdisciplinary teams. Most existing studies have measured attributes of health care teams; however, none have implemented and examined outcomes of a team development intervention. This study was conducted to determine whether a development intervention used with an existing interdisciplinary team would reduce the length of stay for patients in an acute care setting. A quasi-experimental single-subject time series design was conducted with multiple measures of length of stay collected across baseline, intervention, and reversal phases of the study. Bronstein's Model for Interdisciplinary Collaboration provided the framework for this study. The components of this model were used to guide a team development intervention comprised of 4 consecutive weeks of classroom development sessions and 4 consecutive weeks of booster messaging. Length of stay (LOS) data were collected for each of the study phases to examine preintervention LOS and compare these data with LOS during the intervention and reversal phases. The results of this study revealed that the interdisciplinary team development intervention had no positive effect on the length of stay data. Baseline mean LOS across 12 baseline months was 4.83 days (SD=0.65) with monthly means ranging from 4.1 to 6.3 days. The mean LOS was 5.1 and 4.6 days for the intervention months of May and June and 6.0, 6.5, 5.7, and 5.4 days for the reversal months of July to October, respectively. All means in the intervention and reversal phases were higher than comparable months in the baseline phase. The pattern of the graphed trend was closely aligned with the seasonal variations seen during the baseline months. Although these results showed that the team development intervention provided for this interdisciplinary team had no positive effect on the LOS, there are many factors that may have influenced the results and may provide insights useful for future

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

    NARCIS (Netherlands)

    Bosch, M.; Dijkstra, R.F.; Wensing, M.J.P.; Weijden, T.T. van der; Grol, R.P.T.M.

    2008-01-01

    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 team

  8. Principles supporting dynamic clinical care teams: an American College of Physicians position paper.

    Science.gov (United States)

    Doherty, Robert B; Crowley, Ryan A

    2013-11-05

    The U.S. health care system is undergoing a shift from individual clinical practice toward team-based care. This move toward team-based care requires fresh thinking about clinical leadership and responsibilities to ensure that the unique skills of each clinician are used to provide the best care for the patient as the patient's needs dictate, while the team as a whole must work together to ensure that all aspects of a patient's care are coordinated for the benefit of the patient. In this position paper, the American College of Physicians offers principles, definitions, and examples to dissolve barriers that prevent movement toward dynamic clinical care teams. These principles offer a framework for an evolving, updated approach to health care delivery, providing policy guidance that can be useful to clinical teams in organizing the care processes and clinician responsibilities consistent with professionalism.

  9. 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.

  10. [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.

  11. 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.

  12. Interdisciplinary geriatric and palliative care team narratives: collaboration practices and barriers.

    Science.gov (United States)

    Goldsmith, Joy; Wittenberg-Lyles, Elaine; Rodriguez, Dariela; Sanchez-Reilly, Sandra

    2010-01-01

    Despite the development and implementation of team training models in geriatrics and palliative care, little attention has been paid to the nature and process of teamwork. Geriatrics and palliative care in the clinical setting offer an interdisciplinary approach structured to meet the comprehensive needs of a patient and his or her family. Fellowship members of an interdisciplinary geriatric and palliative care team participated in semistructured interviews. Team members represented social work, chaplaincy, psychology, nursing, and medicine. A functional narrative analysis revealed four themes: voice of the lifeworld, caregiver teamwork, alone on a team, and storying disciplinary communication. The content-ordering function of narratives revealed a divergence in team members' conceptualization of teamwork and team effectiveness, and group ordering of narratives documented the collaborative nature of teams. The study findings demonstrate the potential for narratives as a pedagogical tool in team training, highlighting the benefits of reflective practice for improving teamwork and sustainability.

  13. The role of the surgical care practitioner within the surgical team.

    Science.gov (United States)

    Quick, Julie

    Changes to the surgical workforce and the continued development of health policy have perpetuated the requirement for innovative perioperative roles. The surgical care practitioner is a nurse or allied health professional who works within a surgical team and has advanced perioperative skills, including the ability to undertake surgical interventions.With only limited literature evaluating this role, any benefits of their inclusion to a surgical team are largely anecdotal. This article presents the findings of an autoethnographic inquiry that explored the experiences of surgical team members who worked with the nurse researcher in her role as surgical care practitioner. Surgeons identified the provision of a knowledgeable, competent assistant and operator who enhanced patient care, helped maintain surgical services and supported the training of junior doctors. The professional, ethical and legal obligations of advanced perioperative practice were upheld. Interprofessional collaboration was improved, as was service provision. This further enhanced the patient experience. The traditional viewpoint that nurses who undertake tasks previously associated with medicine should be working to the standard of a doctor is challenged but requires further examination.

  14. [Satisfaction scales with health care to cardiovascular diseases: CARDIOSATIS--patient and team].

    Science.gov (United States)

    Cardoso, Clareci Silva; Bandeira, Marina; Ribeiro, Antonio Luiz Pinho; Oliveira, Graziella Lage; Caiaffa, Waleska Teixeira

    2011-01-01

    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 the scales and the elaboration of its items. The CARDIOSATIS-Team included 15 items and the CARDIOSATIS-Patient included 11. Satisfaction was measured through a five-point Likert scale. The scales' items comprised satisfaction with physical structure, human resources, capacity of resolution, attention and care offered by the service and the satisfaction with the received/given care. The scales also included open questions. CARDIOSATIS scales have showed to be an easy and accessible instrument very well accepted by medical team and patients. Preliminary results presented good characteristics of validity and reliability.

  15. Perceptions of team workers in youth care of what makes teamwork effective.

    Science.gov (United States)

    Buljac-Samardzic, M; van Wijngaarden, J D H; van Wijk, K P; van Exel, N J A

    2011-05-01

    In youth care, little is known about what makes teamwork effective. What is known mostly reflects the view of managers in care organisations, as objective outcome measures are lacking. The objective of this article was to explore the views of youth care workers in different types of teams on the relative importance of characteristics of teamwork for its effectiveness. Q methodology was used. Fifty-one respondents rank-order 34 opinion statements regarding characteristics of teamwork. Individual Q sorts were analysed using by-person factor analysis. The resulting factors, which represented team workers' views of what is important for effective teamwork, were interpreted and described using composite rankings of the statements for each factor and corresponding team workers' explanations. We found three views of what makes teamwork effective. One view emphasised interaction between team members as most important for team effectiveness. A second view pointed to team characteristics that help sustain communication within teams as being most important. In the third view, the team characteristics that facilitate individuals to perform as a team member were put forward as most important for teamwork to be effective. In conclusion, different views exist on what makes a team effective in youth care. These views correspond with the different types of teams active in youth care as well as in other social care settings.

  16. Hospital Palliative Care Teams and Post-Acute Care in Nursing Facilities: An Integrative Review.

    Science.gov (United States)

    Carpenter, Joan G

    2017-01-01

    Although palliative care consultation teams are common in U.S. hospitals, follow up and outcomes of consultations for frail older adults discharged to nursing facilities are unclear. To summarize and critique research on the care of patients discharged to nursing facilities following a hospital-based palliative care consult, a systematic search of PubMed, CINAHL, Ageline, and PsycINFO was conducted in February 2016. Data from the articles (N = 12) were abstracted and analyzed. The results of 12 articles reflecting research conducted in five countries are presented in narrative form. Two studies focused on nurse perceptions only, three described patient/family/caregiver experiences and needs, and seven described patient-focused outcomes. Collectively, these articles demonstrate that disruption in palliative care service on hospital discharge and nursing facility admission may result in high symptom burden, poor communication, and inadequate coordination of care. High mortality was also noted. [Res Gerontol Nurs. 2017; 10(1):25-34.].

  17. 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.

  18. 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.

  19. [Role of pharmacists in the medical team--attempting palliative care].

    Science.gov (United States)

    Ishiguro, T; Takahashi, M; Kato, H; Abe, C; Shioya, A; Ishiguro, T; Yoshizawa, T; Yoshizawa, A

    1999-12-01

    The Pharmacy Department at our hospital is attempting to develop methods for palliative care, for example of cancer pain or smelly tumors. The participation of pharmacists on the medical team for home care is necessary, because the supply of proper drugs for patients' individual conditions is indispensable in palliative care. Communication between not only patients, but also between their families and us, as well as the maintenance of close contact with the medical team, are important in home care.

  20. 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.

  1. Education and Training of Emergency Medical Teams: Recommendations for a Global Operational Learning Framework.

    Science.gov (United States)

    Amat Camacho, Nieves; Hughes, Amy; Burkle, Frederick M; Ingrassia, Pier Luigi; Ragazzoni, Luca; Redmond, Anthony; Norton, Ian; von Schreeb, Johan

    2016-10-21

    An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization's Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs. An essential component to reach this goal is appropriate education and training. Multiple disaster education and training programs are available. However, most are centred on individuals' professional development rather than on the EMTs operational performance. Moreover, no common overarching or standardised training frameworks exist. In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally. The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field. A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training. Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies.  Keywords: disasters; education; emergencies; global health; learning.

  2. 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.

  3. Collaboration, credibility, compassion, and coordination: professional nurse communication skill sets in health care team interactions.

    Science.gov (United States)

    Apker, Julie; Propp, Kathleen M; Zabava Ford, Wendy S; Hofmeister, Nancee

    2006-01-01

    This study explored how nurses communicate professionalism in interactions with members of their health care teams. Extant research show that effective team communication is a vital aspect of a positive nursing practice environment, a setting that has been linked to enhanced patient outcomes. Although communication principles are emphasized in nursing education as an important component of professional nursing practice, actual nurse interaction skills in team-based health care delivery remain understudied. Qualitative analysis of interview transcripts with 50 participants at a large tertiary hospital revealed four communicative skill sets exemplified by nursing professionals: collaboration, credibility, compassion, and coordination. Study findings highlight specific communicative behaviors associated with each skill set that exemplify nurse professionalism to members of health care teams. Theoretical and pragmatic conclusions are drawn regarding the communicative responsibilities of professional nurses in health care teams. Specific interaction techniques that nurses could use in nurse-team communication are then offered for use in baccalaureate curriculum and organizational in-service education.

  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…

  5. Preparing students to work effectively in interprofessional health and social care teams.

    Science.gov (United States)

    Stevenson, Keith; Seenan, Chris; Morlan, Gordon; Smith, Wendy

    2012-01-01

    Interprofessional education (IPE) has 'learning to work effectively in interprofessional teams' as one of its central learning outcomes. Whilst much is made in IPE of allocating health and social care students into interprofessional teams and setting them a task to complete, it has proved difficult to find a fair and equitable method of assessing how effective each individual has been in contributing to the task. This difficulty is compounded when the module is delivered predominantly online. This paper describes the recent push to establish meaningful educational outcomes for those involved in delivering IPE to pre-registration health and social care students. It then describes the use of a web-based peer assessment tool (Web PA) developed at Loughborough and Hull Universities (UK) which has been adapted by Glasgow Caledonian University (UK) for assessing the outcome of contributing effectively to IPE-related online group tasks. The paper outlines how the process of web-based peer assessment operates in theory and how it has been received in practice. An illustration is given that shows how the process successfully discriminates between those that are working effectively in interprofessional teams and those that are not. The value of the process is discussed.

  6. 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…

  7. “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

  8. Interprofessional experiences and attitudes toward interprofessional health care teams among health sciences students.

    Science.gov (United States)

    Ko, Jungyai; Bailey-Kloch, Marie; Kim, Kyeongmo

    2014-01-01

    This study examined how the interprofessional experience, including education and practice, affects graduate health science students' attitudes toward interprofessional practice in health care teams. Data were collected from 227 graduate students, using the Attitudes toward Health Care Teams (ATHCT) scale. Both social work and other health science students had positive attitudes toward interprofessional collaboration with regard to its ability to improve the quality of a patient's care. The results from hierarchical linear regression analyses demonstrated that female students, older students, and students with longer interprofessional practice experiences had more positive attitudes toward interprofessional collaboration in health care teams. Based on these results, implications for interprofessional education are discussed.

  9. Evaluation of interprofessional relational coordination and patients' perception of care in outpatient oncology teams.

    Science.gov (United States)

    Azar, Jose M; Johnson, Cynthia S; Frame, Amie M; Perkins, Susan M; Cottingham, Ann H; Litzelman, Debra K

    2017-03-01

    This pilot study was designed to measure teamwork and the relationship of teamwork to patient perceptions of care among 63 members of 12 oncology teams at a Cancer Centre in the Midwest. Lack of teamwork in cancer care can result in serious clinical errors, fragmentation of care, and poor quality of care. Many oncology team members, highly skilled in clinical care, are not trained to work effectively as members of a care team. The research team administered the Relational Coordination survey to core oncology team members-medical oncologists, nurse coordinators, and clinical secretaries-to measure seven dimensions of team skills (four relating to communication [frequency, timeliness, accuracy, and problem solving] and three relating to relationship [shared goals, shared knowledge, and mutual respect]) averaged to create a Relational Coordination Index. The results indicated that among the team member roles, nurse coordinator relational coordination indices were the strongest and most positively correlated with patient perception of care. Statistically significant correlations were intra-nurse coordinator relational coordination indices and two patient perception of care factors (information and education and patient's preferences). All other nurse coordinator intra-role as well as inter-role correlations were also positively correlated, although not statistically significant.

  10. 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

  11. How Communication Among Members of the Health Care Team Affects Maternal Morbidity and Mortality.

    Science.gov (United States)

    Brennan, Rita Allen; Keohane, Carol Ann

    In the United States, rates of severe maternal morbidity and mortality have escalated in the past decade. Communication failure among members of the health care team is one associated factor that can be modified. Nurses can promote effective communication. We provide strategies that incorporate team training principles and structured communication processes for use by providers and health care systems to improve the quality and safety of patient care and reduce the incidence of maternal mortality and morbidity.

  12. Social networks in health care teams: evidence from the United States.

    Science.gov (United States)

    Poghosyan, Lusine; Lucero, Robert J; Knutson, Ashley R; W Friedberg, Mark; Poghosyan, Hermine

    2016-10-10

    Purpose The purpose of this paper is to synthesize existing evidence regarding health care team networks, including their formation and association with outcomes in various health care settings. Design/methodology/approach Network theory informed this review. A literature search was conducted in major databases for studies that used social network analysis methods to study health care teams in the USA between 2000 and 2014. Retrieved studies were reviewed against inclusion and exclusion criteria. Findings Overall, 25 studies were included in this review. Results demonstrated that health care team members form professional (e.g. consultation) and personal (e.g. friendship) networks. Network formation can be influenced by team member characteristics (i.e. demographics and professional affiliations) as well as by contextual factors (i.e. providers sharing patient populations and physical proximity to colleagues). These networks can affect team member practice such as adoption of a new medication. Network structures can also impact patient and organizational outcomes, including occurrence of adverse events and deficiencies in health care delivery. Practical implications Administrators and policy makers can use knowledge of health care networks to leverage relational structures in teams and tailor interventions that facilitate information exchange, promote collaboration, increase diffusion of evidence-based practices, and potentially improve individual and team performance as well as patient care and outcomes. Originality/value Most health services research studies have investigated health care team composition and functioning using traditional social science methodologies, which fail to capture relational structures within teams. Thus, this review is original in terms of focusing on dynamic relationships among team members.

  13. 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.

  14. Improving the Interdisciplinary Team Work in the Operating Room

    DEFF Research Database (Denmark)

    Tørring, Birgitte

    2016-01-01

    In surgical teams, where health professionals are highly interdependent and work under time pressure, it is of particular importance that the team work is well-functioning to secure treatment quality and patient safety. Using the theory of relational coordination (RC) may be the key to unlocking...... period in 2014 in two orthopedic surgical wards in a university hospital. A directed content analysis on the basis of theory of RC is used to transform the data to show different typologies of interdisciplinary team work. RC was subsequently measured using the RC Survey. Data describe very complex...... conditions for team work in the OR. Four typologies of interdisciplinary team work are identified. The teams have a varying degree of relationship and coordination based on shared goals and different characteristics of communication are identified. Based on these findings and the results from the measurement...

  15. Military Interprofessional Health Care Teams: How USU is Working to Harness the Power of Collaboration.

    Science.gov (United States)

    D'Angelo, Matthew R; Saperstein, Adam K; Seibert, Diane C; Durning, Steven J; Varpio, Lara

    2016-11-01

    Despite efforts to increase patient safety, hundreds of thousands of lives are lost each year to preventable health care errors. The Institute of Medicine and other organizations have recommended that facilitating effective interprofessional health care team work can help address this problem. While the concept of interprofessional health care teams is known, understanding and organizing effective team performance have proven to be elusive goals. Although considerable research has been conducted in the civilian sector, scholars have yet to extend research to the military context. Indeed, delivering the highest caliber of health care to our service men and women is vitally important. This commentary describes a new initiative as the Uniformed Services University of the Health Sciences aimed at researching the characteristics of successful military interprofessional teams and why those characteristics are important. It also describes the interprofessional education initiative that Uniformed Services University is launching to help optimize U.S. military health care.

  16. 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…

  17. 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.

  18. 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

  19. Factors that influence the stroke care team's effectiveness in reducing the length of hospital stay

    NARCIS (Netherlands)

    L.M.T. Schouten (Loes); M.E.J.L. Hulscher (Marlies); R.P. Akkermans (Reinier); J.J.E. van Everdingen (Jannes); R.P.T.M. Grol (Richard); R. Huijsman (Robbert)

    2008-01-01

    textabstractBACKGROUND AND PURPOSE: The purpose of this study was to explore the effects of a quality improvement program for improving stroke care and the determinants of success at the team and hospital levels. METHOD: For 16 months, 23 multidisciplinary stroke service teams participated in a qual

  20. Factors that influence the stroke care team's effectiveness in reducing the length of hospital stay.

    NARCIS (Netherlands)

    Schouten, L.M.; Hulscher, M.E.J.L.; Akkermans, R.; Everdingen, J.J. van; Grol, R.P.T.M.; Huijsman, R.

    2008-01-01

    BACKGROUND AND PURPOSE: The purpose of this study was to explore the effects of a quality improvement program for improving stroke care and the determinants of success at the team and hospital levels. Method- For 16 months, 23 multidisciplinary stroke service teams participated in a quality improvem

  1. 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.

  2. The Preventable Admissions Care Team (PACT): A Social Work-Led Model of Transitional Care.

    Science.gov (United States)

    Basso Lipani, Maria; Holster, Kathleen; Bussey, Sarah

    2015-10-01

    In 2010, the Preventable Admissions Care Team (PACT), a social work-led transitional care model, was developed at Mount Sinai to reduce 30-day readmissions among high-risk patients. PACT begins with a comprehensive bedside assessment to identify the psychosocial drivers of readmission. In partnership with the patient and family, a patient-centered action plan is developed and carried out through phone calls, accompaniments, navigations and home visits, as needed, in the first 30 days following discharge. 620 patients were enrolled during the pilot from September 2010-August 2012. Outcomes demonstrated a 43% reduction in inpatient utilization and a 54% reduction in emergency department visits among enrollees. In addition, 93% of patients had a follow-up appointment within 7-10 days of discharge and 90% of patients attended the appointment. The success of PACT has led to additional funding from the Centers for Medicare and Medicaid Services under the Community-based Care Transitions Program and several managed care companies seeking population health management interventions for high risk members.

  3. What Should You Ask Your Health Care Team About Thyroid Cancer?

    Science.gov (United States)

    ... Should You Ask Your Health Care Team About Thyroid Cancer? As you deal with thyroid cancer and the ... ask are: When you’re told you have thyroid cancer What kind of thyroid cancer do I have? ...

  4. Knowledge translation: An interprofessional approach to integrating a pain consult team within an acute care unit.

    Science.gov (United States)

    Feldman, Kira; Berall, Anna; Karuza, Jurgis; Senderovich, Helen; Perri, Giulia-Anna; Grossman, Daphna

    2016-11-01

    Management of pain in the frail elderly presents many challenges in both assessment and treatment, due to the presence of multiple co-morbidities, polypharmacy, and cognitive impairment. At Baycrest Health Sciences, a geriatric care centre, pain in its acute care unit had been managed through consultations with the pain team on a case-by-case basis. In an intervention informed by knowledge translation (KT), the pain specialists integrated within the social network of the acute care team for 6 months to disseminate their expertise. A survey was administered to staff on the unit before and after the intervention of the pain team to understand staff perceptions of pain management. Pre- and post-comparisons of the survey responses were analysed by using t-tests. This study provided some evidence for the success of this interprofessional education initiative through changes in staff confidence with respect to pain management. It also showed that embedding the pain team into the acute care team supported the KT process as an effective method of interprofessional team building. Incorporating the pain team into the acute care unit to provide training and ongoing decision support was a feasible strategy for KT and could be replicated in other clinical settings.

  5. 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

  6. Primary care teams: are we there yet? Implications for workforce planning.

    Science.gov (United States)

    Grover, Atul; Niecko-Najjum, Lidia M

    2013-12-01

    Recent studies suggest that team-based primary care models could contribute to eliminating the predicted physician shortages. In this article, the authors explore existing team-based clinical care delivery models, comparing specialist and primary care teams, that include patient-centered medical homes and accountable care organizations. Next, the authors describe the barriers to adopting these models on a large scale, particularly the regulatory, financial, and cultural factors as well as scope of practice considerations for nonphysician providers. The authors' aim is not to evaluate the merits of team-based primary care models but, rather, to ascertain whether such models should be at the center of current physician workforce planning policies. The authors argue that although emerging evidence indicates that primary care teams can improve patient outcomes, few data exist to suggest that these models will drastically reduce the need for additional physicians or other providers. Thus, the authors conclude that additional research is needed to evaluate the ability of such models to alleviate provider deficits. And, while policy makers should work toward their ideal health care system, they also must expand the physician workforce to meet the growing demand for health care services in the existing one.

  7. Improving the Interdisciplinary Team Work in the Operating Room

    DEFF Research Database (Denmark)

    Tørring, Birgitte

    2016-01-01

    In surgical teams, where health professionals are highly interdependent and work under time pressure, it is of particular importance that the team work is well-functioning to secure treatment quality and patient safety. Using the theory of relational coordination (RC) may be the key to unlocking...... period in 2014 in two orthopedic surgical wards in a university hospital. A directed content analysis on the basis of theory of RC is used to transform the data to show different typologies of interdisciplinary team work. RC was subsequently measured using the RC Survey. Data describe very complex...... with the purpose of identifying different ways of communicating and managing relationship in contexts of variable complexity and to develop an intervention program. An ethnographic field study where data are collected through participant observations (35 teams) and semi-structured interviews (15), over a 10-months...

  8. Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions

    Science.gov (United States)

    van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia; Daniëls, Ramon; Lenzen, Stephanie Anna; van der Weijden, Trudy; Beurskens, Anna

    2017-01-01

    Background. The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. Objectives. This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Methods. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Results. Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. Conclusion. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members’ awareness of aspects that could be improved before training them in dealing with specific challenges. PMID:28122925

  9. 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...

  10. [Better multidisciplinary team meetings are linked to better care

    NARCIS (Netherlands)

    Drielen, E. van; Vries, A.W. de; Ottevanger, P.B.; Hermens, R.P.M.G.

    2012-01-01

    Discussing a patient in an oncology multidisciplinary team meeting (MTM) increases the value of the quality of the treatment chosen. MTMs are increasingly mentioned in guidelines and indicator sets. Based on literature review and observations, the Comprehensive Cancer Centre Netherlands (CCCNL), in

  11. The role of the multidisciplinary health care team in the management of patients with Marfan syndrome.

    Science.gov (United States)

    von Kodolitsch, Yskert; Rybczynski, Meike; Vogler, Marina; Mir, Thomas S; Schüler, Helke; Kutsche, Kerstin; Rosenberger, Georg; Detter, Christian; Bernhardt, Alexander M; Larena-Avellaneda, Axel; Kölbel, Tilo; Debus, E Sebastian; Schroeder, Malte; Linke, Stephan J; Fuisting, Bettina; Napp, Barbara; Kammal, Anna Lena; Püschel, Klaus; Bannas, Peter; Hoffmann, Boris A; Gessler, Nele; Vahle-Hinz, Eva; Kahl-Nieke, Bärbel; Thomalla, Götz; Weiler-Normann, Christina; Ohm, Gunda; Neumann, Stefan; Benninghoven, Dieter; Blankenberg, Stefan; Pyeritz, Reed E

    2016-01-01

    Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS. First, we show how the initiative and collaboration of patient representatives, scientists, and physicians resulted in the foundation of Marfan centers, initially in the US and later in Germany, and how and why such centers evolved over time. Then, we elucidate the three main structural elements; a team of coordinators, core disciplines, and auxiliary disciplines of health care. Moreover, we explain how a multidisciplinary health care team integrates into many other health care structures of a university medical center, including external quality assurance; quality management system; clinical risk management; center for rare diseases; aorta center; health care teams for pregnancy, for neonates, and for rehabilitation; and in structures for patient centeredness. We provide accounts of medical goals and standards for each core discipline, including pediatricians, pediatric cardiologists, cardiologists, human geneticists, heart surgeons, vascular surgeons, vascular interventionists, orthopedic surgeons, ophthalmologists, and nurses; and of auxiliary disciplines including forensic pathologists, radiologists, rhythmologists, pulmonologists, sleep specialists, orthodontists, dentists, neurologists, obstetric surgeons, psychiatrist/psychologist, and rehabilitation specialists. We conclude that a multidisciplinary health care team is a means

  12. The role of the multidisciplinary health care team in the management of patients with Marfan syndrome

    Science.gov (United States)

    von Kodolitsch, Yskert; Rybczynski, Meike; Vogler, Marina; Mir, Thomas S; Schüler, Helke; Kutsche, Kerstin; Rosenberger, Georg; Detter, Christian; Bernhardt, Alexander M; Larena-Avellaneda, Axel; Kölbel, Tilo; Debus, E Sebastian; Schroeder, Malte; Linke, Stephan J; Fuisting, Bettina; Napp, Barbara; Kammal, Anna Lena; Püschel, Klaus; Bannas, Peter; Hoffmann, Boris A; Gessler, Nele; Vahle-Hinz, Eva; Kahl-Nieke, Bärbel; Thomalla, Götz; Weiler-Normann, Christina; Ohm, Gunda; Neumann, Stefan; Benninghoven, Dieter; Blankenberg, Stefan; Pyeritz, Reed E

    2016-01-01

    Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS. First, we show how the initiative and collaboration of patient representatives, scientists, and physicians resulted in the foundation of Marfan centers, initially in the US and later in Germany, and how and why such centers evolved over time. Then, we elucidate the three main structural elements; a team of coordinators, core disciplines, and auxiliary disciplines of health care. Moreover, we explain how a multidisciplinary health care team integrates into many other health care structures of a university medical center, including external quality assurance; quality management system; clinical risk management; center for rare diseases; aorta center; health care teams for pregnancy, for neonates, and for rehabilitation; and in structures for patient centeredness. We provide accounts of medical goals and standards for each core discipline, including pediatricians, pediatric cardiologists, cardiologists, human geneticists, heart surgeons, vascular surgeons, vascular interventionists, orthopedic surgeons, ophthalmologists, and nurses; and of auxiliary disciplines including forensic pathologists, radiologists, rhythmologists, pulmonologists, sleep specialists, orthodontists, dentists, neurologists, obstetric surgeons, psychiatrist/psychologist, and rehabilitation specialists. We conclude that a multidisciplinary health care team is a means

  13. 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

  14. Attitudes of primary care team to diagnosing dementia.

    Science.gov (United States)

    Thomas, Hywel

    2010-04-01

    Healthcare professionals in primary care are gatekeepers to specialist services and are important in terms of ensuring access to community support and appropriate referral for the sizable number of older people with mental health problems. This literature review explores the role of primary care professionals, particularly GPs and practice nurses, in diagnosing and managing patients with dementia. It recommends that education and training are required to raise awareness of the importance of accurate diagnosis and management in primary care.

  15. Surgical teams: role perspectives and role dynamics in the operating room.

    Science.gov (United States)

    Leach, Linda Searle; Myrtle, Robert C; Weaver, Fred A

    2011-05-01

    Observations of surgical teams in the operating room (OR) and interviews with surgeons, circulating registered nurses (RNs), anaesthesiologists and surgical technicians reveal the importance of leadership, team member competencies and an enacted environment that encourages feelings of competence and cooperation. Surgical teams are more loosely coupled than intact and bounded. Team members tend to rely on expected role behaviours to bridge lack of familiarity. While members of the surgical team identified technical competence and preparation as critical factors affecting team performance, they had differing views over the role behaviours of other members of the surgical team that lead to surgical team performance. Observations revealed that the work climate in the OR can shape interpersonal relations and begins to be established when the room is being set up for the surgical case, and evolves as the surgical procedure progresses. The leadership and supervisory competencies of the circulating RNs establish the initial work environment. Both influenced the degree of cooperation and support that was observed, which had an effect on the interactions and relationships between other members of the surgical team. As the surgery unfolds, the surgeon's behaviours and interpersonal relations modify this environment and ultimately influence the degree of team work, team satisfaction and team performance.

  16. 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

  17. The effect of multidisciplinary team care on cancer management

    OpenAIRE

    Abdulrahman, Ganiy Opeyemi

    2011-01-01

    Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical o...

  18. The Role of Jedburgh Teams in Operations Market Garden

    Science.gov (United States)

    1990-06-01

    closer to SJoerdsma. On 5 March 1945, Germans foraged Brinkgreve’s safe house for milk and eggs, discovered him there, and killed him. (85) £nqmmmv af...have compromised one of the Belgium Dutch teams which never deployed. Scherrer was killed in Algeria . Major Wilson was a Royal Artilleryman was in his

  19. 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.

  20. 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.

  1. 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.

  2. Team Cognition As a Means to Improve Care Delivery in Critically Ill Patients With Cancer After Hematopoietic Cell Transplantation.

    Science.gov (United States)

    McNeese, Nathan J; Khera, Nandita; Wordingham, Sara E; Arring, Noel; Nyquist, Sharon; Gentry, Amy; Tomlinson, Brian; Cooke, Nancy J; Sen, Ayan

    2016-11-01

    Hematopoietic cell transplantation (HCT) is an important and complex treatment modality for a variety of hematologic malignancies and some solid tumors. Although outcomes of patients who have undergone HCT and require care in intensive care units (ICUs) have improved over time, mortality rates remain high and there are significant associated costs. Lack of a team-based approach to care, especially during critical illness, is detrimental to patient autonomy and satisfaction, and to team morale, ultimately leading to poor quality of care. In this manuscript, we describe the case of a patient who had undergone HCT and was in the ICU setting, where inconsistent team interaction among the various stakeholders delivering care resulted in a lack of shared goals and poor outcomes. Team cognition is cognitive processing at the team level through interactions among team members and is reflected in dynamic communication and coordination behaviors. Although the patient received multidisciplinary care as needed in a medically complicated case, a lack of team cognition and, particularly, inconsistent communication among the dynamic teams caring for the patient, led to mixed messages being delivered with high-cost implications for the health-care system and the family. This article highlights concepts and recommendations that begin a necessary in-depth assessment of implications for clinical care and initiate a research agenda that examines the effects of team cognition on HCT teams, and, more generally, critical care of the patient with cancer.

  3. A multidisciplinary team care approach improves outcomes in high-risk pediatric neuroblastoma patients.

    Science.gov (United States)

    Chang, Hsiu-Hao; Liu, Yen-Lin; Lu, Meng-Yao; Jou, Shiann-Tarng; Yang, Yung-Li; Lin, Dong-Tsamn; Lin, Kai-Hsin; Tzen, Kai-Yuan; Yen, Ruoh-Fang; Lu, Ching-Chu; Liu, Chia-Ju; Peng, Steven Shinn-Forng; Jeng, Yung-Ming; Huang, Shiu-Feng; Lee, Hsinyu; Juan, Hsueh-Fen; Huang, Min-Chuan; Liao, Yung-Feng; Lee, Ya-Ling; Hsu, Wen-Ming

    2017-01-17

    We assessed the impact of a multidisciplinary team care program on treatment outcomes in neuroblastoma patients. Newly diagnosed neuroblastoma patients received treatment under the Taiwan Pediatric Oncology Group (TPOG) N2002 protocol at the National Taiwan University Hospital beginning in 2002. A multidisciplinary team care approach that included nurse-led case management for patients treated under this protocol began in January 2010. Fifty-eight neuroblastoma patients, including 29 treated between 2002 and 2009 (Group 1) and 29 treated between 2010 and 2014 (Group 2), were enrolled in the study. The 5-year overall survival (OS) and event-free survival (EFS) rates for all 58 patients were 59% and 54.7%, respectively. Group 2 patients, who were treated after implementation of the multidisciplinary team care program, had better 3-year EFS (P = 0.046), but not OS (P = 0.16), rates than Group 1 patients. In a multivariate analysis, implementation of the multidisciplinary team approach was the only significant independent prognostic factor for neuroblastoma patients. In further subgroup analyses, the multidisciplinary team approach improved EFS, but not OS, in patients with stage 4 disease, those in the high-risk group, and those with non-MYCN amplified tumors. These data indicate a multidisciplinary team care approach improved survival outcomes in high-risk neuroblastoma patients. However, further investigation will be required to evaluate the long-term effects of this approach over longer follow-up periods.

  4. 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

  5. Manned-Unmanned Teaming: Expanding the Envelope of UAS Operational Employment (Reprint)

    Science.gov (United States)

    2014-11-01

    or ’over the horizon’ thinkers . In fact, in May of this year, the fi rst successful Hellfi re missile strike in Afghanistan was conducted with team ...USAARL Report No. 2015-11 Manned-Unmanned Teaming : Expanding the Envelope of UAS Operational Employment (Reprint) By Steven J. Gaydos1,2 Ian...Association Aviation, Space, and Environmental Medicine x Vol. 85, No. 12 x December 2014 1231 SCIENCE AND TECHNOLOGY WATCH Manned-Unmanned Teaming

  6. Women Marines in Counterinsurgency Operations: Lioness and Female Engagement Teams

    Science.gov (United States)

    2010-04-05

    The discovery of Lucy Brewer’s autobiography led the Marine Corps to acknowledge that she was perhaps the first woman Marine.5 In 1918, the...the team removed their Kevlar helmets and glasses .. This showed the Iraqi women that the Lioness members were in fact female and seemed to put...communicated ~sing the interpreter. During the engagement, the women Marines removed their Kevlar helmets allowing the Afghan women to observe that

  7. 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.

  8. Mouth Cancer for Clinicians. Part 9: The Patient and Care Team.

    Science.gov (United States)

    Kalavrezos, Nicholas; Scully, Crispian

    2016-04-01

    A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of the multidisciplinary team (MDT; or multi-speciality team) and its roles, and an overview of the implications of therapies that are discussed more fully in future articles in the series.

  9. 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

  10. 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.

  11. 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.

  12. The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams.

    Science.gov (United States)

    Amir, Z; Scully, J; Borrill, C

    2004-12-01

    Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role.

  13. 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.

  14. 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.

  15. 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.

  16. [A mental health multidisciplinary team for pain and somatic care].

    Science.gov (United States)

    Judice, Magali; Valoris, Jahida; Rullac, Maryse; Deveaux, Florence

    2014-05-01

    Patients suffering from mental illness or pervasive developmental disorders often resist examination and treatment. The Regional pain and somatic care in mental health centre of the Etampes public health institute (EPS) uses gas and air when carrying out nursing procedures. The nurses support patients with compassion, attentive to any nonverbal indication of pain.

  17. 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

  18. [Better multidisciplinary team meetings are linked to better care].

    Science.gov (United States)

    van Drielen, Eveline; de Vries, Antoinette W; Ottevanger, P B Nelleke; Hermens, Rosella P M G

    2012-01-01

    Discussing a patient in an oncology multidisciplinary team meeting (MTM) increases the value of the quality of the treatment chosen. MTMs are increasingly mentioned in guidelines and indicator sets. Based on literature review and observations, the Comprehensive Cancer Centre Netherlands (CCCNL), in collaboration with IQ Healthcare and the Department of Medical Oncology of the UMC St Radboud Nijmegen in the Netherlands, has conducted research into the quality criteria for a good MTM. Two of our studies show that the organisation of MTMs can be significantly improved. Based on the results, we developed a checklist to accomplish this. The most significant areas of improvement for optimising the organisation of MTMs are: (a) the presence of specialists from all relevant disciplines; (b) a capable chairman who promotes the efficiency of the MTM; and (c) the reduction of intruding factors, such as mobile phones and participants who walk in and out.

  19. Nurses' perceptions of multidisciplinary team work in acute health-care.

    Science.gov (United States)

    Atwal, Anita; Caldwell, Kay

    2006-12-01

    Multidisciplinary teamwork is viewed as one of the key processes through which care is managed in the British National Health Service, and yet is often viewed as one of the most problematic. Working in a multidisciplinary team requires many skills, which involves understanding not only one's own role but also the role of other professionals. The aim of this study was to explore nurses' perceptions of multidisciplinary teamwork in acute health-care. Nineteen nurses were interviewed using the critical incident approach to obtain their perceptions of multidisciplinary teamwork. Direct observation was conducted to record interactions between nurses and health-care professionals in multidisciplinary teams. In total, 14 meetings were attended in elder care and orthopaedics and seven in acute medicine. The findings of this study identified three barriers that hindered teamwork: (i) differing perceptions of teamwork; (ii) different levels of skills acquisitions to function as a team member; and (iii) the dominance of medical power that influenced interaction in teams. Thus, education establishments and nursing managers need to ensure that the acquisition of team-playing skills is an integral part of continued professional development.

  20. A new quality assurance package for hospital palliative care teams: the Trent Hospice Audit Group model.

    Science.gov (United States)

    Hunt, J; Keeley, V L; Cobb, M; Ahmedzai, S H

    2004-07-19

    Cancer patients in hospitals are increasingly cared for jointly by palliative care teams, as well as oncologists and surgeons. There has been a considerable growth in the number and range of hospital palliative care teams (HPCTs) in the United Kingdom. HPCTs can include specialist doctors and nurses, social workers, chaplains, allied health professionals and pharmacists. Some teams work closely with existing cancer multidisciplinary teams (MDTs) while others are less well integrated. Quality assurance and clinical governance requirements have an impact on the monitoring of such teams, but so far there is no standardised way of measuring the amount and quality of HPCTs' workload. Trent Hospice Audit Group (THAG) is a multiprofessional research group, which has been developing standards and audit tools for palliative care since the 1990s. These follow a format of structure-process-outcome for standards and measures. We describe a collaborative programme of work with HPCTs that has led to a new set of standards and audit tools. Nine HPCTs participated in three rounds of consultation, piloting and modification of standard statements and tools. The final pack of HPCT quality assurance tools covers: policies and documentation; medical notes review; questionnaires for ward-based staff. The tools measure the HPCT workload and casemix; the views of ward-based staff on the supportive role of the HPCT and the effectiveness of HPCT education programmes, particularly in changing practice. The THAG HPCT quality assurance pack is now available for use in cancer peer review.

  1. Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work

    OpenAIRE

    Mazzocato Pamela; Hvitfeldt Forsberg Helena; von Thiele Schwarz Ulrica

    2011-01-01

    Abstract Objective Teamwork has been suggested as a promising approach to improving care processes in emergency departments (ED). However, for teamwork to yield expected results, implementation must involve behavior changes. The aim of this study is to use behavior analysis to qualitatively examine how teamwork plays out in practice and to understand eventual discrepancies between planned and actual behaviors. Methods The study was set in a Swedish university hospital ED during the initial ph...

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. [Nurse's care practice according to the view of the healthcare team].

    Science.gov (United States)

    Castanha, Maria de Loudes; Zagonel, Ivete Palmira Sanson

    2005-01-01

    This study aims to comprehend the healthcare team perception about the (in)visibility of care practice of being a nurse in pediatric critical care units, according to Paterson and Zderad Humanist Theory. This is a qualitative research that combines the phenomenological approach. For data collection, it was used semi-structured interviews with nurses, physicians, psichologists, physiotherapists, nurse aides and hygienization employes working in pediatric critical care units of a hospital in Curitiba. The analysis followed the steps proposed by Giorgi and presented six categories, being three related to nurses' perception and three related to the multiprofessional team. Based on these statements it was possible to outline a conceptual model of nurses' perception about invisibility in their care practice, and also showed ways to obtain nurses' visibility.

  8. Multidisciplinary care team for cancer patients and its implementation in several Middle Eastern countries.

    Science.gov (United States)

    Silbermann, M; Pitsillides, B; Al-Alfi, N; Omran, S; Al-Jabri, K; Elshamy, K; Ghrayeb, I; Livneh, J; Daher, M; Charalambous, H; Jafferri, A; Fink, R; El-Shamy, M

    2013-10-01

    This article introduces palliative care to cancer patients in Middle Eastern countries. It considers the importance of the multidisciplinary team in providing an adequate service to the patient and his/her family. It provides views of professionals from the various countries with regard to the role of the nurse in such teams; whereby the three elements of palliative care nursing entail: 1. Working directly with patients and families; 2. Working with other health and social care professionals to network and co-ordinate services; and 3. working at an organizational level to plan, develop and manage service provision in local, regional and national settings. This article also details the challenges that nurses face in the Middle East and outlines the preferable ways to overcome such challenges. The latter include more focused educational activities at the undergraduate and graduate levels and continuous clinical training throughout their work as palliative care nurse specialists.

  9. 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.

  10. 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.

  11. Red Team Operations to Assess Information Technology Vulnerabilities

    NARCIS (Netherlands)

    Veltman, M.; Parker, R.L.

    1999-01-01

    All Information and Communication Technology (ICT) systems have vulnerabilities. Weaknesses in these systems are introduced either during the specification, implementation or operational phase. Leaving aside these introduced vulnerabilities are intentional or unintentional, the fact remains that the

  12. The role of a community palliative care specialist nurse team in caring for people with metastatic breast cancer.

    Science.gov (United States)

    Leadbeater, Maria

    2013-02-01

    An audit was undertaken of people with a diagnosis of breast cancer who were referred to a community palliative care specialist nursing team over a 12-month period, to explore the reasons for referral to the service and the duration of involvement with the service. Breast cancer patients accounted for 10% of the total referrals to the specialist service, with symptom management (including pain control) and emotional support being the main reasons for referral. The majority of people referred with breast cancer had metastatic breast cancer (87%); interestingly, 13% had primary breast cancer. The mean duration of intervention was 3 months and 1 week. Referrals seemed to occur late in patients' disease trajectories, and total numbers were lower than might be expected. It may be concluded that there is scope for the specialist palliative care team to be a more integral part of care for patients with metastatic breast cancer.

  13. 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.

  14. Moving Toward Improved Teamwork in Cancer Care: The Role of Psychological Safety in Team Communication.

    Science.gov (United States)

    Jain, Anshu K; Fennell, Mary L; Chagpar, Anees B; Connolly, Hannah K; Nembhard, Ingrid M

    2016-11-01

    Effective communication is a requirement in the teamwork necessary for improved coordination to deliver patient-centered, value-based cancer care. Communication is particularly important when care providers are geographically distributed or work across organizations. We review organizational and teams research on communication to highlight psychological safety as a key determinant of high-quality communication within teams. We first present the concept of psychological safety, findings about its communication effects for teamwork, and factors that affect it. We focus on five factors applicable to cancer care delivery: familiarity, clinical hierarchy-related status differences, geographic dispersion, boundary spanning, and leader behavior. To illustrate how these factors facilitate or hinder psychologically safe communication and teamwork in cancer care, we review the case of a patient as she experiences the treatment-planning process for early-stage breast cancer in a community setting. Our analysis is summarized in a key principle: Teamwork in cancer care requires high-quality communication, which depends on psychological safety for all team members, clinicians and patients alike. We conclude with a discussion of the implications of psychological safety in clinical care and suggestions for future research.

  15. 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…

  16. 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

  17. Correlates of team effectiveness: An exploratory study of firefighter's operations during emergency situations.

    Science.gov (United States)

    Jouanne, Elise; Charron, Camilo; Chauvin, Christine; Morel, Gaël

    2017-05-01

    This paper examines elements contributing to the effectiveness of firefighting teams carrying out typical tasks. Fourteen firefighter crews were filmed during nineteen real operations and answered questionnaires relating to psychosocial dimensions. Results have shown that "enriched closed-loops" of communication, positive emotional interactions and a "gamma" type of adaptation are positively related to team effectiveness. Conversely, open and incomplete loops of communication, negative emotional interactions, "beta" and "alpha" types of adaptation are negatively related to team effectiveness. Furthermore, there is a mediated link between organisational trust and motivation on the one hand and team effectiveness on the other. These findings highlight the necessity to consider both cognitive and psychosocial variables to account for team effectiveness in the firefighting profession. They also emphasize the need to expand firefighter training to the "non-technical" aspects of the competence.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. Strategies for encouraging patient/family member partnerships with the health care team.

    Science.gov (United States)

    Ahmann, Elizabeth; Dokken, Deborah

    2012-01-01

    The 5th International Conference of the Institute for Patient- and Family-Centered Care (IPFCC), held in Washington, DC, from June 4-6, 2012, offered an opportunity for almost 1,000 conference participants to share and learn about exciting new patient- and family-centered initiatives occurring across the U.S. and in many other countries. One focus addressed by keynote and plenary speakers, as well as numerous conference sessions and poster presentations, was how nurses and other health care professionals can encourage patients and family members to become partners with their health care teams. Various presenters shared strategies ranging from initial approaches to acknowledging family members as part of the team and offering simple, non-threatening roles in care provision, to policies and approaches inviting increased participation in health care encounters, to higher level involvement in the care planning process, and to partnership roles extending beyond care of the individual child and family. A wealth of ideas can be implemented at various levels by individual nurses, units, and health care institutions.

  3. 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.

  4. 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.

  5. 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.

  6. Improving post-stroke recovery: the role of the multidisciplinary health care team

    Directory of Open Access Journals (Sweden)

    Clarke DJ

    2015-09-01

    Full Text Available David J Clarke, Anne Forster Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, UK Abstract: Stroke is a leading cause of serious, long-term disability, the effects of which may be prolonged with physical, emotional, social, and financial consequences not only for those affected but also for their family and friends. Evidence for the effectiveness of stroke unit care and the benefits of thrombolysis have transformed treatment for people after stroke. Previously viewed nihilistically, stroke is now seen as a medical emergency with clear evidence-based care pathways from hospital admission to discharge. However, stroke remains a complex clinical condition that requires health professionals to work together to bring to bear their collective knowledge and specialist skills for the benefit of stroke survivors. Multidisciplinary team working is regarded as fundamental to delivering effective care across the stroke pathway. This paper discusses the contribution of team working in improving recovery at key points in the post-stroke pathway. Keywords: stroke care, rehabilitation, multidisciplinary, interdisciplinary, team working

  7. Total simulation of operator team behavior in emergencies at nuclear power plants.

    Science.gov (United States)

    Takano, K; Sunaoshi, W; Suzuki, K

    2000-09-01

    In a large and complex system (i.e., a space aeronautics and nuclear power plant) it would be valuable to conduct operator training and support to demonstrate standard operators' behavior in coping with an anomaly caused by multiple malfunctions in which procedures would not have been stipulated previously. A system simulating operator team behavior including individual operator's cognitive behavior, his operations and physical behavior, and even verbal communication among team members, has been developed for a typical commercial nuclear power plant. This simulation model is not a scenario-based system but a complete knowledge-based system, based on the mental model that was envisaged by detailed analyses of experimental results obtained in the full-scope plant simulator. This mental model is composed of a set of knowledge bases and rules able to generate both diagnosis and prognosis depending on the observed situation even for multiple malfunctions. Simulation results of operator team behavior and plant dynamics were compared with corresponding experiments in several anomalies of multiple malfunctions. The comparison showed a reasonable agreement, so the simulation conditions were varied on cognitive task processing speed of individual operators, on team role sharing scheme, and on human machine interface (1st generation to 2nd generation control panel) to assess the sensitivity of this simulation model. Finally, it was shown that this simulation model has applications for the use of training standards and computer aided operator support systems.

  8. Reducing health care hazards: lessons from the commercial aviation safety team.

    Science.gov (United States)

    Pronovost, Peter J; Goeschel, Christine A; Olsen, Kyle L; Pham, Julius C; Miller, Marlene R; Berenholtz, Sean M; Sexton, J Bryan; Marsteller, Jill A; Morlock, Laura L; Wu, Albert W; Loeb, Jerod M; Clancy, Carolyn M

    2009-01-01

    The movement to improve quality of care and patient safety has grown, but examples of measurable and sustained progress are rare. The slow progress made in health care contrasts with the success of aviation safety. After a tragic 1995 plane crash, the aviation industry and government created the Commercial Aviation Safety Team to reduce fatal accidents. This public-private partnership of safety officials and technical experts is responsible for the decreased average rate of fatal aviation accidents. We propose a similar partnership in the health care community to coordinate national efforts and move patient safety and quality forward.

  9. Improving post-stroke recovery: the role of the multidisciplinary health care team.

    Science.gov (United States)

    Clarke, David J; Forster, Anne

    2015-01-01

    Stroke is a leading cause of serious, long-term disability, the effects of which may be prolonged with physical, emotional, social, and financial consequences not only for those affected but also for their family and friends. Evidence for the effectiveness of stroke unit care and the benefits of thrombolysis have transformed treatment for people after stroke. Previously viewed nihilistically, stroke is now seen as a medical emergency with clear evidence-based care pathways from hospital admission to discharge. However, stroke remains a complex clinical condition that requires health professionals to work together to bring to bear their collective knowledge and specialist skills for the benefit of stroke survivors. Multidisciplinary team working is regarded as fundamental to delivering effective care across the stroke pathway. This paper discusses the contribution of team working in improving recovery at key points in the post-stroke pathway.

  10. 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.

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

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    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.

  12. IPO operational algorithm teams throughout the life cycle of NPOESS environmental satellites

    Science.gov (United States)

    Duda, James L.; Emch, Pamela G.

    2004-09-01

    The tri-agency Integrated Program Office (IPO) created Operational Algorithm Teams (OATs) in 1997 to provide scientific advice for managing the development and operation of the National Polar-orbiting Operational Environmental Satellite System (NPOESS). The scientific advice focuses on (1) assuring sound science in instrument and systems design in addition to (2) assuring development and implementation of sound scientific algorithms. This paper outlines the role of IPO operational algorithm teams from mission conception, through instrument design and development, algorithm science code development and conversion to operational code, data processing system implementation, calibration, validation, and, finally, operational data and products distribution to a range of users for weather, national security, and climate science. The composition of the algorithm science teams changes substantially as the sensors and algorithms are developed, tested, integrated, launched, become operational, and age on-orbit. The concept of leveraging our heritage scientists has proven successful with many tangible benefits to the government, the contractor teams, and, ultimately, the nation's taxpayers.

  13. Safety in the operating theatre--a transition to systems-based care.

    Science.gov (United States)

    Weiser, Thomas G; Porter, Michael P; Maier, Ronald V

    2013-03-01

    All surgeons want the best, safest care for their patients, but providing this requires the complex coordination of multiple disciplines to ensure that all elements of care are timely, appropriate, and well organized. Quality-improvement initiatives are beginning to lead to improvements in the quality of care and coordination amongst teams in the operating room. As the population ages and patients present with more complex disease pathology, the demands for efficient systematization will increase. Although evidence suggests that postoperative mortality rates are declining, there is substantial room for improvement. Multiple quality metrics are used as surrogates for safe care, but surgical teams--including surgeons, anaesthetists, and nurses--must think beyond these simple interventions if they are to effectively communicate and coordinate in the face of increasing demands.

  14. Same agency, different teams: perspectives from home and inpatient hospice care.

    Science.gov (United States)

    Lysaght Hurley, Susan; Barg, Frances K; Strumpf, Neville; Ersek, Mary

    2015-07-01

    Tremendous growth in hospice over the past 30 years in the United States has increased the number of terminally ill patients dying at home. Recently, however, more hospice patients are dying at inpatient facilities. To understand the varying perceptions about care in the home and inpatient hospice, we conducted semistructured interviews with 24 interdisciplinary team (IDT) members and analyzed the data using the constant comparative method. Core interdisciplinary tasks, including identifying the focus of energy, tailoring family caregiver involvement, acknowledging who is in charge, and knowing both sides differed in the home and inpatient settings. Despite the overarching umbrella of hospice care, home and inpatient hospice settings create different foci for IDT members, burdens and privileges for family caregivers, and control of the care plan. Key differences between home and inpatient hospice processes of care highlight the complexity of patient-centered end-of-life care in the United States.

  15. 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.

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

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    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.

  17. Burnout in nurses working in Portuguese palliative care teams: a mixed methods study.

    Science.gov (United States)

    Fonseca, Antonio; Pereira, Sandra; Carvalho, Ana Sofia

    2012-08-01

    Repeat contact with suffering, dying, and death is considered to be a risk factor for burnout among health professionals, particularly nurses working in palliative care. A mixed methods study was conducted to identify burnout levels, risk and protective factors, prevention strategies, and the emotional impact of working in palliative care among nurses in Portugal. A quantitative questionnaire was completed by nursing members of nine different palliative care teams and was supported by interviews and observation. Although the participants were exposed to risk factors, such as work overload, disorganisation, difficult relationships within the team and with patients' relatives, they showed a low risk of burnout. These results appear to be related both to the protective factors identified-namely the ethic of care in the relationship the nurses establish with patients, families, and within their teams-and to the preventive strategies they actively adopt for burnout prevention. The positive aspects of the nurses' roles help them to build a positive view of their work, which also promotes their own personal and professional development.

  18. 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

  19. The role of the multidisciplinary health care team in the management of patients with Marfan syndrome

    Directory of Open Access Journals (Sweden)

    von Kodolitsch Y

    2016-11-01

    Full Text Available Yskert von Kodolitsch,1 Meike Rybczynski,1 Marina Vogler,2 Thomas S Mir,3 Helke Schüler,1 Kerstin Kutsche,4 Georg Rosenberger,4 Christian Detter,5 Alexander M Bernhardt,5 Axel Larena-Avellaneda,6 Tilo Kölbel,6 E Sebastian Debus,6 Malte Schroeder,7,8 Stephan J Linke,9,10 Bettina Fuisting,9 Barbara Napp,1 Anna Lena Kammal,11 Klaus Püschel,11 Peter Bannas,12 Boris A Hoffmann,13 Nele Gessler,13 Eva Vahle-Hinz,14 Bärbel Kahl-Nieke,14 Götz Thomalla,15 Christina Weiler-Normann,16 Gunda Ohm,17 Stefan Neumann,18 Dieter Benninghoven,19 Stefan Blankenberg,1 Reed E Pyeritz20 1Clinic of Cardiology, University Heart Centre, 2Marfan Hilfe Deutschland e.V., Zentrumsehstärke, 3Clinic for Pediatric Cardiology, University Heart Centre, 4Institute of Human Genetics, 5Clinic of Cardiovascular Surgery, University Heart Centre, 6Clinic of Vascular Medicine, University Heart Centre, 7Department of Trauma, Hand, and Reconstructive Surgery, 8Department of Orthopedics, 9Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 10Smilow Center for Translational Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 11Department of Legal Medicine, 12Diagnostic and Interventional Radiology Department and Clinic, 13Clinic of Electrophysiology, University Heart Centre, 14Department of Orthodontics, Center for Dental and Oral Medicine, 15Clinic of Neurology, 16Martin Zeitz Center for Rare Diseases, 17Strategic Business Development, 18Business Unit Quality Management, University Medical Center Hamburg-Eppendorf, 19Mühlenberg-Clinic for Rehabilitation, Bad Malente-Gremsmühlen, 20Zentrumsehstärke, Hamburg, Germany Abstract: Marfan syndrome (MFS is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary

  20. An overview of moral distress and the paediatric intensive care team.

    Science.gov (United States)

    Austin, Wendy; Kelecevic, Julija; Goble, Erika; Mekechuk, Joy

    2009-01-01

    A summary of the existing literature related to moral distress (MD) and the paediatric intensive care unit (PICU) reveals a high-tech, high-pressure environment in which effective teamwork can be compromised by MD arising from different situations related to: consent for treatment, futile care, end-of-life decision making, formal decision-making structures, training and experience by discipline, individual values and attitudes, and power and authority issues. Attempts to resolve MD in PICUs have included the use of administrative tools such as shift worksheets, the implementation of continuing education, and encouragement to report. The literature does not yet show these approaches to be effective in the resolution of MD. The need to acknowledge MD among PICU teams is discussed and an argument made that, to facilitate understanding among team members, practice stories need to be shared.

  1. Primary care emergency team training in situ means learning in real context

    Science.gov (United States)

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

    2016-01-01

    Objective The purpose of our study was to explore the local learning processes and to improve in situ team training in the primary care emergency teams with a focus on interaction. Design, setting and subjects As participating observers, we investigated locally organised trainings of teams constituted ad hoc, involving nurses, paramedics and general practitioners, in rural Norway. Subsequently, we facilitated focus discussions with local participants. We investigated what kinds of issues the participants chose to elaborate in these learning situations, why they did so, and whether and how local conditions improved during the course of three and a half years. In addition, we applied learning theories to explore and challenge our own and the local participants’ understanding of team training. Results In situ team training was experienced as challenging, engaging, and enabling. In the training sessions and later focus groups, the participants discussed a wide range of topics constitutive for learning in a sociocultural perspective, and topics constitutive for patient safety culture. The participants expanded the types of training sites, themes and the structures for participation, improved their understanding of communication and developed local procedures. The flexible structure of the model mirrors the complexity of medicine and provides space for the participants’ own sense of responsibility. Conclusion Challenging, monthly in situ team trainings organised by local health personnel facilitate many types of learning. The flexible training model provides space for the participants’ own sense of responsibility and priorities. Outcomes involve social and structural improvements, including a sustainable culture of patient safety. Key Points Challenging, monthly in situ team trainings, organised by local health personnel, facilitate many types of learning.The flexible structure of the training model mirrors the complexity of medicine and the realism of the

  2. 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.

  3. 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.

  4. 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.

  5. The Occupational Therapy in adult Intensive Care Unit (ICU and team perceptions

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    Tatiana Barbieri Bombarda

    2016-10-01

    Full Text Available Introduction: The National Health Surveillance Agency (ANVISA, on 24 February 2010, adopted resolution number 7, which makes mandatory the presence of an occupational therapist as an active member of the Intensive Care Unit professional team. It is believed that the ICU scope is a small professional practice in Occupational Therapy due to the small number of publications in the literature. Objective: To describe the experience and actions developed by occupational therapy in an adult ICU and report the staff awareness reagrding this practice at a state hospital, located in the state of São Paulo. Method: This is an experience report in which we conducted document analysis to obtain data regarding actions taken by occupational therapy, as well as the application of a questionnaire with the team to understand the professionals perceptions regarding the care provided. The data obtained was processed through thematic content analysis. Results: We identified that the occupational therapy intervention transited by functional aspects and support for coping, with the recognition of these actions by the team. Conclusion: The described action consists of practices derived from the occupational therapy insertion process in an adult ICU and meets the desire to encourage the research development in this area for the promotion of debates to promote technical improvement of the profession in the care of critically ill patients.

  6. 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.

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

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    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

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

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    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

  9. [Team Care for Patient Safety, TeamSTEPPS to Improve Nontechnical Skills and Teamwork--Actions to Become an HRO].

    Science.gov (United States)

    Kaito, Ken

    2015-07-01

    It is important to develop safer medical systems and follow manuals of medical procedures for patient safety. However, these approaches do not always result in satisfactory results because of many human factors. It is known that defects of nontechnical skills are more important than those of technical skills regarding medical accidents and incidents. So, it is necessary to improve personal nontechnical skills and compensate for each other's defects based on a team approach. For such purposes, we have implemented TeamSTEPPS to enhance performance and patient safety in our hospital. TeamSTEPPS (team strategies and tools to enhance performance and patient safety) is a useful method to improve the nontechnical skills of each member and the team. In TeamSTEPPS, leadership to share mental models among the team, continuous monitoring and awareness for team activities, mutual support for workload and knowledge, and approaches to complete communication are summarized to enhance teamwork and patient safety. Other than improving nontechnical skills and teamwork, TeamSTEPPS is also very important as a High Reliability Organization (HRO). TeamSTEPPS is worth implementing in every hospital to decrease medical errors and improve patient outcomes and satisfaction.

  10. Education and multidisciplinary team care concepts for pediatric and adolescent diabetes mellitus.

    Science.gov (United States)

    Brink, Stuart J; Miller, Marilyn; Moltz, Kathleen C

    2002-01-01

    The DCCT scientifically established the basis for optimizing blood glucose control in type 1 diabetes mellitus around the world using a multidisciplinary team approach and patient-centered adjustments of food and insulin based upon blood glucose data generated by the patient. Pediatric diabetologists no longer believe that it is prudent to allow higher blood glucose levels in prepubertal children but much educational emphasis must be placed upon minimizing serious episodes of hypoglycemia. Individualized treatment should be determined by a close working relationship between highly trained diabetes nurses, educators and dieticians with the patient as the focus of self-care decisions, and a pediatric diabetologist ideally setting the philosophical and medical goals. Rather than the diabetes health care team being the only ones to initiate treatment, patient and parents should be empowered to analyze their own data, identify patterns, solve problems with food and activity, and do so based upon actual blood glucose results. This empowerment paradigm helps decrease care frustrations and improve treatment outcomes. Survival education followed by in-depth problem solving education and organized follow-up education are all needed steps for successful diabetes management. Identification of psychosocial barriers and energy diverting behavioral and family issues just as knowledge about learning styles play key roles in this process. Dogma should be avoided. More physiological utilization of insulin analogs, greater insulin dosing flexibility with a multidose insulin regimen coupled with adaptation of insulin to food and activity, should allow maximum benefit. Four major types of learning styles are reviewed: concrete sequential learners, abstract sequential learners, abstract random learners and concrete random learners. Health Belief Models, Locus of Control constructs, and Self-Efficacy models all provide sophisticated ways to help identify and overcome learning and self-care

  11. 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

  12. 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.

  13. 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.

  14. 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...

  15. Community and Team Member Factors that Influence the Operations Phase of Local Prevention Teams: The PROSPER Project

    OpenAIRE

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

    2007-01-01

    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, 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 con...

  16. 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.

  17. Providing Nutritional Care in the Office Practice: Teams, Tools, and Techniques.

    Science.gov (United States)

    Kushner, Robert F

    2016-11-01

    Provision of dietary counseling in the office setting is enhanced by using team-based care and electronic tools. Effective provider-patient communication is essential for fostering behavior change: the key component of lifestyle medicine. The principles of communication and behavior change are skill-based and grounded in scientific theories and models. Motivational interviewing and shared decision making, a collaboration process between patients and their providers to reach agreement about a health decision, is an important process in counseling. The stages of change, self-determination, health belief model, social cognitive model, theory of planned behavior, and cognitive behavioral therapy are used in the counseling process.

  18. 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.

  19. A survey of chaplains' roles in pediatric palliative care: integral members of the team.

    Science.gov (United States)

    Lyndes, Kathryn A; Fitchett, George; Berlinger, Nancy; Cadge, Wendy; Misasi, Jennifer; Flanagan, Erin

    2012-01-01

    To date, the field of health care chaplaincy has had little information about how pediatric palliative care (PPC) programs meet the spiritual needs of patients and families. We conducted a qualitative study consisting of surveys of 28 well-established PPC programs in the United States followed by interviews with medical directors and professional chaplains in 8 randomly selected programs among those surveyed. In this report, we describe the PPC chaplain activities, evidence regarding chaplain integration with the PPC team, and physician and chaplain perspectives on the chaplains' contributions. Chaplains described their work in terms of processes such as presence, while physicians emphasized outcomes of chaplains' care such as improved communication. Learning to translate what they do into the language of outcomes will help chaplains improve health care colleagues' understanding of chaplains' contributions to care for PPC patients and their families. In addition, future research should describe the spiritual needs and resources of PPC patients and families and examine the contribution chaplains make to improved outcomes for families and children facing life-limiting illnesses.

  20. 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.

  1. Onychocryptosis: principles of non-operative and operative care.

    Science.gov (United States)

    Murray, W R

    1979-01-01

    Onychocryptosis has many causal factors which contribute to the impingement of the nail edge with the soft tissue nail wall. The treatment protocol for ingrown toenail includes a regimen of conservative care, nail plate avulsion and nail bed ablation.

  2. Quality of interhospital transport of the critically ill : impact of a Mobile Intensive Care Unit with a specialized retrieval team

    NARCIS (Netherlands)

    Wiegersma, Janke S.; Droogh, Joep M.; Zijlstra, Jan G.; Fokkema, Janneke; Ligtenberg, Jack J. M.

    2011-01-01

    Introduction: In order to minimize the additional risk of interhospital transport of critically ill patients, we started a mobile intensive care unit (MICU) with a specialized retrieval team, reaching out from our university hospital-based intensive care unit to our adherence region in March 2009. T

  3. 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.

  4. 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.

  5. The Effects of the Transforming Care at the Bedside Program on Perceived Team Effectiveness and Patient Outcomes.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; O'Connor, Patricia; Biron, Alain; Lavigne, Geneviéve L; Fréchette, Julie; Briand, Anaïck

    The objective of the study was to document the impact of Transforming Care at the Bedside (TCAB) program on health care team's effectiveness, patient safety, and patient experience. A pretest and posttest (team effectiveness) and a time-series study design (patient experience and safety) were used. The intervention (the TCAB program) was implemented in 8 units in a multihospital academic health science center in Montreal, Quebec, Canada. The impact of TCAB interventions was measured using the Team Effectiveness (TCAB teams, n = 50), and Clostridium difficile-associated diarrhea and vancomycin-resistant Enterobacter rates (patient safety) and Hospital Consumer Assessment of Healthcare Providers and Systems (patient experience; n = 551 patients). The intervention was composed of 4 learning modules, each lasting 12 to 15 weeks of workshops held at the start of each module, combined with hands-on learning 1 day per week. Transforming Care at the Bedside teams also selected 1 key safety indicator to improve throughout the initiative. Pretest and posttest differences indicate improvement on the 5 team effectiveness subscales. Improvement in vancomycin-resistant Enterococcus rate was also detected. No significant improvement was detected for patient experience. These findings call to attention the need to support ongoing quality improvement competency development among frontline teams.

  6. Implementation of a multidisciplinary team that includes a registered dietitian in a neonatal intensive care unit improved nutrition outcomes.

    Science.gov (United States)

    Sneve, Jennifer; Kattelmann, Kendra; Ren, Cuirong; Stevens, Dennis C

    This study determined whether nutrition outcomes of neonates who were receiving neonatal intensive care were improved with the implementation of a fully functioning multidisciplinary team that included a registered dietitian. A medical record review was conducted of neonates with birth weights of 1500 g or less who were cared for in Sanford Children's Hospital neonatal intensive care unit from January 1 to December 31, 2001 (prior to functioning multidisciplinary team establishment) and January 1 to December 31, 2004 (subsequent to establishment of a multidisciplinary team). Data from charts in the 2 time periods were examined for differences in nutrition outcomes. Outcome variables included length of stay, birth weight, discharge weight, weight gained for specified time periods, weight at full feeds, weight gain per day, length, head circumference, and number of days to start enteral feeding. Analysis of covariance, controlling for the effect of birth weight, was used to determine differences and was considered significant at P multidisciplinary team (1099 g, 95% CI: 955-1165 vs 1164 g, 95% CI: 1067-1211, respectively). Weight at discharge, total weight gained, total daily weight gained, daily weight gain from birth to the initiation of enteral feeds, daily weight gain from birth to full feeds, and head circumference growth were significantly greater for neonates in the postgroup than in the pre-multidisciplinary team group. Implementation of a multidisciplinary team that included a registered dietitian improved the nutrition outcomes of low birth weight infants in a neonatal intensive care unit.

  7. Home‐care nursing staff in self‐directed teams are more satisfied with their job and perceive more autonomy over patient care. A nationwide survey.

    NARCIS (Netherlands)

    Maurits, E.E.M.; Veer, A.J.E. de; Groenewegen, P.P.; Francke, A.L.

    2017-01-01

    Aims: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy ov

  8. 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.

  9. Improving teamwork, confidence, and collaboration among members of a pediatric cardiovascular intensive care unit multidisciplinary team using simulation-based team training.

    Science.gov (United States)

    Figueroa, Mayte I; Sepanski, Robert; Goldberg, Steven P; Shah, Samir

    2013-03-01

    Findings show that simulation-based team training (SBTT) is effective at increasing teamwork skills. Postpediatric cardiac surgery cardiac arrest (PPCS-CA) is a high-risk clinical situation with high morbidity and mortality. Whereas adult guidelines managing cardiac arrest after cardiac surgery are available, little exists for pediatric cardiac surgery. The authors developed a post-PPCS-CA algorithm and used SBTT to improve identification and management of PPCS-CA in the pediatric cardiovascular intensive care unit. Their goal was to determine whether participation aids in improving teamwork, confidence, and communication during these events. The authors developed a simulation-based training course using common postcardiac surgical emergency scenarios with specific learning objectives. Simulated scenarios are followed by structured debriefings. Participants were evaluated based on critical performance criteria, key elements in the PPCS-CA algorithm, and Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS) principles. Surveys performed before, immediately after, and 3 months after participation evaluated perception of skill, knowledge, and confidence. The study had 37 participants (23 nurses, 5 cardiology/critical care trainees, 5 respiratory therapists, and 4 noncategorized subjects). Confidence and skill in the roles of team leader, advanced airway management, and cardioversion/defibrillation were increased significantly (p Team STEPPS concepts immediately after training and 3 months later. This study showed SBTT to be effective in improving communication and increasing confidence among members of a multidisciplinary team during crisis scenarios. Thus, SBTT provides an excellent tool for teaching and implementing new processes.

  10. Operating room team members' views of workload, case difficulty, and nonroutine events.

    Science.gov (United States)

    Minnick, Ann F; Donaghey, Beth; Slagle, Jason; Weinger, Matthew B

    2012-01-01

    Interventions such as mandatory "time-outs" have contributed to intraoperative safety but improvements are still necessary. We present data provided by 3 professions always present in the intraoperative setting that suggest next steps in the quest for improvements. We describe the differences and similarities in operating room (OR) nurses', anesthesia providers', and surgeons' beliefs about team function, case difficulty, nonroutine event (NRE), and error causation using a qualitative design at 3 Veterans' Administration hospitals. Intraoperative errors are costly in lives, suffering, and dollars. A quality improvement tenet states that workers are a rich information source regarding the context within which quality can be improved. Identifying and describing OR providers' beliefs are necessary steps in devising novel approaches to quality improvement. Intraoperative NRE and error prevention opportunities exist within and outside of the OR. There may be "cascade" and "perfect storm conditions" before and during operative procedures that increase the likelihood of NREs. Confirmation of these phenomena could improve prediction and prevention of NREs. Exploration of differences in team definition and team performance ratings by provider type may also identify avenues for improvement.

  11. 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.

  12. Multidisciplinary team care for people with rheumatoid arthritis: a systematic review and meta-analysis.

    Science.gov (United States)

    Bearne, Lindsay M; Byrne, Anne-Marie; Segrave, Hannah; White, Claire M

    2016-03-01

    The objective of this study was to systematically review the evidence from randomised controlled trials (RCTs) evaluating the effectiveness of multidisciplinary team (MDT) care for the management of disability, disease activity and quality of life (QoL) in adults with rheumatoid arthritis (RA). Data sources identified published (MEDLINE, PsychINFO, EMBASE, CINAHL, Web of Science, CENTRAL) and unpublished (OpenGrey) literature. Independent data extraction and quality assessment, using the Cochrane risk of bias tool, were conducted by two reviewers. The primary outcome was change in disability at 12 months; secondary outcomes included disability at other time points and disease activity and QoL at 12 months. Where possible, the pooled effect sizes were calculated for inpatient or outpatient MDT interventions. Four hundred and fifteen studies were retrieved. Twelve manuscripts, which reported 10 RCTs, representing 1147 participants were included. Only data from five high- or moderate-quality trials were pooled according to clinical setting. There was no difference in disability between inpatient MDT care and any comparison group [mean difference (95% confidence intervals) 0.04, -0.13 to 0.20] or between outpatient MDT care and comparison groups (0.09, -0.07 to 0.25) at 12 months. There was no difference in disability at 2 years or <12 months or disease activity and QoL at 12 months between MDT care and any comparison group. There is limited evidence evaluating the effect of MDT care on disability, disease activity or QoL in people with RA. There is likely to be no effect of MDT care on disability at 12 months or other time points.

  13. 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.

  14. Radiology as the Point of Cancer Patient and Care Team Engagement: Applying the 4R Model at a Patient's Breast Cancer Care Initiation.

    Science.gov (United States)

    Weldon, Christine B; Friedewald, Sarah M; Kulkarni, Swati A; Simon, Melissa A; Carlos, Ruth C; Strauss, Jonathan B; Bunce, Mikele M; Small, Art; Trosman, Julia R

    2016-12-01

    Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer. It is uniquely positioned to play the value-adding role of facilitating patient and team engagement during cancer care initiation. The 4R approach (Right Information and Right Care to the Right Patient at the Right Time), previously proposed for optimizing teamwork and care delivery during cancer treatment, could be applied at the time of diagnosis. The 4R approach considers care for every patient with cancer as a project, using project management to plan and manage care interdependencies, assign clear responsibilities, and designate a quarterback function. The authors propose that radiology assume the quarterback function during breast cancer care initiation, developing the care initiation sequence, as a project care plan for newly diagnosed patients, and engaging patients and their care teams in timely, coordinated activities. After initial consultations and treatment plan development, the quarterback function is transitioned to surgery or medical oncology. This model provides radiologists with opportunities to offer value-added services and solidifies radiology's relevance in the evolving health care environment. To implement 4R at cancer care initiation, it will be necessary to change the radiology practice model to incorporate patient interaction and teamwork, develop 4R content and local adaption approaches, and enrich radiology training with relevant clinical knowledge, patient interaction

  15. 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...

  16. 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.

  17. [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.

  18. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team

    Directory of Open Access Journals (Sweden)

    Andréia Tomazoni

    2014-10-01

    Full Text Available OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units.METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121.RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument.CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units.

  19. 糖尿病多学科护理团队运作模式研究进展%Review of multidisciplinary team care approach for diabetic patients

    Institute of Scientific and Technical Information of China (English)

    丁建玲; 魏兰; 李萍

    2014-01-01

    The authors reviewed the operation system of multidisciplinary team work for diabetic patients, including team member structure, job responsibility, training, evaluation index and so on. Then they pointed out that our diabetic care team system needed improvement in several aspects, such as team building, team member assessment, and patients' outcome evaluation.%从糖尿病多学科团队成员的构成、职责分工、人员培训、评价指标等方面,综述了国内外糖尿病多学科团队护理的运作模式,提出我国糖尿病多学科团队护理需要在多个方面予以规范和完善,尤其是团队的构建、团队成员的考核与评价指标、患者的评价指标体系方面。

  20. Understanding and caring for an operating microscope

    Directory of Open Access Journals (Sweden)

    Ismael Cordero

    2014-04-01

    Full Text Available An operating or surgical microscope is an optical instrument that provides the surgeon with a stereoscopic, high quality magnified and illuminated image of the small structures in the surgical area.

  1. Automatic approach to stabilization and control for multi robot teams by multilayer network operator

    Directory of Open Access Journals (Sweden)

    Diveev Askhat

    2016-01-01

    Full Text Available The paper describes a novel methodology for synthesis a high-level control of autonomous multi robot teams. The approach is based on multilayer network operator method that belongs to a symbolic regression class. Synthesis is accomplished in three steps: stabilizing robots about some given position in a state space, finding optimal trajectories of robots’ motion as sets of stabilizing points and then approximating all the points of optimal trajectories by some multi-dimensional function of state variables. The feasibility and effectiveness of the proposed approach is verified on simulations of the task of control synthesis for three mobile robots parking in the constrained space.

  2. [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.

  3. An interprofessional team approach to fall prevention for older home care clients ‘at risk’ of falling: health care providers share their experiences

    Directory of Open Access Journals (Sweden)

    Pamela Baxter

    2009-05-01

    Full Text Available Background: Providing care for older home care clients ‘at risk’ of falling requires the services of many health care providers due to predisposing chronic, complex conditions. One strategy to ensure that quality care is delivered is described in the integrated care literature; interprofessional collaboration. Engaging in an interprofessional team approach to fall prevention for this group of clients seems to make sense. However, whether or not this approach is feasible and realistic is not well described in the literature. As well, little is known about how teams function in the community when an interprofessional approach is engaged in. The barriers and facilitators of such an approach are also not known. Purpose: The purpose of this qualitative study was to describe the experiences of five different health care professionals as they participated in an interprofessional team approach to care for the frail older adult living at home and at risk of falling. Methodology: This study took place in Hamilton, ON, Canada and was part of a randomized controlled trial, the aim of which was to determine the effects and costs of a multifactorial and interdisciplinary team approach to fall prevention for older home care clients ‘at risk’ of falling. The current study utilized an exploratory descriptive design to answer the following research questions: how do interprofessional teams describe their experiences when involved in a research intervention requiring collaboration for a 9-month period of time? What are the barriers and facilitators to teamwork? Four focus groups were conducted with the care-provider teams (n=9 6 and 9 months following group formation. Results: This study revealed several themes which included, team capacity, practitioner competencies, perceived outcomes, support and time. Overall, care providers were positive about their experiences and felt that through an interprofessional approach benefits could be experienced by both

  4. 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.

  5. 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.

  6. 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 .

  7. Detainee Health Care: Essential Element of Stability Operations

    Science.gov (United States)

    2012-03-22

    food , by mutilation, death, or any other barbarity. 31 Missing from the 1864 and 1906 Geneva Conventions were guidelines for the treatment of able...government.74 Accordingly the host nation Ministry of Health ( MoH ) must eventually assume the health care of detainees. This requires a functioning health...care system and alignment of current detainee medical operations with the MoH capability without reducing the standard of care. This process begins

  8. 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

  9. Community health worker integration into the health care team accomplishes the triple aim in a patient-centered medical home: a Bronx tale.

    Science.gov (United States)

    Findley, Sally; Matos, Sergio; Hicks, April; Chang, Ji; Reich, Douglas

    2014-01-01

    Community health workers are ideally suited to the care coordination niche within the patient-centered medical home (PCMH) team, but there are few case studies detailing how to accomplish this integration. This qualitative study documents how community health workers (CHWs) were integrated into a PCMH in South Bronx, New York. Results show that integration was linked to clear definition of their care coordination role within the care team, meticulous recruitment, training and supervision by a senior CHW, shared leadership of the care management team, and documented value for money. By helping the team understand patients' backgrounds, constraints, and preferences, they helped everyone genuinely focus on the patient.

  10. Multidisciplinary teams involved: detection of drug-related problems through continuity of care

    Directory of Open Access Journals (Sweden)

    Elena Yaiza Romero-Ventosa

    2016-12-01

    Full Text Available Objective: To quantify Drug-Related problems (DRPs by establishing a Strategic Continuity of Care Program (e-Conecta- Concilia Program; e-CC focused on the drug therapy of patients within an Integrated Management Structure, in order to guarantee the therapeutical efficiency, safety and traceability of patients. Method: A prospective study at 8 months. The project included 22 Hospital Pharmacists and 12 Primary Care Pharmacists. Electronic clinical records were used, which can be accessed by all healthcare levels. Those interventions required in order to create a Standard Operating Procedure (SOP were carried out (creation of working groups, computing, meeting points, for coordination among pharmacists in different care levels through a common communication system. The working groups formed by pharmacists of both care levels established the following inclusion criteria: patients with chronic diseases and polymedicated, patients for whom drug-related problems (DRP had been detected, detection of any off-label use in Primary Care, or discrepancies in the standardization of medical prescriptions. Results: In the setting of the e-CC program, interventions were unified and discrepancies were identified. During this project, 245 drug-related problems were detected; the majority regarding inadequate dosing, regimen, or duration (24%, and involving Group B medications (33%, according to the ATC classification. Conclusions: The implementation of a Continuity of Care SOP between pharmacists allowed to detect and solve DRPs and discrepancies in patient pharmacotherapy, with a high rate of acceptance (84.1% of interventions

  11. 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.

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

    Science.gov (United States)

    Hack, Nawaz; Akbar, Umer; Monari, Erin H; Eilers, Amanda; Thompson-Avila, Amanda; Hwynn, Nelson H; Sriram, Ashok; Haq, Ihtsham; Hardwick, Angela; Malaty, Irene A; Okun, Michael S

    2015-01-01

    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.

  13. The specialized role of the RN in the Program of All-inclusive Care for the Elderly (PACE) interdisciplinary care team.

    Science.gov (United States)

    Madden, Karen A; Waldo, Mary; Cleeter, Deborah

    2014-01-01

    There is an increasing volume of literature supporting the Program of All-inclusive Care for the Elderly (PACE) as an innovative model of health care delivery for frail seniors. Registered Nurses (RN) hold an essential position among the PACE interdisciplinary teams (IDT) which serve as the foundational practice approach to patient care. There are currently 97 PACE programs in 31 states. Federal and respective state laws provide comprehensive specifications for IDT composition, minimum qualification of team members and services provided. The role of the RN is not fully defined beyond the requirement of periodic assessments. The intent of this study was to explore and describe the role of the nurse in PACE and to compare nursing care delivery models. Focused interviews and survey results show great variation in nursing roles as well as some common themes among nursing leaders for the vision of PACE nurses.

  14. [Effectiveness of Team-Based Learning (TBL) as a new teaching approach for pharmaceutical care education].

    Science.gov (United States)

    Suno, Manabu; Yoshida, Toshiko; Koyama, Toshihiro; Zamami, Yoshito; Miyoshi, Tomoko; Mizushima, Takaaki; Tanimoto, Mitsune

    2013-01-01

    The concept of Team-Based Learning (TBL) was developed in the late 1970s by Larry Michaelsen, who wanted students to enjoy the benefits of small group learning within large classes in the business school environment. In contrast to problem-based learning (PBL), which is student centered, TBL is typically instructor centered. Recently, TBL is being used as a teaching method in over 60 health science professional schools in the US and other countries. In the present study, the impact of adopting TBL in teaching pharmaceutical care practices to students was evaluated. Students were required to answer a set of multiple-choice questions individually in individual readiness assessment test (IRAT) before the TBL sessions to assess their level of preparation. The same set of questions was then reattempted by the group readiness assessment test (GRAT) during TBL. Comparing the scores obtained in the GRAT and IRAT before the first TBL session, the scores from the GRAT were always higher than those of the IRAT, indicating that TBL has encouraged active learning. In addition, students were surveyed about their level of satisfaction with TBL and written comments about TBL were solicited. The results of the questionnaire showed that 87.3±9.3% of the students were satisfied. Moreover, no student commented that TBL was in any way inferior to the PBL. Implementation of a TBL approach was successfully integrated into the pharmaceutical care education course. In order to further improve the usefulness of TBL in teaching pharmaceutical care, a hybrid teaching approach that also comprises PBL and a lecture-based course is desirable.

  15. 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.

  16. Problems Associated with Coordination and Role Definitions in Health Care Teams: A Hospice Program Evaluation and Intervention Case Study.

    Science.gov (United States)

    Berteotti, Carol R.; And Others

    Using an evaluation of a hospital-based hospice as a case study, this paper analyzes problematic issues surrounding health care teams (HCTs) in light of findings revealed in the literature concerning HCT structures and processes. The factors of coordination and role definitions in HCTs and their manifestations in a particular hospice HCT in terms…

  17. A Review of the First 10 Years of Critical Care Aeromedical Transport During Operation Iraqi Freedom and Operation Enduring Freedom The Importance of Evacuation Timing

    Science.gov (United States)

    2014-06-25

    person team(an intensive careunit [ ICU ] physician, ICU nurse, and respiratory therapist) with a self- carriedequipment set capableof supporting the...The care process en route begins at the point of wounding and continues through the delivery of the pa- tient to rehabilitation centers back in the...fa- cilities evolved along with limited ICU capabilities. Solutions were continually advanced and operational strategies modi- fied tomeet the

  18. 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.

  19. 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...... or pre-arranged at random. Therefore we investigate the importance of team formation in the entrepreneurial classroom and ask: (i) What are the underlying factors that influence outcomes of teamwork in student groups? (ii) How does team formation influence student perception of learning?, and (iii) Do...... 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...

  20. Application of Human-Autonomy Teaming (HAT) Patterns to Reduced Crew Operations (RCO)

    Science.gov (United States)

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

    2016-01-01

    As part of the Air Force - NASA Bi-Annual Research Council Meeting, slides will be presented on recent Reduced Crew Operations (RCO) work. 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. A methodology for identifying HAT patterns to an advanced cockpit project is discussed.

  1. Relationship between depression and medication adherence in cardiovascular disease: the perfect challenge for the integrated care team

    Science.gov (United States)

    Goldstein, Carly M; Gathright, Emily C; Garcia, Sarah

    2017-01-01

    Many individuals with cardiovascular disease (CVD) experience depression that is associated with poor health outcomes, which may be because of medication nonadherence. Several factors influence medication adherence and likely influence the relationship between depression and medication adherence in CVD patients. This comprehensive study reviews the existing literature on depression and medication adherence in CVD patients, addresses the methods of and problems with measuring medication adherence, and explains why the integrated care team is uniquely situated to improve the outcomes in depressed CVD patients. This paper also explores how the team can collaboratively target depressive symptoms and medication-taking behavior in routine clinical care. Finally, it suggests the limitations to the integrated care approach, identifies targets for future research, and discusses the implications for CVD patients and their families. PMID:28352161

  2. Revisiting empowerment: a study of improvement work in health care teams.

    Science.gov (United States)

    Müllern, Tomas; Nordin, Annika

    2012-01-01

    This article reports on a study of team empowerment in a large clinic at a Swedish hospital. The focus of the study was to understand how a high degree of empowerment enabled the teams to develop and sustain a high level of performance. More specifically, a model of empowerment was used to identify important factors that contribute to team empowerment in 3 teams at the clinic. In the analysis of the empirical data, 21 factors were identified and the degree of empowerment in the 3 teams was assessed.

  3. 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.

  4. Self-reported patient psychosocial needs in integrated primary health care: A role for social work in interdisciplinary teams.

    Science.gov (United States)

    Craig, Shelley; Frankford, Rachel; Allan, Kate; Williams, Charmaine; Schwartz, Celia; Yaworski, Andrea; Janz, Gwen; Malek-Saniee, Sara

    2016-01-01

    Despite being identified as significant determinants of health, depression and anxiety continue to be underdiagnosed and undertreated in primary care settings. This study examined the psychosocial health needs of patients at four urban interdisciplinary primary health teams. Quantitative analysis revealed that nearly 80% of patients reported anxiety and/or depression. Self-reported anxiety and depression was correlated with poor social relationships, compromised health status and underdeveloped problem-solving skills. These findings suggest that social workers have a vital role to play within interdisciplinary primary health teams in the amelioration of factors associated with anxiety and depression.

  5. Assessment of palliative care team activities--survey of medications prescribed immediately before and at the beginning of opioid usage.

    Science.gov (United States)

    Myotoku, Michiaki; Murayama, Yoko; Nakanishi, Akiko; Hashimoto, Norio; Koyama, Fumiko; Irishio, Keiko; Kawaguchi, Syunichi; Yamaguchi, Seiji; Ikeda, Kenji; Hirotani, Yoshihiko

    2008-02-01

    We established the Terminal Care Study Group, consisting of physicians, pharmacists, and nurses, in September 2001, and developed the group into the Palliative Care Team. We have surveyed the state of concomitant medications immediately before and at the beginning of opioid usage (except injections) to assess the role of the Palliative Care Team. The survey period was 3 years from October 1, 2002 to September 30, 2005. While the frequency of the prescription of non-steroidal anti-inflammatory drugs (NSAIDs), laxatives, or antiemetics before the beginning of opioid administration did not differ significantly among the 3 periods, that at the beginning of opioid administration increased significantly in 2003 compared with 2002, and increased further in 2004. Many of the drugs used were those that were recommended in our cancer pain management program. Thus, the activities of the Palliative Care Team are considered to have led to proper measures for the control of the major adverse effects of opioids such as constipation and nausea/vomiting in addition to pain control in accordance with the WHO's pain ladder, and also contributed to improvements of the patients' QOL.

  6. 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

  7. 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…

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

    Science.gov (United States)

    Mogobe, Keitshokile Dintle; Shaibu, Sheila; Matshediso, Ellah; Sabone, Motshedisi; Ntsayagae, Esther; Nicholas, Patrice K; Portillo, Carmen J; Corless, Inge B; Rose, Carol Dawson; Johnson, Mallory O; Webel, Allison; Cuca, Yvette; Rivero-Méndez, Marta; Solís Báez, Solymar S; Nokes, Kathleen; Reyes, Darcel; Kemppainen, Jeanne; Reid, Paula; Sanzero Eller, Lucille; Lindgren, Teri; Holzemer, William L; Wantland, Dean

    2016-01-01

    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.

  9. 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.

  10. [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.

  11. 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 re...... received by this multidisciplinary team and to evaluate the quality of acute medical treatment of these patients....

  12. High-Performing Primary Care Teams: Creating The Air Force Medical Home Advantage

    Science.gov (United States)

    2015-02-17

    teams demonstrate a high level of cohesion. Underpinning this cohesion is a foundation of “mutual trust…defined as the shared perception …that individuals...disadvantage is the potential for decreased cohesion. 19 The beauty of multidisciplinary teams is that each member brings a perspective unique to his/her

  13. 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,…

  14. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study

    OpenAIRE

    Lamb, Benjamin W; Jalil, Rozh T; Sevdalis, Nick; Vincent, Charles; Green, James S A

    2014-01-01

    Background The prevalence of multidisciplinary teams (MDT) for the delivery of cancer care is increasing globally. Evidence exists of benefits to patients and healthcare professionals. However, MDT working is time and resource intensive. This study aims to explore members’ views on existing practices of urology MDT working, and to identify potential interventions for improving the efficiency and productivity of the MDT meeting. Methods Members of urology MDTs across the UK were purposively re...

  15. 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.

  16. Factors Surgical Team Members Perceive Influence Choices of Wearing or Not Wearing Personal Protective Equipment during Operative/Invasive Procedures

    Science.gov (United States)

    Cuming, Richard G.

    2009-01-01

    Exposure to certain bloodborne pathogens can prematurely end a person's life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail…

  17. Intraprofessional, team-based treatment planning for oral health students in the comprehensive care clinic.

    Science.gov (United States)

    Mattheos, Nikos; Storrs, Mark; Foster, Lea; Oberholzer, Theunis

    2012-12-01

    In 2009, Griffith University School of Dentistry and Oral Health, in Queensland, Australia, introduced into its various curricula the concept of team-based treatment planning (TBTP), aiming to facilitate intraprofessional, interdisciplinary training and peer learning among its students. Fifty student teams were organized, each of which included students from three programs (Dental Science, Oral Health Therapy, and Dental Technology) and three years of study (third-, fourth-, and fifth-year students). This study prospectively evaluated the impact of TBTP on students' perceptions and attitudes towards teamwork and their role in a team of peers. A total of 202 students who participated in fifty TBTP teams were prospectively surveyed at baseline and at six and twelve months after introduction of TBTP. "Reliable" and "responsible" were reported to be the most important qualities of both an effective team leader and member. Fifth-year students identified "hard-working" as an important quality of the ideal leader as opposed to the fourth-year students who ranked "supportive" higher. Attitudes of the fifth-year students towards TBTP appeared to have declined significantly from the previous years, while fourth-year students remained consistently more positive. In addition, fourth-year students appeared more likely to enjoy working in a team and considered themselves more effective in a team. No gender differences were observed, other than female students' appearing less confident to lead a team. It was concluded that the function of student-directed interdisciplinary, intraprofessional treatment planning teams might pose disproportionate strain on fifth-year students, impacting their attitudes to such modes of work.

  18. 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…

  19. 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.

  20. 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.

  1. 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

  2. Critical care nurses' perceptions of their roles in family-team conflicts related to treatment plans.

    Science.gov (United States)

    Edwards, Marie Patricia; Throndson, Karen; Dyck, Felicia

    2012-03-01

    Conflict over treatment plans is a cause of concern for those working in critical care environments. The purpose of this study was to explore and describe critical care nurses' perceptions of their roles in situations of conflict between family members and health-care providers in intensive care units. Using a qualitative descriptive design, 12 critical care nurses were interviewed individually and 4 experienced critical care nurses participated in focus group interviews. The roles described by the nurses were as follows: providing safe, competent, quality care to patients; building or restoring relationships of trust with families; and supporting other nurses. The nurses highlighted the level of stress when conflict arises, the need to be cautious in providing care and communicating with family members, and the need for support for nurses. More research related to working in situations of conflict is required, as is enhanced education for critical care nurses.

  3. Barriers and facilitators of Canadian quality and safety teams: a mixed-methods study exploring the views of health care leaders

    Directory of Open Access Journals (Sweden)

    White DE

    2016-12-01

    Full Text Available Deborah E White,1 Jill M Norris,1 Karen Jackson,2 Farah Khandwala3 1Faculty of Nursing, University of Calgary, 2Workforce Research and Evaluation, Alberta Health Services, 3Cancer Care Services, Alberta Health Services, Calgary, AB, Canada Background: Health care organizations are utilizing quality and safety (QS teams as a mechanism to optimize care. However, there is a lack of evidence-informed best practices for creating and sustaining successful QS teams. This study aimed to understand what health care leaders viewed as barriers and facilitators to establishing/implementing and measuring the impact of Canadian acute care QS teams.Methods: Organizational senior leaders (SLs and QS team leaders (TLs participated. A mixed-methods sequential explanatory design included surveys (n=249 and interviews (n=89. Chi-squared and Fisher’s exact tests were used to compare categorical variables for region, organization size, and leader position. Interviews were digitally recorded and transcribed for constant comparison analysis.Results: Five qualitative themes overlapped with quantitative data: (1 resources, time, and capacity; (2 data availability and information technology; (3 leadership; (4 organizational plan and culture; and (5 team composition and processes. Leaders from larger organizations more often reported that clear objectives and physician champions facilitated QS teams (p<0.01. Fewer Eastern respondents viewed board/senior leadership as a facilitator (p<0.001, and fewer Ontario respondents viewed geography as a barrier to measurement (p<0.001. TLs and SLs differed on several factors, including time to meet with the team, data availability, leadership, and culture.Conclusion: QS teams need strong, committed leaders who align initiatives to strategic directions of the organization, foster a quality culture, and provide tools teams require for their work. There are excellent opportunities to create synergy across the country to address each

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

    Science.gov (United States)

    Howell, Joel D

    2011-09-06

    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.

  5. Evaluation of a Pilot Project to Introduce Simulation-Based Team Training to Pediatric Surgery Trauma Room Care

    Directory of Open Access Journals (Sweden)

    Markus Lehner

    2017-01-01

    Full Text Available Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings. Each scenario incorporated elements of pediatric trauma management as well as Crew Resource Management (CRM educational objectives. Participants completed anonymous pre- and postcourse questionnaires and rated the course itself as well as their own medical qualification and knowledge of CRM. Results. Participants found the course very realistic and selected scenarios highly relevant to their daily work. They reported a feeling of improved medical and nontechnical skills as well as no uncomfortable feeling during scenarios or debriefings. Conclusion. To our knowledge this pilot-project represents the first successful implementation of a simulation-based team-training course focused on pediatric trauma care in German-speaking countries with good acceptance.

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

    OpenAIRE

    2015-01-01

    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 Scien...

  7. Goal-based design pattern for delegation of work in health care teams.

    Science.gov (United States)

    Grando, Adela; Peleg, Mor; Glasspool, David

    2010-01-01

    We show how a domain and language independent design pattern, defined as networks of tasks and goals, can be used to formally specify the transfer of responsibility and accountability when tasks are delegated in healthcare teams. The pattern is general enough to be applied unchanged across a broad range of different healthcare situations.

  8. 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 m...

  9. Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless?

    Science.gov (United States)

    Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia

    2015-01-01

    Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

  10. 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.

  11. [Career planning for explanation of clinical test results and program of inspections: developing medical technologists for team medical care].

    Science.gov (United States)

    Uchida, Misuko

    2013-04-01

    Current medical care is subdivided according to medical advances, and sophistication and new techniques are necessary. In this setting, doctors and nurses have been explaining to and consulting patients about their medical examinations; however, in recent years, medical technologists have performed these duties at the start of the team's medical care. Therefore, we think it is possible for patients to receive clear and convincing explanations. Most patients cannot understand their examination data, which are written using numbers and charts, etc. Recently, the Nagano Medical Technologist Society has been developing technologists who could explain examination results to patients. This development training included hospitality and communication. The certificate of completion will be issued in March when the program starts.

  12. 5As Team obesity intervention in primary care: development and evaluation of shared decision-making weight management tools.

    Science.gov (United States)

    Osunlana, A M; Asselin, J; Anderson, R; Ogunleye, A A; Cave, A; Sharma, A M; Campbell-Scherer, D L

    2015-08-01

    Despite several clinical practice guidelines, there remains a considerable gap in prevention and management of obesity in primary care. To address the need for changing provider behaviour, a randomized controlled trial with convergent mixed method evaluation, the 5As Team (5AsT) study, was conducted. As part of the 5AsT intervention, the 5AsT tool kit was developed. This paper describes the development process and evaluation of these tools. Tools were co-developed by the multidisciplinary research team and the 5AsT, which included registered nurses/nurse practitioners (n = 15), mental health workers (n = 7) and registered dieticians (n = 7), who were previously randomized to the 5AsT intervention group at a primary care network in Edmonton, Alberta, Canada. The 5AsT tool development occurred through a practice/implementation-oriented, need-based, iterative process during learning collaborative sessions of the 5AsT intervention. Feedback during tool development was received through field notes and final provider evaluation was carried out through anonymous questionnaires. Twelve tools were co-developed with 5AsT. All tools were evaluated as either 'most useful' or 'moderately useful' in primary care practice by the 5AsT. Four key findings during 5AsT tool development were the need for: tools that were adaptive, tools to facilitate interdisciplinary practice, tools to help patients understand realistic expectations for weight loss and shared decision-making tools for goal setting and relapse prevention. The 5AsT tools are primary care tools which extend the utility of the 5As of obesity management framework in clinical practice.

  13. 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

  14. Mitigating Task Saturation in Critical Care Air Transport Team Red Flag Checklist

    Science.gov (United States)

    2015-04-14

    PO, Jensen MK, Lippert A, Østergaard D. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams...technical skills (NOTECHS). The current study was conducted to evaluate predictors of competence in non-technical skills . Sixteen CCATTs were studied over...was assigned a non- technical skill score or “red flag score.” The team’s average red flag score correlated with task saturation during the simulated

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

    OpenAIRE

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

    2012-01-01

    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...

  16. 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.

  17. [Interprofessional teamwork in health care].

    Science.gov (United States)

    Antoni, Conny H

    2010-01-01

    Providing health care requires the integrative co-operation of physicians, nurses and other professionals in the health care sector. The success of such interprofessional teamwork does not only rely on the team members' task knowledge, but also on their teamwork-related knowledge, their skills and attitudes. In this paper a theoretical framework for team effectiveness is developed and used to identify factors improving team success. Within this context interprofessional team composition is perceived as a characteristic of team diversity, which needs to be perceived as a chance for better patient care in order to be used effectively.

  18. Clinical review: the role of the intensivist and the rapid response team in nosocomial end-of-life care.

    Science.gov (United States)

    Hilton, Andrew K; Jones, Daryl; Bellomo, Rinaldo

    2013-04-26

    In-hospital end-of-life care outside the ICU is a new and increasing aspect of practice for intensive care physicians in countries where rapid response teams have been introduced. As more of these patients die from withdrawal or withholding of artificial life support, determining whether a patient is dying or not has become as important to intensivists as the management of organ support therapy itself. Intensivists have now moved to making such decisions in hospital wards outside the boundaries of their usual closely monitored environment. This strategic change may cause concern to some intensivists; however, as custodians of the highest technology area in the hospital, intensivists are by necessity involved in such processes. Now, more than ever before, intensive care clinicians must consider the usefulness of key concepts surrounding nosocomial death and dying and the importance and value of making a formal diagnosis of dying in the wards. In this article, we assess the conceptual background, reference points, challenges and implications of these emerging aspects of intensive care medicine.

  19. 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.

  20. Improving post-stroke recovery: the role of the multidisciplinary health care team

    OpenAIRE

    Clarke, DJ; Forster, A.

    2015-01-01

    David J Clarke, Anne Forster Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, UK Abstract: Stroke is a leading cause of serious, long-term disability, the effects of which may be prolonged with physical, emotional, social, and financial consequences not only for those affected but also for their family and friends. Evidence for the effectiveness of stroke unit care and the benefits of thrombolysis have transformed treatment for people after ...

  1. Occupational Health Screenings of Aeromedical Evacuation and Critical Care Air Transport Team Crew Members

    Science.gov (United States)

    2015-08-01

    concerning mental health problems. 3.2.2 Physical Exercise Behaviors. Participants were asked the following: how often do you engage in physical... depression ) as a reason for an increase in mental health supp01i utilization. CCATT crew members did not rep01i any other reasons for an increase...health care. However, AE crew members also endorsed emotional distress, such as depression , leading to their increase in seeking mental health care

  2. Uptake of a team briefing in the operating theatre: a Burkean dramatistic analysis.

    Science.gov (United States)

    Whyte, Sarah; Cartmill, Carrie; Gardezi, Fauzia; Reznick, Richard; Orser, Beverley A; Doran, Diane; Lingard, Lorelei

    2009-12-01

    Communication among healthcare professionals is a focus for research and policy interventions designed to improve patient safety, but the challenges of changing interprofessional communication patterns are rarely described. We present an analysis of 756 preoperative briefings conducted by general surgery teams (anesthesiologists, nurses, and surgeons) at four urban Canadian hospitals in the context of two research studies conducted between August 2004 and December 2007. We ask the questions: how and why did briefings succeed, how and why did they fail, and what did they mean for different participants? Ethnographic fieldnotes documenting the coordination and performance of team briefings were analyzed using Kenneth Burke's concepts of motive and attitude. The language and behaviour of participants were interpreted as purposive and situated actions which reveal perceptions, beliefs and values. Motives and attitudes varied both within and across sites, professions, individuals, and briefings. They were contingent on the organizational, medical and social scenes in which the briefings took place and on participants' multiple perceived purposes for participating (protecting patient safety, exchanging information, engaging with the team, fulfilling professional commitments, participating in research, and meeting social expectations). Participants' attitudes reflected their recognition (or rejection) of specific purposes, the briefings' perceived effectiveness in serving these purposes, and the briefings' perceived alignment (or conflict) with other priorities. Our findings illustrate the intrinsically rhetorical and variable nature of change.

  3. 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.

  4. LandCyber Operations: A Double Edged Sword or a Dream Team?

    Science.gov (United States)

    2013-03-01

    moved to formalize cyber-electromagnetic activities ( CEMA ) into doctrine.29 However, this move potentially boxes cyber activities into a dark corner...lines of operation for CEMA : cyberspace operations, electronic warfare (EW), and electromagnetic support operations (EMSO). Cyberspace operations...the development of the network is a long term project, so is the integration of CEMA into staff processes and operations. ARCYBER and the MCCoE

  5. 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.

  6. What were the perceptions of primary care teams on learning from a single multidisciplinary simulation-based training intervention?

    Science.gov (United States)

    Strachan, Alasdair N; Graham, Alastair C; Hormis, Anil P; Hilton, Gill

    2011-07-01

    Medical emergencies in general practice are uncommon and their management requires good teamwork, communication and effective use of the available resources by the whole primary care team. To address this need the Montagu Clinical Simulation Centre developed and delivered a half-day simulation-based medical emergencies course for primary care teams (GPs, practice nurses and administrative staff). Each half-day course comprises two simulated medical emergencies, which are video-taped and then debriefed. The course was evaluated using a multi-level approach by seeking the staff's reactions to the course, their learning, the behaviour changes produced and the results for the organisation. We gained this information through self-reporting using end-of-course and follow-up questionnaires. The immediate feedback was very positive, showing they had learnt the objectives set. We then surveyed all those who had attended training between 2003 and 2007. A follow-up questionnaire was developed and sent to the practice managers who then co-ordinated their completion and return using a pre-paid return envelope. The survey was carried out in two cohorts. The first set of follow-up questionnaires was sent out in September 2004 to all those that had attended up to the end of May 2004 and the second set sent out in May 2008 to those who had attended between June 2004 and May 2007. Of the 338 available to complete the follow-up questionnaire, 208 responded, giving a response rate of 62%. Eighty percent of practices had made changes to equipment, emergency protocols or training and 20% of the participants had been involved in managing a medical emergency since attending the course. Of those, 86% indicated that their management and confidence had improved, that they were better able to take a lead role, give instruction and delegate tasks as required. Based on the self-reported perceptions of learning, we believe that the lessons learnt have been translated into positive changes at a

  7. 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.

  8. 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

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

    Science.gov (United States)

    Lahaj, Mary

    2011-12-01

    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. The article explores the challenges of this new profession and advocates having a Muslim chaplain available in the hospital to serve Muslim patients, families, and the non-Muslim staff.

  10. [Parents of a critically ill child - what do they expect from the team of the pediatric intensive care unit?].

    Science.gov (United States)

    Spitz-Köberich, Christine; Barth, Michael; Spirig, Rebecca

    2010-10-01

    Having an ill child that is being treated in a pediatric intensive care unit (PICU) is tremendously stressful for the parents, both physically and emotionally. To help them cope with the circumstances they find themselves in, parents often develop expectations which are addressed to the team of the PICU, and which they find important to be fulfilled. Many of these expectations are culturally shaped. At present, there exist no data from German speaking area. Thus, this qualitative study was undertaken to fill this gap. Episodic interviews were conducted with five mothers and two fathers. Using the content analysis technique described by Mayring, one main category and six subcategories emerged from the data. "Concering about the sick child" was of particular importance for the parents. Their own expectations were reflected in the six subcategories: "Knowing that the child is receiving good care", "Being with the child", "Being involved", "Experiencing care for oneself and one's child", "Being informed" and "Experiencing continuity". These results are congruent with prior research reported in the international literature. Having a desire for a continuous medical support and the clear separation of roles between physicians and nurses are new findings from this investigation which have not been described previously.

  11. 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.

  12. Nursing operations automation and health care technology innovations: 2025 and beyond.

    Science.gov (United States)

    Suby, ChrysMarie

    2013-01-01

    This article reviews why nursing operations automation is important, reviews the impact of computer technology on nursing from a historical perspective, and considers the future of nursing operations automation and health care technology innovations in 2025 and beyond. The increasing automation in health care organizations will benefit patient care, staffing and scheduling systems and central staffing offices, census control, and measurement of patient acuity.

  13. Assessment of Intervention by a Palliative Care Team Working in a Japanese General Hospital: A Retrospective Study.

    Science.gov (United States)

    Amano, Koji; Morita, Tatsuya; Tatara, Ryohei; Katayama, Hirofumi; Aiki, Sayo; Kitada, Namiki; Fumimoto, Hiromi; Sato, Emi

    2015-09-01

    Our objective was to explore the effectiveness of a palliative care team (PCT) by investigating potential differences in opioid prescription between patients who had had PCT involvement before admission to an inpatient hospice and those who had not. A total of 221 patients met the criteria; they were divided into an intervention group (n = 140) and a control group (n = 81). The daily dose of opioid before admission to the hospice was significantly higher in the intervention group (P < .001). The difference between the maximum opioid dose and the initial dose, the rate of increase in opioids until death, and the length of stay in the hospice were not significantly different between the groups. A PCT contributes to more appropriate use of opioids before admission to a hospice.

  14. Intensive care unit admission in patients following rapid response team activation: call factors, patient characteristics and hospital outcomes.

    Science.gov (United States)

    Le Guen, M P; Tobin, A E; Reid, D

    2015-03-01

    Rapid Response Systems (RRSs) have been widely introduced throughout hospital health systems, yet there is limited research on the characteristics and outcomes of patients admitted to an intensive care unit (ICU) following RRS activation. Using database extraction, this study examined the factors associated with ICU admission and patient outcome in patients receiving RRS activation in a tertiary level hospital between 2009 and 2013. Of 3004 RRS activations, 392 resulted in ICU admissions. Call factors associated with ICU admission and increased hospital mortality included tachypnoea (P Medical Emergency Team call triggers breached simultaneously (P admission included young age (P admission and hospital mortality post RRS activation. This information may be useful for risk stratification of deteriorating patients and determination of appropriate escalation.

  15. [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.

  16. [Hypnosis integrated in burn care: impact on the healthcare team's stress].

    Science.gov (United States)

    Bertholet, Olivier; Davadant, Maryse; Cromec, Ioan; Berger, Mette M

    2013-09-11

    Hypnosis for burn care was introduced in 2004 in the CHUV burn center showing great benefit for burned patients. Whereas advantages of hypnosis for the patient are well established, the impact on the medical staff remains poorly assessed. This manuscrit reviews current attested benefits of hypnosis for patients, specially for burned patients. The results of a recent study assessing the impact of hypnosis on the staffs level of stress caused by burn treatment, will also be introduced.

  17. Improving recovery time following heart transplantation: the role of the multidisciplinary health care team

    OpenAIRE

    Roussel MG; Gorham N; Wilson L; Mangi AA

    2013-01-01

    Maureen G Roussel,1 Noreen Gorham,2 Lynn Wilson,2 Abeel A Mangi2 1Heart and Vascular Center, Yale-New Haven Hospital, New Haven, CT, USA; 2Center for Advanced Heart Failure, Mechanical Circulatory Support and Cardiac Transplantation, Yale New Haven Heart and Vascular Institute, Yale-New Haven Hospital, New Haven, CT, USA Background: The care of cardiac transplant patients is complex requiring a finely orchestrated endeavor to save a patient’s life. Given the chronic and complex nat...

  18. 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.

  19. 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.

  20. 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.

  1. Winning the Soft War: The Employment of Tactical PSYOP Teams in Combat Operations

    Science.gov (United States)

    2012-06-08

    PSYOP, and the supported commander in, “7 Deadly Sins of PSYOP.” Using Dante’s epic poem , “The Divine Comedy,” McCarthy uses the seven deadly sins; lust...Information Age: Assessing U.S. Army Employment of Psychological Operations in the Contemporary Operating Environment.” Monograph, Ft. Leavenworth, KS

  2. 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

  3. 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.

  4. Developing quality indicators for family support services in community team-based mental health care.

    Science.gov (United States)

    Serene Olin, S; Kutash, Krista; Pollock, Michele; Burns, Barbara J; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E

    2014-01-01

    Quality indicators for programs integrating parent-delivered family support services for children's mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components.

  5. 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.

  6. 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.

  7. 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…

  8. Returning to contingency: the forward trauma team.

    Science.gov (United States)

    Dickinson, Andrew; Dalal, S; Beales, L

    2016-12-01

    During Herrick 19, Main Operating Base Price Role 1 treatment facility saw one of the busiest periods of Role 1 trauma care within the British Afghanistan campaign. Within 5 months 73 trauma casualties were treated, 48 of whom were category A. This article shares the experiences of this Role 1 and its unusual context, and discusses the relevance with regard to future medical planning. The focus is on the human element; a fundamental of all military operations yet one that is often overlooked. We consider the team construct and the team members of Role 1 and suggest how this team and its leaders can be optimally prepared, supported and maintained, and then safely disassembled. We also consider how best this team can be placed within the battle group formation in order to provide the highest standard of care.

  9. [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.

  10. 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

  11. General practice and specialist palliative care teams: an exploration of their working relationship from the perspective of clinical staff working in New Zealand.

    Science.gov (United States)

    Keane, Barry; Bellamy, Gary; Gott, Merryn

    2017-01-01

    With the future focus on palliative and end-of-life care provision in the community, the role of the general practice team and their relationship with specialist palliative care providers is key to responding effectively to the projected increase in palliative care need. Studies have highlighted the potential to improve co-ordination and minimise fragmentation of care for people living with palliative care need through a partnership between generalist services and specialist palliative care. However, to date, the exact nature of this partnership approach has not been well defined and debate exists about how to make such partnerships work successfully. The aim of this study was to explore how general practice and specialist palliative care team (SPCT) members view their relationship in terms of partnership working. Five focus group discussions with general practices and SPCT members (n = 35) were conducted in 2012 in two different regions of New Zealand and analysed using a general inductive approach. The findings indicate that participants' understanding of partnership working was informed by their identity as a generalist or specialist, their existing rules of engagement and the approach they took towards sustaining the partnership. Considerable commitment to partnership working was shown by all participating teams. However, their working relationship was based primarily on trust and personal liaison, with limited formal systems in place to enable partnership working. Tensions between the cultures of 'generalism' and 'specialism' also provided challenges for those endeavouring to meet palliative care need collaboratively in the community. Further research is required to better understand the factors associated with successful partnership working between general practices and specialist palliative care in order to develop robust strategies to support a more sustainable model of community palliative care.

  12. Preventive Medicine and Its Role in the Special Operation Forces Medical Team.

    Science.gov (United States)

    Agudelo, Juan J

    2015-01-01

    Throughout history, Soldiers in wartime have been especially vulnerable to infectious diseases, which have devastated and decimated entire armies, causing suspension and, in some cases, complete cancellation of military operations. Dr. William Foege,1 a renowned Harvard epidemiologist, and his colleagues claim that throughout history, infectious diseases have killed more Soldiers than have weapons. Reality shows that it does not matter if your Soldiers had the best training available with the best equipment and top of the world intelligence: if your personnel get sick, they become more of a liability than an asset for a combat operation. This article presents some of the key findings that continue to affect our Special Operations Forces (SOF) and how the use of specifically designed new products can help in controlling short- and long-term consequences of infectious diseases.

  13. 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.

  14. Mission control team structure and operational lessons learned from the 2009 and 2010 NASA desert RATS simulated lunar exploration field tests

    Science.gov (United States)

    Bell, Ernest R.; Badillo, Victor; Coan, David; Johnson, Kieth; Ney, Zane; Rosenbaum, Megan; Smart, Tifanie; Stone, Jeffry; Stueber, Ronald; Welsh, Daren; Guirgis, Peggy; Looper, Chris; McDaniel, Randall

    2013-10-01

    The NASA Desert Research and Technology Studies (Desert RATS) is an annual field test of advanced concepts, prototype hardware, and potential modes of operation to be used on human planetary surface space exploration missions. For the 2009 and 2010 NASA Desert RATS field tests, various engineering concepts and operational exercises were incorporated into mission timelines with the focus of the majority of daily operations being on simulated lunar geological field operations and executed in a manner similar to current Space Shuttle and International Space Station missions. The field test for 2009 involved a two week lunar exploration simulation utilizing a two-man rover. The 2010 Desert RATS field test took this two week simulation further by incorporating a second two-man rover working in tandem with the 2009 rover, as well as including docked operations with a Pressurized Excursion Module (PEM). Personnel for the field test included the crew, a mission management team, engineering teams, a science team, and the mission operations team. The mission operations team served as the core of the Desert RATS mission control team and included certified NASA Mission Operations Directorate (MOD) flight controllers, former flight controllers, and astronaut personnel. The backgrounds of the flight controllers were in the areas of Extravehicular Activity (EVA), onboard mechanical systems and maintenance, robotics, timeline planning (OpsPlan), and spacecraft communicator (Capcom). With the simulated EVA operations, mechanized operations (the rover), and expectations of replanning, these flight control disciplines were especially well suited for the execution of the 2009 and 2010 Desert RATS field tests. The inclusion of an operations team has provided the added benefit of giving NASA mission operations flight control personnel the opportunity to begin examining operational mission control techniques, team compositions, and mission scenarios. This also gave the mission operations

  15. Travelling with cystic fibrosis: recommendations for patients and care team members.

    Science.gov (United States)

    Hirche, T O; Bradley, J; d'Alquen, D; De Boeck, K; Dembski, B; Elborn, J S; Gleiber, W; Lais, C; Malfroot, A; Wagner, T O F

    2010-12-01

    There are no European Guidelines on issues specifically related to travel for people with cystic fibrosis (CF). The contributors to these recommendations included 30 members of the ECORN-CF project. The document is endorsed by the European Cystic Fibrosis Society and sponsored by the Executive Agency of Health and Consumers of the European Union and the Christiane Herzog Foundation. The main goal of this paper is to provide patient-oriented advice that complements medical aspects by offering practical suggestions for all aspects involved in planning and taking a trip. The report consists of three main sections, preparation for travel, important considerations during travel and at the destination, and issues specific to immunocompromised travellers. People with CF should be encouraged to consult with their CF centre prior to travel to another country. The CF centre can advise on the necessary preparation for travel, the need for vaccinations, essential medications that should be brought on the trip and also provide information relating to CF care in the region and plan of action in case of an emergency.

  16. ORGANIZATION AND PROCEDURES GUIDE FOR PERFORMING MAJOR AMBULATORY AND SHORT-STAY SURGERY IN COORDINATION WITH THE PRIMARY HEALTH CARE TEAM

    Directory of Open Access Journals (Sweden)

    Javier Cruz Rodríguez

    2015-11-01

    Full Text Available Currently, there are constraints on coordination between the primary and secondary levels of care, and we lack a regulatory document for surgical activity in major ambulatory and short-stay surgery, which affects the quality of this modality of care. Such reasons led to the design of the “Organization and Procedures Guide for Performing Major Ambulatory and Short-stay Surgery in Coordination with the Primary Health Care Team". The guide was assessed by 90 experts with experience in the primary and secondary levels of care, who endorsed the quality and relevance of the proposal. It contains recommendations to help primary and secondary care professionals involved in surgical care to select the most appropriate approach to conditions treated by means of ambulatory or short-stay surgery. The recommendations are based on the latest available scientific evidence supporting the use of ambulatory surgery, short-stay surgery and home hospitalization.

  17. Dynamics of Interagency Cooperation Process at Provincial Reconstruction Team in Operations ISAF and Enduring Freedom

    Science.gov (United States)

    2010-06-11

    recently visited three PRTs in Afghanistan: Panshir (US led), Bamiyan (New Zealand defense forces) and Mazar e Sharif (Sweden). She says that each PRT has...opportunity to visit and work with PRTs Bamiyan (led by New Zealand Defense Forces), Mazar e Sharif (Swedish Forces) and Herat (Italian Forces). During...relationships and the deficiencies at PRT level were really based, she says, upon the different environments in which the PRTs operated. She did find Bamiyan

  18. 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

  19. 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

  20. Actual Situations and Problems of Postoperative Nursing Care for the Elderly who Underwent Neurosurgical Operation

    OpenAIRE

    2014-01-01

    The objective of the study is to identify nursing care and related problems involved in extending the daily life and supporting self-care of the elderly who underwent neurosurgical operation, and to determine the direction of nursing care. Subjects were six nurses who had been working in anacute-phase department for five years or longer. Collected data was analyzed by the qualitative synthesis method (KJ method). The results clarified [nursing care to enhance the treatment effect of neurosurg...

  1. A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

    Directory of Open Access Journals (Sweden)

    Jennifer DeVoe

    2016-12-01

    Full Text Available Maintaining continuous health insurance coverage is important. With recent expansions in access to coverage in the United States after “Obamacare,” primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients. We describe efforts to longitudinally track health insurance rates using data from the electronic health record (EHR of a primary care network and to use these data to support practice-based insurance outreach and assistance. Although we highlight a few examples from one network, we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care. By partnering with researchers through practice-based research networks and other similar collaboratives, primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care.

  2. FIGHTING WAY OF 29TH SEPARATE SKI TEAM DURING OFFENSIVE OPERATIONS OF CENTRAL FRONT

    Directory of Open Access Journals (Sweden)

    Sergey V. Ushkalov

    2016-01-01

    Full Text Available By the beginning of 1943 the Soviet armed forces have achieved major successes. The counter-offensive at Stalingrad dramatically changed strategic situation on the Soviet-German front in favor of the Red Army. In these circumstances, the Supreme Command decided; leveraging the success of the Stalingrad counteroffensive, expand common forward fight from Leningrad to the Caucasus. It was decided to concentrate its efforts on the south-westerly direction, that is, where enemy was applied particularly noticeable damage and where least expected his stubborn resistance. Important role in operations against the Army Group "Center" was assigned to the Central Front, which was formed after the defeat of F. Paulus at Stalingrad during the operation "Ring". The Central Front included 21th Army under the command of Lieutenant General I.M. Chistyakov, 65 Army under the command of Lieutenant-General P.I. Baht, 70th Army under the command of Major-General G.F. Tarasova, 16 th Air Army under the command of Lieutenant-General S. Rudenko, 2 Panzer Army under the command of Lieutenant General A.G. Rodin, 2nd Guards Cavalry Corps under the command of Lieutenant-General V. Kryukov, which included the 29th Infantry Brigade separate ski, This article discusses the combat path of the 29th separate ski Infantry Brigade involved in the battle for the interception of Soviet strategic initiative in the Second World War. Thoroughly studied and analyzed the documents of the Central Archive of the Russian Federation Ministry of Defense, as well as the available literature on the subject that has allowed to clearly define the goals and objectives of the study, formulated the methodological basis - the principle of scientific historicism and objectivity, as well as the principle of systems in the study of history as part of the test of chronological period. It is shown in what difficult conditions these events took place. Example of soldiers of the 29th Infantry Brigade

  3. Preliminary investigation into sport and exercise psychology consultants' views and experiences of an interprofessional care team approach to sport injury rehabilitation.

    Science.gov (United States)

    Arvinen-Barrow, Monna; Clement, Damien

    2017-01-01

    Sport injury rehabilitation has moved from predominately physical treatment to a more holistic care. However, limited research has explored the views and experiences of those involved in such an approach. The purpose of this study was to preliminarily investigate sport psychology consultants' (SPCs') views and experiences of an interprofessional team approach to sport injury rehabilitation. A cross-sectional online survey previously used with athletic trainers was distributed via a US-based sport/exercise psychology list-serve (N = 1245). A total of 62 (27 men, 35 women, M age 38.2 years, age range: 22-73 years) participants with 10.6 (SD = 9.8) years of experience as an SPC were included in the final analyses. On average, SPCs felt that it was very important (M = 6.6; SD = 0.6) for athletes to have access to an interprofessional care team. Of the sample, 64.5% (n = 40) typically worked as part of an interprofessional care team 44.7% of the time. The SPCs (n = 28; 45.2%) also indicated that the primary treatment providers (e.g., athletic trainer, physical therapist) were typically serving as the primary point person for such teams. Since gaining entry to sport medicine can be an area SPCs struggle with, building effective working relationships with treatment providers can help promote and increase SPCs involvement in providing holistic, interprofessional care to athletes with injuries. To ensure athletes' successful biopsychosocial return to sport, different individuals and professionals should work together for the benefit of the athlete by adopting holistic care during sports injury rehabilitation.

  4. 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.

  5. 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.

  6. 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

  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.

  8. [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.

  9. Long-Term Impact of an Electronic Health Record-Enabled, Team-Based, and Scalable Population Health Strategy Based on the Chronic Care Model

    Science.gov (United States)

    Kawamoto, Kensaku; Anstrom, Kevin J; Anderson, John B; Bosworth, Hayden B; Lobach, David F; McAdam-Marx, Carrie; Ferranti, Jeffrey M; Shang, Howard; Yarnall, Kimberly S H

    2016-01-01

    The Chronic Care Model (CCM) is a promising framework for improving population health, but little is known regarding the long-term impact of scalable, informatics-enabled interventions based on this model. To address this challenge, this study evaluated the long-term impact of implementing a scalable, electronic health record (EHR)- enabled, and CCM-based population health program to replace a labor-intensive legacy program in 18 primary care practices. Interventions included point-of-care decision support, quality reporting, team-based care, patient engagement, and provider education. Among 6,768 patients with diabetes receiving care over 4 years, hemoglobin A1c levels remained stable during the 2-year pre-intervention and post-intervention periods (0.03% and 0% increases, respectively), compared to a 0.42% increase expected based on A1c progression observed in the United Kingdom Prospective Diabetes Study long-term outcomes cohort. The results indicate that an EHR-enabled, team- based, and scalable population health strategy based on the CCM may be effective and efficient for managing population health.

  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. Wound care in primary health care: district nurses' needs for co-operation and well-functioning organization.

    Science.gov (United States)

    Friman, Anne; Klang, Birgitta; Ebbeskog, Britt

    2010-01-01

    Most patients with leg- and foot ulcers are managed within non-institutional care. The aim of this study was to investigate the district nurses' wound management, including wound appearance, assignment of responsibility, guidelines for wound treatment and co-operation with other professional groups. The study has a descriptive quantitative approach. Data was collected using a wound registration form and a questionnaire. The selection of participants was made by random sampling. District nurses (n = 26) in five health-care centers situated in central Stockholm and two of its suburbs, participated in the study. The results show that the wound appearance is dominated by traumatic wounds. Approximately 40% of the wounds were not medically diagnosed. The area of responsibility of different professional groups was not defined and guidelines for wound treatment were mostly lacking. The decision about wound management was generally made by the district nurse. Co-operation with the general practitioner was lacking and when a consultation with dermatologist was required, the routines concerning referral were undefined. Co-operation with the assistant nurses consisted of redressing the wounds in home care. Interprofessional co-operation was regarded as important for wound healing. The paper provides insights into the district nurses' wound management and co-operation in wound care.

  12. 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.

  13. 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 ...

  14. 质量控制小组管理模式在手术室护理管理中的应用分析%Application Analysis of Quality Control Team Management on Nursing Management in the Operating Room

    Institute of Scientific and Technical Information of China (English)

    吴娟娟

    2016-01-01

    目的:探析质量控制小组管理模式在手术室护理管理中的应用效果。方法选取我科720台手术操作,设立质量控制小组后,观察护理质量控制平均评分及不良事件发生率。结果实行质量控制管理后,护理质量和不良事件发生率均优于实施前(P<0.05)。结论质量控制小组管理模式的实施,可培养护理人员的管理能力,从而提高护理质量,减少不良事件发生率。%Objective Analysis of the quality control team management in the operating room nursing management.Methods Chose 720 surgical procedures,seting up quality control team to observe the quality of care and controling the average score after the incidence of adverse events.Results After the implementation of quality control management,quality of care and adverse events were significantly better than before(P<0.05).Conclusion The implementation of quality control team management mode,nurses can train management capabilities,thus improve the quality of care, reduce the incidence of adverse events.

  15. 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…

  16. [Observation in day care centers for children and infants: reflection on the team role of the psychologist].

    Science.gov (United States)

    Mauvais, P

    1995-01-01

    This work tempts to emphasize the relation between the quality of the reception of the young child and the shared observation work done by the team. It also tries to define the psychologist's contribution.

  17. 层次化护理团队在优质护理服务中的应用探讨%Application of Hierarchical Nursing Teams in Quality Care

    Institute of Scientific and Technical Information of China (English)

    安蒙; 李红玉; 高博

    2012-01-01

    将所研究的临床科室的护理人员按照职称进行分层并组成护理团队.1年后比较实施前后护理质量和护理服务质量的相关指标.实施后,护理质量和护理服务质量均有显著提高(P<0.01).临床科室组建层次化优质护理团队,能为患者提供更为安全、满意的护理服务,推动优质护理服务的开展.%Making clinical departments of nursing staff in the hierarchical and composing of the nursing team according to degree and work experience,jointly by the team to complete the work of the basic care,routine care,specialty care,accountability and overall nursing and psychological care, and to compare of the clinical quality of care and care services, 1 year later. As a results, the nursing quality and care service were significantly improved through formatting of hierarchical quality care team compared with those before formatting the nursing team(P<0. 01). The formation of hierarchical quality care team offers the patients with safe and high -quality.

  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 [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.

  19. 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.

  20. 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...

  1. [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.

  2. 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.

  3. Exploring new operational research opportunities within the Home Care context: the chemotherapy at home.

    Science.gov (United States)

    Chahed, Salma; Marcon, Eric; Sahin, Evren; Feillet, Dominique; Dallery, Yves

    2009-06-01

    Home Care (HC) services provide complex and coordinated medical and paramedical care to patients at their homes. As health care services move into the home setting, the need for developing innovative approaches that improve the efficiency of home care organizations increases. We first conduct a literature review of investigations dealing with operation planning within the area of home care management. We then address a particular issue dealing with the planning of operations related to chemotherapy at home as it is an emergent problem in the French context. Our interest is focused on issues specific to the anti-cancer drug supply chain. We identify various models that can be developed and analyze one of them.

  4. 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.

  5. 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.

  6. 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...

  7. Critical Care

    Science.gov (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications ... a team of specially-trained health care providers. Critical care usually takes place in an intensive care ...

  8. A Multidisciplinary Health Care Team's Efforts to Improve Educational Attainment in Children with Sickle-Cell Anemia and Cerebral Infarcts

    Science.gov (United States)

    King, Allison; Herron, Sonya; McKinstry, Robert; Bacak, Stephen; Armstrong, Melissa; White, Desiree; DeBaun, Michael

    2006-01-01

    The primary objective of this study was to improve the educational success of children with sickle-cell disease (SCD) and cerebral infarcts. A prospective intervention trial was conducted; a multidisciplinary team was created to maximize educational resources for children with SCD and cerebral infarcts. Students were evaluated systematically…

  9. Horizontal equity and mental health care: a study of priority ratings by clinicians and teams at outpatient clinics

    Directory of Open Access Journals (Sweden)

    Holman Per

    2012-06-01

    Full Text Available Abstract Background In Norway, admission teams at Community Mental Health Centres (CMHCs assess referrals from General Practitioners (GPs, and classify the referrals into priority groups according to treatment needs, as defined in the Act of Patient Rights. In this study, we analyzed classification of similar referrals to determine the reliability of classification into priority groups (i.e., horizontal equity. Methods Twenty anonymous case vignettes based on representative referrals were classified by 42 admission team members at 16 CMHCs in the South-East Health Region of Norway. All clinicians were experienced, and were responsible for priority setting at their centres. The classifications were first performed independently by the 42 clinicians (i.e., individual rating, and then evaluated utilizing team consensus within each CMHC (i.e., team rating. Interrater reliability was estimated using intraclass correlation coefficients (ICCs while the reliability of rating across raters and units (generalizability were estimated using generalizability analysis. Results The ICCs (2.1 single measure, absolute agreement varied between 0.40 and 0.51 using individual ratings and between 0.39 and 0.58 using team ratings. Our findings suggest a fair (low degree of interrater reliability, and no improvement of team ratings was observed when compared to individual ratings. The generalizability analysis, for one rater within each unit, yields a generalizability coefficient of 0.50 and a dependability coefficient of 0.53 (D study. These findings confirm that the reliability of ratings across raters and across units is low. Finally, the degree of inconsistency, for an average measurement, appears to be higher within units than between units (G study. Conclusion The low interrater reliability and generalizability found in our study suggests that horizontal equity to mental health services is not ensured with respect to priority. Priority -setting in teams provides

  10. Interdisciplinary collaboration in hospice team meetings.

    Science.gov (United States)

    Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George; Regehr, Kelly

    2010-05-01

    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, and team member completion of a survey. Findings revealed that the team's reflection on process was most likely to occur in team meetings, however least likely to occur when caregivers were present. Although team members had a high perception of interdependence and flexibility of roles, this was less likely to be enacted in team meetings with and without the presence of caregivers. Caregiver participation in team meetings had a positive impact on collaborative communication and the potential benefit of caregiver inclusion in team meetings is explored.

  11. A Comparative Evaluation of Structure, Process, and Outcomes Pre- and Post-Implementation of Primary Care Teams

    Science.gov (United States)

    2000-08-01

    back pain among patients seen by primary care practitioners, chiropractors , and orthopedic surgeons. Clinical outcomes did not differ significantly among...low back pain among patients seen by primary care practitioners, chiropractors , and orthopedic surgeons. The New England Journal of Medicine, 333(14...Garrett, J., Jackman, A., McLaughlin, C., Fryer, J., Smucker, D., & The North Carolina Back Pain Project (1995). The outcomes and costs of care for acute

  12. Interprofessional Workplace Learning in Primary Care: Students from Different Health Professions Work in Teams in Real-Life Settings

    OpenAIRE

    Bondevik, Gunnar Tschudi; Holst, Lone; Haugland, Mildrid; Baerheim, Anders; Raaheim, Arild

    2015-01-01

    Interprofessional education may be defined as an occasion when two or more professions learn with, from, and about each other in order to improve collaboration and quality of care. We studied the self-reported experiences from Norwegian health care students participating in interprofessional workplace learning in primary care. We discuss the results particularly in light of self-determination theory. During 2012, 24 students from eight different health educations at the University of Bergen a...

  13. 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

  14. 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.

  15. Building a rapid response team.

    Science.gov (United States)

    Halvorsen, Lisa; Garolis, Salomeja; Wallace-Scroggs, Allyson; Stenstrom, Judy; Maunder, Richard

    2007-01-01

    The use of rapid response teams is a relatively new approach for decreasing or eliminating codes in acute care hospitals. Based on the principles of a code team for cardiac and/or respiratory arrest in non-critical care units, the rapid response teams have specially trained nursing, respiratory, and medical personnel to respond to calls from general care units to assess and manage decompensating or rapidly changing patients before their conditions escalate to a full code situation. This article describes the processes used to develop a rapid response team, clinical indicators for triggering a rapid response team call, topics addressed in an educational program for the rapid response team members, and methods for evaluating effectiveness of the rapid response team.

  16. 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.

  17. Faith and Belief, Importance, Community, Address in Care spiritual history tool by C. M. Puchalski as an instrument for an interdisciplinary team in patient car

    Directory of Open Access Journals (Sweden)

    Krakowiak Piotr

    2015-12-01

    Full Text Available Being aware of the tradition of research on spirituality in theology and the existence of detailed publications and research concerning psychology of religion and religiosity in psychology as well as other sciences in Poland, the authors propose the recognition and adaptation of the FICA tool for spirituality research. The belief in the importance of deepening the knowledge and providing tools to research spirituality of human existence results from a long practice of the authors in palliative and hospital care. Understanding a difficulty in operationalizing the category of spirituality, they attempted at searching for a method that would be applicable to persons at the end of their lives as well as to all the suffering. Having analyzed the research tools built by Polish science as well as available ones on religiosity and spirituality the following paper aims at presenting the unknown FICA tool (F – Faith and Believe, I – Importance, C – Community, A – Address in Care in Poland by Prof. Dr. Christina M. Puchalski, USA, being adapted to Polish practice. The tool presented allows for the evaluation of spiritual experience of persons taken medical and social care of by every member of multidisciplinary team of professionals. Since the FICA tool is a qualitative scale it does not need a normalization and standardization methodology. However, a cultural adaptation is crucial in order to make the practical tool become help in answering spiritual and existential questions posed by patients to workers and voluntaries engaged in the process of Care.

  18. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok

    2015-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Post-Nargis medical care: experience of a Korean Disaster Relief Team in Myanmar after the cyclone.

    Science.gov (United States)

    Kim, Hoon; Han, Seung Baik; Kim, Ji Hye; Kim, Jun Sig; Hong, EunSeog

    2010-02-01

    The objective of this study was to assess the epidemiology and clinical data of patients observed by the Korean Disaster Relief Team, during its deployment in Myanmar, from 6 to 12 June 2008. A cross-sectional, medical record-based study in the Korean Disaster Relief Team clinic, established a month after the cyclone Nargis devastated Myanmar. Data collected included demographic variables, and whether or not the problem was acute or chronic, and traumatic or medical. We included 2641 patients in the study. Of those, 57.6% presented with an acute condition, and the rest had chronic conditions. Approximately 5% of the patients presented with trauma/injury; and in 29% of the trauma cases, the problem was directly related to the cyclone. The most common diagnostic category was musculoskeletal problems (21.5%), followed by respiratory (15.3%), and digestive (14.6%) abnormalities. A little over 5% of patients had posttraumatic stress disorder, and the odds ratio was 2.62 (95% confidence interval 1.63-4.21) for women to have posttraumatic stress disorder. Most of the patients (97.5%) had minor problems and were sent home. In conclusion, a huge unmet medical need in at-risk populations and a relatively large proportion of chronic medical conditions should be considered in any future planning of a similar type of disaster.

  5. Child Care Service Regional Team Mode on Improving Quality of Child Health Care%儿童保健区域团队服务模式与儿童保健质量分析

    Institute of Scientific and Technical Information of China (English)

    陈晓; 兰雅平

    2013-01-01

    目的 探讨儿童保健区域团队服务模式与儿童保健质量分析.方法 按地段划分区域,组建社区儿童保健区域团队,以深圳市第四人民医院23家社康中心0~2岁社区儿童为对象,每个社康中心抽取180名儿童,共计4140人,即从0,1,2岁组中随机抽取常住、暂住儿童各30名,其中女童2120人,男童2020人.结果 在儿童保健区域团队服务模式实施前后(第一、二、三阶段)儿童保健进行比较分析,儿童保健覆盖率、系统管理率、体弱儿管理率、特殊儿童发现率、相关业务完成指标和家长育儿知识知晓率均有显著提高,差异均有统计学意义(P<0.05).结论 儿童保健区域团队服务模式可以提高儿童保健的服务质量.%Objective To investigate the role of child care service regional team mode in improving the quality of child health care.Methods The child care service regional team was built according to the section of an area.The children aged 0 to 2 years from 23 community health service centers were investigated.180 children from each center and total 4140 children were sampled.There were 30 permanent children and 30 temporary children in 0,1 and 2 years age group,which included 2120 girls and 2020 boys.Results The health care coverage,rate of system management,management rate of frail children,detection rate of children with special needs,completion of the relevant business indicators,parenting knowledge awareness of parents were improved after the implementation of the child health regional team mode,and the differences were statistically significant(P < 0.05).Conclusion The child health regional team mode can improve the quality of child health services.

  6. 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.

  7. 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

  8. Hospice Care

    Science.gov (United States)

    Hospice care is end-of-life care. A team of health care professionals and volunteers provides it. ... can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's ...

  9. 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.

  10. 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.

  11. 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.

  12. 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…

  13. Teaching quality essentials: the effectiveness of a team-based quality improvement curriculum in a tertiary health care institution.

    Science.gov (United States)

    Majka, Andrew J; Cook, Katlyn E; Lynch, Stacia L; Garovic, Vesna D; Ghosh, Amit K; West, Colin P; Feyereisn, Wayne L; Paat, John J; Williams, Brandon J; Hale, Curt W; Botz, Catherine T; Phul, Ashley E; Mueller, Paul S

    2013-01-01

    A unique quality improvement (QI) curriculum was implemented within the Division of General Internal Medicine to improve QI knowledge through multidisciplinary, team-based education, which also met the QI requirement for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) and the Mayo Quality Fellows program. Participants completed up to 4 QI learning modules, including pretest and posttest assessments. A participant who successfully completed all 4 modules received certification as a Silver Quality Fellow and credit toward the quality requirement for ABIM MOC. Of 62 individuals invited to participate, 33 (53%) completed all 4 modules and corresponding pretests and posttests. Participants substantially improved knowledge in all 4 quality modules. Study group participants' pretest scores averaged 71.0%, and their posttest scores averaged 92.7%. Posttest scores of reference group participants compared favorably, averaging 89.2%. Initial assessments showed substantial knowledge improvements and successful implementation of staff-developed QI projects.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Impact of computerized information systems on workload in operating room and intensive care unit.

    Science.gov (United States)

    Bosman, R J

    2009-03-01

    The number of operating rooms and intensive care departments equipped with a clinical information system (CIS) is rapidly expanding. Amongst the putative advantages of such an installation, reduction in workload for the clinician is one of the most appealing. The scarce studies looking at workload variations associated with the implementation of a CIS, only focus on direct workload discarding indirect changes in workload. Descriptions of the various methods to quantify workload are provided. The hypothesis that a third generation CIS can reduce documentation time for ICU nurses and increase time they spend on patient care, is supported by recent literature. Though it seems obvious to extrapolate these advantages of a CIS to the anesthesiology department or physicians in the intensive care, studies examining this assumption are scarce.

  20. 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

  1. 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...

  2. 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

  3. 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.

  4. A hypertext information system for standard operating procedures in haematological intensive care.

    Science.gov (United States)

    Horsch, A; Sokol, R; Heneka, D; Lasic, G

    1997-01-01

    In times of cost reduction efforts the role of standard operating procedures for both medical and nursing procedures gets increasing importance. Such standards are necessary if the quality of patient care shall not suffer but even improve. While some sophisticated approaches are coming up with generation of clinical processes from formal protocol models in connection with documentation systems the clinical practice actually looks quite different: Paper-based "operating standards" are used in day-to-day work, if any. In this paper a simple and powerful WWW-based hypertext information system for easy provision and maintenance of nursing standards is presented.

  5. Real-Time Reporting of Small Operational Failures in Nursing Care

    Directory of Open Access Journals (Sweden)

    Kathleen R. Stevens

    2016-01-01

    Full Text Available Addressing microsystem problems from the frontline holds promise for quality enhancement. Frontline providers are urged to apply quality improvement; yet no systematic approach to problem detection has been tested. This study investigated a self-report approach to detecting operational failures encountered during patient care. Methods. Data were collected from 5 medical-surgical units over 4 weeks. Unit staff documented operational failures on a small distinctive Pocket Card. Frequency distributions for the operational failures in each category were calculated for each hospital overall and disaggregated by shift. Rate of operational failures on each unit was also calculated. Results. A total of 160 nurses participated in this study reporting a total of 2,391 operational failures over 429 shifts. Mean number of problems per shift varied from 4.0 to 8.5 problems with equipment/supply problems being the most commonly reported category. Conclusions. Operational failures are common on medical-surgical clinical units. It is feasible for unit staff to record these failures in real time. Many types of failures were recognized by frontline staff. This study provides preliminary evidence that the Pocket Card is a feasible approach to detecting operational failures in real time. Continued research on methodologies to investigate the impact of operational failures is warranted.

  6. QUALITY MANAGEMENT IN HEALTH CARE - CONTRIBUTING TO PATIENT SAFETY AND EFFICIENCY OF BUSINESS OPERATION

    OpenAIRE

    Nevenka Kovac

    2014-01-01

    In order to ensure efficient and effective health care, of equal high quality and accessibility, at all the levels of healthcare and across the entire Croatian territory, all operators in health services are required to establish, develop and maintain a system for assuring and improving the quality in healthcare. Legal requirement to introduce quality management systems into healthcare institutions notwithstanding, a quality management system is equally important in regard to the provision of...

  7. 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)

  8. Impact of value based breast cancer care pathway implementation on pre-operative breast magnetic resonance imaging utilization

    Science.gov (United States)

    McCray, Devina K. S.; Grobmyer, Stephen R.

    2017-01-01

    Background Bilateral breast magnetic resonance imaging (MRI) is commonly used in the diagnostic workup of breast cancer (BC) to assess extent of disease and identify occult foci of disease. However, evidence for routine use of pre-operative MRI is lacking. Breast MRI is costly and can lead to unnecessary tests and treatment delays. Clinical care pathways (care paths) are value-based guidelines, which define management recommendations derived by expert consensus and available evidence based data. At Cleveland Clinic, care paths created for newly diagnosed BC patients recommend selective use of pre-operative MRI. We evaluated the number of pre-operative MRIs ordered before and after implementing an institution wide BC care paths in April 2014. Methods A retrospective review was conducted of BC cases during the years 2012, 2014, and part of 2015. Patient, tumor and treatment characteristics were collected. Pre-operative MRI utilization was compared before and after care path implementation. Results We identified 1,515 BC patients during the study period. Patients were more likely to undergo pre-operative MRI in 2012 than 2014 (OR: 2.77; Pcare path indications. Conclusions Implementation of online BC care paths at our institution was associated with a decreased use of pre-operative MRI overall and in patients without a BC care path indication, driving value based care through the reduction of pre-operative breast MRIs. PMID:28210553

  9. 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.

  10. Application of Team Teaching Method in Nursing Teaching in Operation Room%团队教学法在手术室护理教学的应用

    Institute of Scientific and Technical Information of China (English)

    兰祥玉; 陈静

    2014-01-01

    Objective To find out the teaching method for practice nurses of operation room and improve the teaching quality of nursing students. Methods Through investigating results of al the practice nurses in traditional teaching and team teaching in three years ,and analyzed the results. Results The team teaching can strengthen Ideological education and the knowledge of practice nurses, can make practice nurses fast into the operation room work role. Conclusion The team teaching can improve the initiative and aviod defects of operation room teachers to improving the teaching quality of practice nurses of operation room.%目的:探讨手术室实习护生的带教方法,提高护生实习的教学质量。方法通过对手术室带教方法由传统教学法革新为团队教学法的前后各3年时间的全部实习护生进行调查,将实习护生出科成绩和带教人员情况进行对照分析。结果组成带教团队,加强对护生的思想教育与理论知识教学,从模拟训练过渡到实践操作,抓好师生之间的反思与总结工作,能使护生较快投入手术室的工作角色,进行正常的手术室护理工作,教学效果显著。结论团队教学法更能发挥手术室带教老师的积极性,规避带教老师的自身缺陷,形成取长补短的效应,对促进实习护生的教学质量有积极的作用。

  11. 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

  12. 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

    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 ...

  13. Modifying Post-Operative Medical Care after EBV Implant May Reduce Pneumothorax Incidence.

    Directory of Open Access Journals (Sweden)

    Dominik Herzog

    Full Text Available Endoscopic lung volume reduction (ELVR with valves has been shown to improve COPD patients with severe emphysema. However, a major complication is pneumothoraces, occurring typically soon after valve implantation, with severe consequences if not managed promptly. Based on the knowledge that strain activity is related to a higher risk of pneumothoraces, we asked whether modifying post-operative medical care with the inclusion of strict short-term limitation of strain activity is associated with a lower incidence of pneumothorax.Seventy-two (72 emphysematous patients without collateral ventilation were treated with bronchial valves and included in the study. Thirty-two (32 patients received standard post-implantation medical management (Standard Medical Care (SMC, and 40 patients received a modified medical care that included an additional bed rest for 48 hours and cough suppression, as needed (Modified Medical Care (MMC.The baseline characteristics were similar for the two groups, except there were more males in the SMC cohort. Overall, ten pneumothoraces occurred up to four days after ELVR, eight pneumothoraces in the SMC, and only two in the MMC cohorts (p=0.02. Complicated pneumothoraces and pneumothoraces after upper lobe treatment were significantly lower in MMC (p=0.02. Major clinical outcomes showed no significant differences between the two cohorts.In conclusion, modifying post-operative medical care to include bed rest for 48 hours after ELVR and cough suppression, if needed, might reduce the incidence of pneumothoraces. Prospective randomized studies with larger numbers of well-matched patients are needed to confirm the data.

  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. 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

  16. Air Force Operational Medicine: Using the Estimating Supplies Program to Develop Materiel Solutions for the Operational Clinical Requirements for the U.S. Air Force Otolaryngology Team (FFENT)

    Science.gov (United States)

    2007-10-10

    FFNEU units provide care for trauma to the head and neck, like facial fractures involving the maxillary sinuses and fascial infections requiring...NECK, LARYNGEAL FRACTURE 100% 1 DC 818 MAXILLARY SINUSITIS-INFECTION OF SINUS AREA ACCOMPANIED BY INFLAMMATION AND DRAINAGE 10% 90% 3 DC 823 SOFT...GUEDEL SM 80MM LG PLAS 10S 6515015199161 GLOVE PT EXAM LARGE NON STER POWDER FREE 100S 6505007720157 LIDOCAINE HYDROCHLORIDE TOP VISC 4% 50 ML

  17. Real-time Cooperative Behavior for Tactical Mobile Robot Teams: Skills Impact Study for Tactical Mobile Robot Operational Units

    Science.gov (United States)

    2000-11-01

    viewpoint – the worlds can mix in almost any proportion, and a TMR OCU rep- resents such a mix. Most existing COTS wearable technology does not address...of using AR technology to facilitate the operation of a TMR OCU, but it does not address the ef- fectiveness of wearable technology for

  18. Conflict of roles: a conflict of ideas? The unsettled relations between care team staff and independent mental health advocates.

    Science.gov (United States)

    McKeown, Mick; Ridley, Julie; Newbigging, Karen; Machin, Karen; Poursanidou, Konstantina; Cruse, Kaaren

    2014-10-01

    Drawing on a national study of independent mental health advocacy, we explored the social relations of independent advocacy. The study was commissioned by the Department of Health (England), and involved a case study design covering eight different geographies and service configurations, and interviews or focus groups with a total of 289 stakeholders across two phases of inquiry. This paper focused on the analysis of qualitative data relevant to the relationship between mental health-care services and independent advocacy services, drawn from interviews with 214 participants in phase two of the study. Discussion of these particular findings affords insights into the working relations of independent advocacy within mental health services beset by reorganizational change and funding cuts, and increasing levels of legally-sanctioned compulsion and coercion. We offer a matrix, which accounts for the different types of working relationships that can arise, and how these are associated with various levels of understanding of independent advocacy and appreciation for the value of advocacy. The discussion is framed by the wider literature on advocacy and the claims by practitioners, such as nurses, for an advocacy role as part of their professional repertoire.

  19. Development of training-related health care software by a team of clinical educators: their experience, from conception to piloting

    Directory of Open Access Journals (Sweden)

    ap Dafydd D

    2016-11-01

    Full Text Available Derfel ap Dafydd,1 Ruth Williamson,2 Philip Blunt,3 Dominic M Blunt4 1Department of Radiology, Royal Marsden NHS Foundation Trust, London, 2Imaging Department, Royal Bornemouth Hospital, Bornemouth, 3Savernake IT Ltd, Marlborough, 4Imaging Department, Imperial College Healthcare NHS Trust, London, UK Abstract: The difficulties of producing useful, bespoke, and affordable information technology systems for large health care organizations are well publicized, following several high-profile endeavors in the UK. This article describes the experience of a small group of clinical radiologists and their collaborators in producing an information technology system – from conception to piloting. This system, called Trainee Tracker, enables automated target date recalculation of trainee milestones, depending on their work patterns and other individual circumstances. It utilizes an automated email alert system to notify the educational supervisors and trainees of approaching and elapsed target dates, in order to identify trainees in difficulty early and address their training needs accordingly. The challenges and advantages, both common to and contrasting with larger-scale projects, are also considered. The benefits of the development team’s “agile” approach to software development and the lessons learned will be of interest to medical educators, particularly those with expertise in e-portfolios and other training-related software. Keywords: training, appraisal, ARCP, Annual Review of Clinical Progression, portfolio, trainer

  20. [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...

  1. Identifying and training non-technical skills for teams in acute medicine.

    Science.gov (United States)

    Flin, R; Maran, N

    2004-10-01

    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 from aviation psychology that produced the behavioural marker system NOTECHS for rating European pilots' non-technical skills for teamwork on the flightdeck, this paper outlines the Anaesthetists Non-Technical Skills behavioural rating system for anaesthetists working in operating theatre teams. This taxonomy was used as the design basis for a training course, Crisis Avoidance Resource Management for Anaesthetists used to develop these skills, based in an operating theatre simulator. Further developments of this training programme for teams in emergency medicine are outlined.

  2. A designated centre for people with disabilities operated by RehabCare, Kilkenny

    LENUS (Irish Health Repository)

    Lunn, Peter D

    2010-03-01

    Recall data from a representative sample of 3080 adults in Ireland in 2003 is used to investigate transitions into and out of regular participation in sports and exercise--an important contributor to overall physical activity. The method produces a continuous picture of participation across the life-course, allowing key transition periods in the life-course to be identified and the determinants of transitions to be analysed with multivariate models. Late adolescence emerges as an important period, when many people drop out from team sports, especially females. Participation in adulthood mostly involves taking up individual sports and exercise activities. The likelihood of making this transition is strongly associated with socio-economic status. Transitions in activity during adulthood do not display significant sex differences, suggesting that the gender gap for involvement in sports and exercise has its roots in childhood. The method also allows age and cohort effects to be distinguished, revealing higher participation among more recent cohorts. The findings must be interpreted carefully, since they are reliant on the accuracy of personal recall. Yet they have implications for how physical activity policy applies over the life-course, suggesting possible returns to targeting lower socio-economic groups in early adulthood, to offering a broader range of activities to young females, and to researching and promoting those activities most likely to be of interest to current young adults as they age.

  3. A designated centre for people with disabilities operated by RehabCare, Dublin 18

    LENUS (Irish Health Repository)

    Lunn, Peter D

    2010-03-01

    Recall data from a representative sample of 3080 adults in Ireland in 2003 is used to investigate transitions into and out of regular participation in sports and exercise--an important contributor to overall physical activity. The method produces a continuous picture of participation across the life-course, allowing key transition periods in the life-course to be identified and the determinants of transitions to be analysed with multivariate models. Late adolescence emerges as an important period, when many people drop out from team sports, especially females. Participation in adulthood mostly involves taking up individual sports and exercise activities. The likelihood of making this transition is strongly associated with socio-economic status. Transitions in activity during adulthood do not display significant sex differences, suggesting that the gender gap for involvement in sports and exercise has its roots in childhood. The method also allows age and cohort effects to be distinguished, revealing higher participation among more recent cohorts. The findings must be interpreted carefully, since they are reliant on the accuracy of personal recall. Yet they have implications for how physical activity policy applies over the life-course, suggesting possible returns to targeting lower socio-economic groups in early adulthood, to offering a broader range of activities to young females, and to researching and promoting those activities most likely to be of interest to current young adults as they age.

  4. Team Teaching.

    Science.gov (United States)

    Bunyan, L. W.

    The purpose of this study was to review current developments in team teaching and to assess its potential in the Calgary, Alberta, schools. An investigation into team teaching situations in schools in the eastern half of the United States and Canada revealed characteristics common to successful programs (e.g., charismatic leadership and innovative…

  5. 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.        

  6. 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.       

  7. 探讨糖尿病护理小组在糖尿病人护理中的作用效果%To explore the role of diabetes care team in diabetes care

    Institute of Scientific and Technical Information of China (English)

    裴学梅

    2016-01-01

    objective:to explore the application effect of diabetes care in diabetes care team.Selection methods:our hospital in September 2013 to March 2016were treated 88 cases of diabetic patients as observation group (after the formation of diabetes care team),select 88 ca-ses of diabetic patients as control group (before the formation of diabetes group),and compare the quality of the two groups of patients with clinical nursing.Results:observation group of patients with honour from rate and blood glucose control is significantly higher than the con-trol group,the differences,significantly (P <0.05),with statistical significance;Observation group of patients with complications inci-dence was obviously lower than the control group,differences,significantly (P<0.05 ),with statistical significance.Conclusion:pa-tients with diabetes care in diabetes care team application effect is remarkable,can make the patients significantly higher compliance rate and blood sugar control,effectively reduce the incidence of complications,still can make patients have significant clinical value.%目的:探究糖尿病患者护理中糖尿病护理小组的应用效果。方法:选取本院2013年9月~2016年3月收治的88例糖尿病患者设为观察组(在组建糖尿病护理小组后),选取88例糖尿病患者作为对照组(在组建糖尿病小组前),并对两组患者的临床护理质量予以比较。结果:观察组患者的遵从率与血糖控制率明显比对照组高,差异性显著,(P<0.05),具备统计学意义;观察组患者的并发症发生率明显比对照组低,差异性显著,(P<0.05),具备统计学意义。结论:糖尿病患者护理中糖尿病护理小组的应用效果显著,可使患者的遵从率与血糖控制率显著提高,还可以使患者的并发症发生率有效降低,具有显著的临床价值。

  8. 糖尿病护理小组在糖尿病患者临床护理中的作用%Effect of diabetes care team in the clinical nursing of diabetics

    Institute of Scientific and Technical Information of China (English)

    李惠

    2014-01-01

    目的:对糖尿病护理小组在糖尿病患者临床护理中的作用进行探讨。方法:2011年1月-2013年12月收治糖尿病患者90例,均在组建糖尿病护理小组后,作为观察组;在组建糖尿病护理小组前,收治糖尿病患者90例,作为对照组,对糖尿病护理小组组建前后两组临床护理质量进行对比与分析。结果:观察组临床护理质量明显优于对照组,差异有统计学意义(P<0.05)。结论:糖尿病护理小组的组建,不仅有效提高了糖尿病患者的临床护理质量,而且糖尿病护理小组成员的糖尿病护理专业知识水平也得到了大幅度提高,提高了糖尿病患者的遵从性,具有非常重要的意义。%Objective:To explore the effect of diabetes care team in the clinical nursing of diabetics.Methods:90 cases with diabetes were selected from January 2011 to December 2013.They were all after the formation of diabetes care team.They were as the observation group.Before the formation of diabetes care team,90 cases with diabetes were selected as the control group.The clinical nursing qualities of two groups before and after the formation of diabetes care team were compared and analyzed.Results:The clinical nursing quality of the was observation group better than that of the control group.There was a big difference with statistical significance(P<0.05).Conclusion:The formation of diabetes care team not only effectively improve the clinical nursing of diabetics,and the diabetes care professional knowledge level of diabetes care team members also have been improved greatly.It improves the compliance of patients with diabetes.It has very important significance.

  9. [Medical and legal aspects of rape. Referrals to a team for care of rape victims at the regional hospital in Trondheim during the period 1989-1992].

    Science.gov (United States)

    Schei, B; Muus, K M; Moen, M H

    1995-01-10

    Since 1989 a special team of nurses and gynaecologist have taken care of rape victims at the Department of Obstetrics and Gynaecology, University Hospital of Trondheim. Information on cases during the period 1989-92 was recorded retrospectively in a preformulated system. During this period, 141 persons were examined. In 23% of the cases the victim did not want to press charges. Most of the victims were young, 38% were below 20 years of age. A considerable proportion (40%) reported alcohol intake. 78% of the sexual assaults involved penile-vaginal contact. Severe physical violence, more severe assaults than physical restraint, were reported by 24%. Signs of non-genital injuries were documented in 35% of all the victims. 13% showed genital injury. Presence of sperm was documented in 16% of all the examinations. In 67 of the cases there was an identified assailant and a victim who had pressed charges. The conviction rate was 48%. Characteristics of the assault and findings at the examination were related to judicial outcome. Reporting of severe violence (OR (odds ratio) = 5.3), documented genital injuries (OR = 6.5) and the presence of sperms (OR = 5.6) were associated with conviction. These associations were statistically significant. Reported alcohol intake by the victim was negatively associated with conviction (OR = 0.3). Adjusted for lapse of time between the event and the examination and the victim's age, the only factor that still showed a statistically significant association with conviction was the report of severe violence.

  10. 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

  11. The geriatric interdisciplinary team training (GITT) program.

    Science.gov (United States)

    Fulmer, Terry; Flaherty, Ellen; Hyer, Kathryn

    2003-01-01

    Geriatric interdisciplinary team training (GITT) is an initiative funded by the John A. Hartford Foundation since 1995. Building from the substantial knowledge gained from the Veteran's Administration project in interdisciplinary team training and lessons from the Pew Foundation initiative, GITT was reconceived by the Foundation to address the need for teams in the care of older adults in the new era of managed care and health care cost containment. This training program has served to help us understand attitudes toward teams, how teams function, and how teams should be trained in the changing health care environment, where length of stay is dramatically different from the earlier team training projects. This introductory paper provides an overview of GITT, and the companion papers give detail of the GITT curricula, measures and lessons learned.

  12. [Multiprofessional team working in palliative medicine].

    Science.gov (United States)

    Osaka, Iwao

    2013-04-01

    Now, more than ever, palliative medicine has been gaining recognition for its essential role in cancer treatment. Since its beginning, it has emphasized the importance of collaboration among multidisciplinary professionals, valuing a comprehensive and holistic philosophy, addressing a wide range of hopes and suffering that patients and families experience. There are three models (approaches) for the medical teams: multidisciplinary, interdisciplinary, and transdisciplinary. Palliative care teams often choose the interdisciplinary team model, and the teams in the palliative care units may often choose the transdisciplinary team model. Recently, accumulating research has shown the clinical benefits of the interdisciplinary/transdisciplinary approach in palliative care settings. Clarifying appropriate functions and ideal features of physicians in the health care team, and enforcing the suitable team approach will contribute to improve the quality of whole medical practice beyond the framework of "palliative medicine".

  13. 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.

  14. Tracheotomy in Pediatric Patients: In Operating Room or Intensive Care Unit?

    Directory of Open Access Journals (Sweden)

    Umut Kaygusuz

    2014-08-01

    Full Text Available Introduction: The morbidity and mortality rates of tracheotomy are higher in the pediatric population because the incision is small and the trachea is more prone to surgical trauma. Tracheotomy procedure is mostly performed in operating room in most institutions. The aim of the study is to compare the outcomes of tracheotomy procedures between intensive care unit (ICU and operating room (OR in terms of pitfalls, complications and family preferences. Materials and Methods: In between June 2012 and July 2013, at a single institution, 39 patients were prospectively analyzed for age, gender, primary pathology, tracheotomy indications, location of operation, the duration of family consent, perioperative complications and presence of decanulation. Results: Male/female ratio was 20/19. Mean age was 49.9±52.5 (4-204 months. Tracheotomy procedure was performed in OR in 19 patients (45% and in ICU in 20 (54.5% patients. There was no statistically significant difference between groups in terms of complications (OR-48.7%, ICU-51.3%. The time of informed consent was significantly shorter in ICU patients. Conclusions: There is no significant difference in terms of safety for tracheotomy procedure in ICU or OR. Parents give approval to a bedside invasive procedure faster. The words ‘Surgery’ and ‘Operating room’ can easily confuse the parents, extend the duration for endolaryngeal intubation, and increase the cost and labour loss.

  15. 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.

  16. 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

  17. 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.

  18. 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....

  19. 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.

  20. A team-based approach to warfarin management in long term care: A feasibility study of the MEDeINR electronic decision support system

    Directory of Open Access Journals (Sweden)

    Wang Luqi

    2010-06-01

    Full Text Available Abstract Background Previous studies in long-term care (LTC have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0, we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system. Methods For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams. Results LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%, but was only significantly increased for one home (62% to 71%, p Conclusion Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the

  1. 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

  2. Virtual Teams.

    Science.gov (United States)

    Geber, Beverly

    1995-01-01

    Virtual work teams scattered around the globe are becoming a feature of corporate workplaces. Although most people prefer face-to-face meetings and interactions, reality often requires telecommuting. (JOW)

  3. 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…

  4. Letting Down the Team? Social Effects of Team Incentives

    OpenAIRE

    Babcock, Philip; Bedard, Kelly; Charness, Gary; Hartman, John; Royer, Heather

    2012-01-01

    This paper estimates social effects of incentivizing people in teams. In two fieldexperiments featuring exogenous team formation and opportunities for repeated socialinteractions, we find large team effects that operate through social channels. The teamcompensation system induced agents to choose effort as if they valued a marginal dollar ofcompensation for their teammate from two-thirds as much (in one study) to twice as much asthey valued a dollar of their own compensation (in the other stu...

  5. A virtual team group process.

    Science.gov (United States)

    Bell, Marnie; Robertson, Della; Weeks, Marlene; Yu, Deborah

    2002-01-01

    Virtual teams are a phenomenon of the Information Era and their existence in health care is anticipated to increase with technology enhancements such as telehealth and groupware. The mobilization and support of high performing virtual teams are important for leading knowledge-based health professionals in the 21st century. Using an adapted McGrath group development model, the four staged maturation process of a virtual team consisting of four masters students is explored in this paper. The team's development is analyzed addressing the interaction of technology with social and task dynamics. Throughout the project, leadership competencies of value to the group that emerged were demonstrated and incorporated into the development of a leadership competency assessment instrument. The demonstration of these competencies illustrated how they were valued and internalized by the group. In learning about the work of this virtual team, the reader will gain understanding of how leadership impacts virtual team performance.

  6. [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.

  7. [Malpractice in health care teams].

    Science.gov (United States)

    Pizarro, Carlos

    2011-05-01

    To be successful, modern medical acts require the participation of several professionals and assistants and, as such, there has been a steady trend from individual medicine to the collective practice of the profession. This format raises issues in determining when a medical professional or other practitioner is liable for the acts of a colleague. This thesis proposes to resolve the problems involved in the collective practice of medicine by restricting liability to a physician responsible for another practitioner, only to those cases where he/she has been willingly introduced into the medical act.

  8. 42 CFR 456.602 - Inspection team.

    Science.gov (United States)

    2010-10-01

    ... Institutions for Mental Diseases § 456.602 Inspection team. (a) A team, as described in this section and § 456... team must have a psychiatrist or physician knowledgeable about mental institutions and other appropriate mental health and social service personnel. (d) For an ICF that primarily cares for...

  9. 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

  10. 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.

  11. 糖尿病护理团队在风险管理中的作用探究%Diabetes Care Team to Explore the Effect in the Risk Management

    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.

  12. [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.

  13. Palliative Care

    Science.gov (United States)

    ... you are a partner with the palliative care team as you all work toward the same goal — providing the best quality of life for your child for as ... Care for Children With Terminal Illness Managing Home Health Care Taking Care of You: Support ...

  14. DIFFERENT DIMENSIONS OF TEAMS

    OpenAIRE

    Sudhakar, Goparaju Purna

    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...

  15. 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.

  16. 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.

  17. 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…

  18. Team Building

    OpenAIRE

    Galan, Adriana; Scintee, Silvia-Gabriela

    2008-01-01

    Because there are no pure formal or informal organisations in real world, one may conclude that an organisation is a mix of formal and informal groups. Thus, its performance depends on the management ability to recognise the existence of these groups, to transform them from groups into working teams, to motivate and stimulate them to achieve organisation’s goals. We must differentiate the concept of group versus the concept of team. A simple definition of the group can be: two or more persons...

  19. How should teams be formed and managed?

    OpenAIRE

    OWAN, HIDEO

    2014-01-01

    The keys to effective teamwork in firms are (1) carefully designed team-formation policies that take into account what level of diversity of skills, knowledge, and demographics is desirable and (2) balanced team-based incentives. Employers need to choose policies that maximize the gains from teamwork through task coordination, problem solving, peer monitoring, and peer learning. Unions and labor market regulations may facilitate or hinder firms’ attempts at introducing teams and team-based ...

  20. 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.

  1. Team Performance in Emergency Medicine (MedTeams), Draft 3, Instructor Guide

    Science.gov (United States)

    1997-01-01

    MANAGEMENT Attending Physician Charge Nurse Unit Clerk Clinical "Leadership Operations Management Display Slide 1-5 Team Roles in the ED Team Roles in...Followers ♦ Understand team roles ♦ Provide information for decision making ♦ Accept ownership for team decisions ♦ View feedback as an opportunity to

  2. The effect of a team strategy discussion on military team performance

    NARCIS (Netherlands)

    Dalenberg, S.; Vogelaar, A.L.W.; Beersma, B.

    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

  3. Capability Enhancement and Amputee Care in Operation Iraqi Freedom: The Role of a Rehabilitation and Prosthetics Assistance Team in Reconstruction Operations

    Science.gov (United States)

    2009-05-01

    prosthetic devices were delivered (21% of patients seen) with the remainder of patients either BK (36% Multiple (1%) Bilateral Upper (1% Partial Foot (2% KD...femoral limb loss KO- knee disarticulation Seines- ankle disarticulation P;u1ial Foot - Carpal-in et a carpal amputation Bilateral lower extremity limb loss...prosthetic limb lypi- cally marked the transition in rehabilitation goals to functional outcomes such as using an upper extremity prosthesis to per

  4. 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...

  5. 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

  6. Army National Guard Brigade Combat Teams: Future Structure and Roles

    Science.gov (United States)

    2012-04-12

    Operational Mentor and Liaison Teams (OMLT) and the Agribusiness Development Teams (ADT). The OMLTs are international advisory teams deployed to...teams, Agribusiness Development Teams, and Provincial Reconstruction Teams from within its BCTs.74 The IBCTs would be available for rotational...Bureau, “ Agribusiness Development Team,” March 2011, http://www.ng.mil/media/default.aspx#factsheets (accessed November 8, 2011); Peter Geren and

  7. A conceptual framework for automating the operational and strategic decision-making process in the health care delivery system.

    Science.gov (United States)

    Ruohonen, Toni; Ennejmy, Mohammed

    2013-01-01

    Making reliable and justified operational and strategic decisions is a really challenging task in the health care domain. So far, the decisions have been made based on the experience of managers and staff, or they are evaluated with traditional methods, using inadequate data. As a result of this kind of decision-making process, attempts to improve operations usually have failed or led to only local improvements. Health care organizations have a lot of operational data, in addition to clinical data, which is the key element for making reliable and justified decisions. However, it is progressively problematic to access it and make usage of it. In this paper we discuss about the possibilities how to exploit operational data in the most efficient way in the decision-making process. We'll share our future visions and propose a conceptual framework for automating the decision-making process.

  8. 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...

  9. 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...

  10. 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

  11. Building a sports medicine team.

    Science.gov (United States)

    Fu, Freddie H; Tjoumakaris, Fotios Paul; Buoncristiani, Anthony

    2007-04-01

    There have been a growing number of participants in high school and collegiate athletics in recent years, placing ever-increasing demands on the sports medicine team. Building a winning sports medicine team is equally as important to the success of an athletic organization as fielding talented athletes. Acquisition of highly qualified, motivated, and hard-working individuals is essential in providing high quality and efficient health care to the athlete. Maintaining open paths of communication between all members of the team is the biggest key to success and an optimal way to avoid confusion and pitfalls.

  12. 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

  13. 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.

  14. Evaluating operational specifications of point-of-care diagnostic tests: a standardized scorecard.

    Science.gov (United States)

    Lehe, Jonathan D; Sitoe, Nádia E; Tobaiwa, Ocean; Loquiha, Osvaldo; Quevedo, Jorge I; Peter, Trevor F; Jani, Ilesh V

    2012-01-01

    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.

  15. 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...

  16. 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…

  17. Atuação da equipe multidisciplinar na terapia nutricional de pacientes sob cuidados intensivos The action of a multidisciplinary team in the nutritional care of critically ill patients

    Directory of Open Access Journals (Sweden)

    Heitor Pons Leite

    2005-12-01

    Full Text Available Pacientes hospitalizados podem ter necessidades nutricionais especiais em função da desnutrição e dos desequilíbrios metabólicos impostos pelas doenças. A terapia nutricional, principalmente nos estágios críticos das enfermidades, deve ser administrada de modo seguro e eficaz. Vários estudos têm avaliado o papel da equipe multidisciplinar na administração da terapia nutricional. Com o objetivo de identificar os problemas inerentes à administração da terapia nutricional em pacientes hospitalizados e verificar o impacto da atuação de uma equipe multidisciplinar na qualidade dos procedimentos, foi realizada uma revisão que analisou artigos publicados entre 1980 e 2004 sobre o papel da atuação de equipes multidisciplinares no cuidado e na evolução nutricional de pacientes hospitalizados, principalmente os que se encontravam sob cuidados intensivos. Os termos utilizados na pesquisa foram: "multidisciplinary team", "nutritional support", "parente-ral nutrition", "enteral feeding", "critically ill", "intensive care unit","critically ill child". Dos 130 estudos inicialmente identificados, foram selecionados 24, dos quais 14 compararam o padrão de terapia nutricional com e sem a presença da equipe multidisciplinar. Os principais problemas detectados na administração de terapia nutricional em pacientes hospitalizados foram a oferta inadequada de nutrientes, as complicações infecciosas e metabólicas e o uso excessivo de nutrição parenteral. Nos estudos comparativos, a presença da equipe multidisciplinar melhorou o padrão de oferta nutricional, reduziu a incidência de complicações e os custos.Hospitalized patients may have special nutrient requirements imposed by a combination of malnutrition and enhanced utilization of nutrients resulting from the disease process. Nutritional support, mainly during critical stages of disease, should be provided safely and effectively. Several studies have evaluated the paper of a

  18. 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

  19. 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

  20. Assessment of student interprofessional education (IPE) training for team-based geriatric home care: does IPE training change students' knowledge and attitudes?

    Science.gov (United States)

    Reilly, Jo Marie; Aranda, María P; Segal-Gidan, Freddi; Halle, Ashley; Han, Phuu Pwint; Harris, Patricia; Jordan, Katie; Mulligan, Roseann; Resnik, Cheryl; Tsai, Kai-Ya; Williams, Brad; Cousineau, Michael R

    2014-01-01

    Our study assesses changes in students' knowledge and attitudes after participation in an interprofessional, team-based, geriatric home training program. Second-year medical, physician assistant, occupational therapy, social work, and physical therapy students; third-year pharmacy students; and fourth-year dental students were led by interprofessional faculty teams. Student participants were assessed before and after the curriculum using an interprofessional attitudes learning scale. Significant differences and positive data trends were noted at year-end. Our study suggests that early implementation, assessment, and standardization of years of student training is needed for optimal interprofessional geriatric learning. Additionally, alternative student assessment tools should be considered for future studies.

  1. 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...

  2. 'We didn't know anything, it was a mess!' Emergent structures and the effectiveness of a rescue operation multi-team system.

    Science.gov (United States)

    Fleştea, Alina Maria; Fodor, Oana Cătălina; Curşeu, Petru Lucian; Miclea, Mircea

    2017-01-01

    Multi-team systems (MTS) are used to tackle unpredictable events and to respond effectively to fast-changing environmental contingencies. Their effectiveness is influenced by within as well as between team processes (i.e. communication, coordination) and emergent phenomena (i.e. situational awareness). The present case study explores the way in which the emergent structures and the involvement of bystanders intertwine with the dynamics of processes and emergent states both within and between the component teams. Our findings show that inefficient transition process and the ambiguous leadership generated poor coordination and hindered the development of emergent phenomena within the whole system. Emergent structures and bystanders substituted leadership functions and provided a pool of critical resources for the MTS. Their involvement fostered the emergence of situational awareness and facilitated contingency planning processes. However, bystander involvement impaired the emergence of cross-understandings and interfered with coordination processes between the component teams. Practitioner Summary: Based on a real emergency situation, the present research provides important theoretical and practical insights about the role of bystander involvement in the dynamics of multi-team systems composed to tackle complex tasks and respond to fast changing and unpredictable environmental contingencies.

  3. 规范化管理糖尿病护理小组提高专科护理质量的体会%Experience of Standardized Management of Diabetes Care Team to Improve the Quality of College Nursing

    Institute of Scientific and Technical Information of China (English)

    屈春晓

    2016-01-01

    目的:总结规范化管理糖尿病护理小组提高专科护理质量的体会。方法回顾分析我院收治的50例糖尿病患者健康知识得分、护理满意度情况以及20名护士的糖尿病理论知识、技能考核成绩,记录规范化管理糖尿病护理小组后患者和护士的上述指标。结果规范化管理后护士理论知识、技能考核评分、患者健康知识得分、满意度评分高于规范化管理前(P<0.05)。结论规范化管理糖尿病护理小组能够有效的提高专科护理质量。%Objective To summarize the experience of standardized management of diabetes care team to improve the quality of specialized nursing.Methods Retrospective analysis of our hospital 50 cases of diabetic patients with health knowledge score,patient satisfaction and 20 nurses of diabetes knowledge, skils assessment scores recorded standardized management of diabetes care team after patients and nurses in the index.ResultsAfter standardized management,nurses' theoretical knowledge,skils assessment score,patients' health knowledge scores and satisfaction scores were significantly higher than those of standardized management(P<0.05).Conclusion Standardized management of diabetes care team can effectively improve the quality of colege nursing.

  4. 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.

  5. The role of professional and team commitment in nurse-physician collaboration: A dual identity model perspective.

    Science.gov (United States)

    Caricati, Luca; Guberti, Monica; Borgognoni, Patrizia; Prandi, Carmen; Spaggiari, Ivana; Vezzani, Emanuela; Iemmi, Marina

    2015-01-01

    Nurse-physician collaboration involves healthcare operators from different professions working together. The dual identity model predicts that nurse-physician interprofessional collaboration could improve if these operators feel they belong to both their professional category and care unit. This study tested this prediction by analyzing the effect of professional and team commitments on interprofessional collaboration between nurses and physicians in a hospital based in Northern Italy. A cross-section questionnaire survey was administered to 270 nurses and 95 physicians. Results indicate that interprofessional collaboration is positively affected by team commitment, while professional commitment had no effect. In accordance with the dual identity model, results indicate that interprofessional collaboration is higher when: (i) both professional and team commitment is high, and (ii) when team commitment is high and professional commitment is low. These results support dual identity model predictions and suggest that interprofessional collaboration can be increased by bolstering both team and professional commitment of nurses and physicians.

  6. Team ViGIR

    Science.gov (United States)

    2015-10-01

    49 Figure 34. Behavior is running , but currently locked in one of its sub-statemachines. .............................. 49 Figure 35...the team experienced unexpected communication issues during the run . The operators adapted, but were slower than expected due to software issues caused...robot. The Robotics and Human Control Systems Lab has two goals: 1) To develop a deeper understanding of the neural control and biomechanics in the

  7. 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.

  8. Autoclave performance and operator knowledge of autoclave use in primary care: a survey of UK practices.

    Science.gov (United States)

    Coulter, W A; Chew-Graham, C A; Cheung, S W; Burke, F J

    2001-07-01

    Changes in the delivery of health care have increased the demand for minor surgical and screening procedures in general practice. This has increased the risk of cross-infection with blood-borne viruses and the demand for sterile instruments. The aim of this study was to investigate the knowledge and training of medical personnel in England and Wales on aspects of autoclave use, and to test the effectiveness of their practice autoclaves. An anonymous postal questionnaire and autoclave performance survey using biological indicators was made of 700 general medical practitioners selected at random from FHSA lists from 12 Health Authorities in England and Wales. The overall response rate was 53.1% (N= 372) comprising 10% general practitioners and 90% practice nurses. Eighty-two percent of respondents used autoclaves with a mean age of 2.5 years, of which 91% had been serviced in the past year. While 35% of respondents made daily observation of gauges, 19% did not routinely monitor autoclave effectiveness. Six autoclaves failed to sterilize the spore test ampoules. Fourteen percent of respondents did not autoclave instruments after every patient. Only 33.1% reported wearing gloves during minor operations. Fifty five percent had training in cross-infection prevention. It was concluded that although there has been improvement in instrument decontamination procedures in general practice compared with previous surveys, further education of medical practitioners and practice nurses in the use of autoclaves and infection prevention and control is indicated. The failure of 2% of the autoclaves to kill spores suggests the need for increased monitoring of autoclave performance. Two-thirds of practitioners exposed themselves to increased risk of infection by carrying out minor surgery without the protection of gloves.

  9. 关于搜救飞行队建立运行控制中心的一点思考%Reflections on the Construction of Operation Control Center for Search and Rescue Flight Team

    Institute of Scientific and Technical Information of China (English)

    张卫浩

    2014-01-01

    Under the background of specialized construction of search and rescue flight team, from the perspective of future development progress of search and rescue flight team, this paper briefly discusses the idea of establishing operation control center. The establishment of the operation control center can achieve the scientific management and control of the rescue base and rescue aircraft, enhance overall execution, free the leaders of flight team from the daily complex operation work, so that the leaders have more energy to manage the growing number of rescue personnel and constantly open the rescue base.%本文以救助飞行队进行专业化建设为背景,站在救助飞行队未来发展进程的角度,简单阐述了建立运行控制中心的设想。通过建立运行控制中心,可以实现救助飞行队专业人才对救助基地、救助航空器的科学管控,提升综合执行力,让飞行队的领导从繁杂的日常运行工作中解放出来,使他们有更多的精力管理日益增多人员和不断开辟的救助基地。

  10. Skylab IMSS checklist application study for emergency medical care. [emergency medical care operations involving the use and operation of the portable ambulance module

    Science.gov (United States)

    Carl, J. G.; Furukawa, S.

    1975-01-01

    A manual is presented that provides basic technical documentation to support the operation and utilization of the Portable Ambulance Module (PAM) in the field. The PAM is designed to be used for emergency resuscitation and victim monitoring. The functions of all the controls, displays, and stowed equipment of the unit are defined. Supportive medical and physiological data in those areas directly related to the uses of the PAM unit are presented.

  11. 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.

  12. Equipe de enfermagem: experiência do cuidar de criança com cancer nos plantões noturnos Nursing team: experience of care of children with cancer in night shifts

    Directory of Open Access Journals (Sweden)

    Luciana de Lione Melo

    1998-12-01

    Full Text Available Este trabalho se propõe a desvelar algumas facetas da experiência de uma equipe de enfermagem que cuida de crianças com câncer nos plantões noturnos. Para tanto, recorri a uma metodologia qualitativa - método fenomenológico - que me possibilita uma análise compreensiva dos depoimentos da equipe de enfermagem que vivencia esta experiência. As convergências dessas falas são analisadas e possibilitam a identificação de algumas unidades de significado que podem contribuir com subsídios para garantir institucionalmente as condições mínimas de trabalho para equipe de enfermagem, bem como prepará-la para lidar com tais circunstâncias.The present study aimed understanding some aspects of the experience of a nursing team that take care of children with cancer in night shifts. Therefore, the author used a qualitative methodology - phenomenological method - that enabled her to analyse the declarations of the nursing team about their experience. The convergences of their speech were analysed and some units of meaning were identified in order to contribute to institutionally assure the necessary work conditions to the nursing personnel as well as to prepare the team to face these circumstances.

  13. Uterine/Endometrial Cancer: Working with Your Treatment Team

    Science.gov (United States)

    ... healthcare professionals. These people make up your treatment team. They will work with each other and with you to provide the special care you need. Your treatment team may include some of the healthcare professionals listed ...

  14. Discussion of the role of diabetes team in care diabetic patients%糖尿病护理小组在糖尿病人临床护理中的作用

    Institute of Scientific and Technical Information of China (English)

    熊学勤; 罗碧霞; 郑晓玲

    2013-01-01

    Objective To discuss the role of diabetes team in care diabetic patients.Methods The diabetes care team was established,including a group chief leader,four deputy chiefs,and 98 team members of non-diabetes specialist nursing staffs (37 males and 61 female,age ranged from 22 to 36 years old,average age 27+/-1.8 years old),51 of them had college degree,47 of them had bachelor degree,35 of them were nurse practitioner,and 63 were nurses.Diabetes care team leader and deputy team leader participated in the training at the provincial level and above for 2 times,and systematically mastered the knowledge and nursing skills for diabetes patients.The systematic knowledge and trainings of diabetes care were carried out for none-diabetes specialized nursing staffs to improve their professional knowledge and nursing skills.Professional knowledge and skills were assessed before and after training.Results After training,professional knowledge and care skills were obviously enhanced (P<0.05).Conclusion Specialized trainings on knowledge and nursing skills for diabetes could effectively improve the quality of care for people with diabetes.%目的 探讨糖尿病护理小组在糖尿病人护理中的作用.方法 建立糖尿病护理小组,设组长1名,副组长4名,组员为其他非糖尿病专科护理人员98名,其中男37名,女61名,年龄22~36岁,平均年龄(27±1.8)岁,专科学历51名,本科学历47名,护师35名,护士63名.糖尿病护理小组组长及副组长均先后参加省级及以上培训2次,系统掌握糖尿病知识以及糖尿病患者的护理技能.对非糖尿病专科护理人员开展系统的糖尿病知识及糖尿病护理知识培训,提高非糖尿病专科护理人员的糖尿病专业知识及护理技能.培训前及培训后均对98名非糖尿病专科护理人员进行糖尿病专业知识与糖尿病护理技能考核,并比对两次考核成绩.结果 培训后非糖尿病专业护理人员无论从对糖尿病健康教育知识

  15. Establishing human situation awareness using a multi-modal operator control unit in an urban search & rescue human-robot team

    NARCIS (Netherlands)

    Larochelle, B.; Kruijff, G.J.M.; Smets, N.; Mioch, T.; Groenewegen, P.

    2011-01-01

    Early on in a disaster it is crucial for humans to make an assessment of the situation, to help determine further action. Robots can potentially assist humans here, particularly when the hotzone is too dangerous for humans. Crucial in this human-robot team effort is that the system of robot and mean

  16. Determining team cognition from delay analysis using cross recurrence plot.

    Science.gov (United States)

    Hajari, Nasim; Cheng, Irene; Bin Zheng; Basu, Anup

    2016-08-01

    Team cognition is an important factor in evaluating and determining team performance. Forming a team with good shared cognition is even more crucial for laparoscopic surgery applications. In this study, we analyzed the eye tracking data of two surgeons during a laparoscopic simulation operation, then performed Cross Recurrence Analysis (CRA) on the recorded data to study the delay behaviour for good performer and poor performer teams. Dual eye tracking data for twenty two dyad teams were recorded during a laparoscopic task and then the teams were divided into good performer and poor performer teams based on the task times. Eventually we studied the delay between two team members for good and poor performer teams. The results indicated that the good performer teams show a smaller delay comparing to poor performer teams. This study is compatible with gaze overlap analysis between team members and therefore it is a good evidence of shared cognition between team members.

  17. Understanding interdisciplinary health care teams: using simulation design processes from the Air Carrier Advanced Qualification Program to identify and train critical teamwork skills.

    Science.gov (United States)

    Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M

    2010-09-01

    In the report "Five Years After 'To Err is Human' ", it was noted that "the combination of complexity, professional fragmentation, and a tradition of individualism, enhanced by a well-entrenched hierarchical authority structure and diffuse accountability, forms a daunting barrier to creating the habits and beliefs of common purpose, teamwork, and individual accountability for successful interdependence that a safe culture requires". Training physicians, nurses, and other professionals to work in teams is a concept that has been promoted by many patient safety experts. However the model of teamwork in healthcare is diffusely defined, no clear performance metrics have been established, and the use of simulation to train teams has been suboptimal. This paper reports on the first three years of work performed in the Michigan Economic Development Corporation (MEDC) Tri-Corridor life science grant to apply concepts and processes of simulation design that were developed in the air carrier industry to understand and train healthcare teams. This work has been monitored by the American Academy for the Advancement of Science (AAA) and is based on concepts designed in the Advanced Qualification Program (AQP) from the air carrier industry, which trains and assesses teamwork skills in the same manner as technical skills. This grant has formed the foundation for the Center of Excellence for Simulation Education and Research (CESR).

  18. Improving knowledge and changing behavior towards guideline based decisions in diabetes care: a controlled intervention study of a team-based learning approach for continuous professional development of physicians

    Directory of Open Access Journals (Sweden)

    Kühne-Eversmann Lisa

    2013-01-01

    Full Text Available Abstract Background Continuing Professional Development (CPD courses should ideally improve a physician’s knowledge and change their professional behavior in daily practice towards a best clinical practice reference model and guideline adherence. Interactive methods such as team-based learning and case-based learning, as compared to lectures, can impart sustainable knowledge and lead to high satisfaction among participants. We designed an interactive case-based CPD-seminar on diabetes care using a team-based learning approach to evaluate whether it leads to an improvement of short-term knowledge and changing of behavior towards guideline based decisions and how this learning approach is perceived by participants. Methods Questionnaires and an electronic voting system were used to evaluate motivation, acceptance and knowledge of voluntary participants. Furthermore, we analyzed data on index diagnostic tests and referrals of patients with diabetes of participating physicians over a period of six months before and after the course in comparison with a matched control group in a quasi-experimental design. Results Participants (n=103 rated the interactivity and team-based discussions as the main reasons for enhanced learning. They also expected that the course would change their professional behavior. Participants scored a mean of 43.9% right answers before and 62.6% after the course (p Conclusions Our team-based learning CPD-approach was highly accepted and resulted in an increase of short-term knowledge. It significantly increased the referral to diabetes specialists in daily practice whereas all other key professional behavior indicators did change but not significantly.

  19. Imagery Integration Team

    Science.gov (United States)

    Calhoun, Tracy; Melendrez, Dave

    2014-01-01

    The Human Exploration Science Office (KX) provides leadership for NASA's Imagery Integration (Integration 2) Team, an affiliation of experts in the use of engineering-class imagery intended to monitor the performance of launch vehicles and crewed spacecraft in flight. Typical engineering imagery assessments include studying and characterizing the liftoff and ascent debris environments; launch vehicle and propulsion element performance; in-flight activities; and entry, landing, and recovery operations. Integration 2 support has been provided not only for U.S. Government spaceflight (e.g., Space Shuttle, Ares I-X) but also for commercial launch providers, such as Space Exploration Technologies Corporation (SpaceX) and Orbital Sciences Corporation, servicing the International Space Station. The NASA Integration 2 Team is composed of imagery integration specialists from JSC, the Marshall Space Flight Center (MSFC), and the Kennedy Space Center (KSC), who have access to a vast pool of experience and capabilities related to program integration, deployment and management of imagery assets, imagery data management, and photogrammetric analysis. The Integration 2 team is currently providing integration services to commercial demonstration flights, Exploration Flight Test-1 (EFT-1), and the Space Launch System (SLS)-based Exploration Missions (EM)-1 and EM-2. EM-2 will be the first attempt to fly a piloted mission with the Orion spacecraft. The Integration 2 Team provides the customer (both commercial and Government) with access to a wide array of imagery options - ground-based, airborne, seaborne, or vehicle-based - that are available through the Government and commercial vendors. The team guides the customer in assembling the appropriate complement of imagery acquisition assets at the customer's facilities, minimizing costs associated with market research and the risk of purchasing inadequate assets. The NASA Integration 2 capability simplifies the process of securing one

  20. 糖尿病护理服务小组在糖尿病人临床护理中的作用%The Role of Diabetes Care Team in the Clinical Nursing of Patients with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    张伊辉; 王晓飞; 李静

    2016-01-01

    目的:探究在糖尿病的临床护理中,糖尿病护理小组的护理作用。方法选取2014年6月-2015年2月该院未成立糖尿病护理小组前,来该院接受治疗的43例糖尿病病人作为研究对象,并作为比较组,对其实施常规护理服务;选取2015年6月-2015年12月成立糖尿病护理小组后,来该院接受治疗的43例糖尿病病人作为研究对象,并作为探究组。对其实施相应综合护理服务。对比两组病人护理效果满意度。结果探究组病人在经过糖尿病护理小组护理服务后,病人对护理效果的满意度高达100%;比较组病人在经过常规方式的护理服务后,病人对护理效果的满意度达到83.72%。同时在在血糖控制的有效率等指标方面,探究组病人,相较于比较组病人在以上方面情况明显要好,差异有统计学意义(P﹤0.05)。结论在糖尿病的临床护理中,成立护理小组,给予小组成员予以相应的护理知识及技能的培训,能够有效的提升护理工作质量,提高病人对护理效果的满意度。%Objective To explore the clinical nursing of diabetic patients, the nursing effect of diabetes care team. Methods From June 2014 to 2015 year in February the hospital was set up in diabetes care team, to the hospital for treatment of 43 cases of diabetic patients as a case study, and as a comparison group, the conventional nursing service from June 2015; in December 2015 established diabetes care team, to the hospital for treatment of 43 cases of diabetic patients as a case study, and as a research group. The implementation of the corresponding comprehensive nursing service. Comparison of two groups of patients with nursing effect satisfaction. Results Patients in research group after the diabetes care team care, patient sat-isfaction with nursing effect up to 100% of patients in the comparison group;nursing service after the conventional way, the patient satisfaction