Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...
...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...
Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones
This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...
This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\
Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson
Despite large commitments of personnel and equipment to wildfire suppression, relatively little is known about the factors that affect how many resources are ordered and assigned to wildfire incidents and the variation in resources across incident management teams (IMTs). Using detailed data on suppression resource assignments for IMTs managing the highest complexity...
Belbin, R Meredith Meredith
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.
Kosiński, Sylweriusz; Bryja, Magdalena; Wojtaszowicz, Rafał; Górka, Andrzej
Experience of pain associated with both chronic as well as acute medical conditions is a main cause for call for ambulance. The aim of this study was to establish both frequency and characteristics of pain reported by patients treated in pre-hospital environment in a single operational area. The supplementary goal was an analysis of methods of pain alleviation applied by medical personnel in the above described scenario. The written documentation of 6 months of year 2009 provided by doctor-manned as well as paramedic-only ambulances operating in Tatra county, Małopolska, Poland was analyzed. Medical personnel inquired about pain experienced in 57.4% of cases, 10-point numerical rating scale was used in 22.3% of patients. Pain was reported by 43.8% of patients, the most frequent reasons of experienced pain were trauma and cardiovascular diseases. In almost half of the cases pain was referred to the areas of chest and abdomen. Non-traumatic pain was reported by 47.7% of patients, post-traumatic in 41.3% of cases, 11% of subjects reported ischemic chest pain. 42.3% of pain-reporting patients received some form of analgesia, yet only 3% of subjects in this group received opiates. Personnel of paramedic-only ambulances tended to use pain intensity scale more often (P < 0.01), yet administered pain alleviating drugs noticeably less often than the doctor-manned teams (P < 0.01). The use of pain alleviating drugs, opiates especially, was inadequate in proportion to frequency and intensity of pain reported by patients. General, nation-wide standards of pain measurement and treatment in pre-hospital rescue are suggested as a means to improve the efficacy of pain reduction treatment.
Full Text Available The article is based on literature review and authors’ own recent experience in managing multicultural project teams, in international environment. This comparative study considers two groups of projects: technical assistance (TA projects versus information technology (IT projects. The aim is to explore the size and structure of the project teams – according to the team formation and its lifecycle, and to identify some distinctive attributes of the project teams – both similarities and differences between the above mentioned types of projects. Distinct focus of the research is on the multiculturalism of the project teams: how the cultural background of the team members influences the team performance and team management. Besides the results of the study are the managerial implications: how the team managers could soften the cultural clash, and avoid inter-cultural misunderstandings and even conflicts – in order to get a better performance. Some practical examples are provided as well.
Brett, Jeanne; Behfar, Kristin; Kern, Mary C
Multicultural teams offer a number of advantages to international firms, including deep knowledge of different product markets, culturally sensitive customer service, and 24-hour work rotations. But those advantages may be outweighed by problems stemming from cultural differences, which can seriously impair the effectiveness of a team or even bring itto a stalemate. How can managers best cope with culture-based challenges? The authors conducted in-depth interviews with managers and members of multicultural teams from all over the world. Drawing on their extensive research on dispute resolution and teamwork and those interviews, they identify four problem categories that can create barriers to a team's success: direct versus indirect communication, trouble with accents and fluency, differing attitudes toward hierarchy and authority, and conflicting norms for decision making. If a manager--or a team member--can pinpoint the root cause of the problem, he or she is likelier to select an appropriate strategy for solving it. The most successful teams and managers, the authors found, dealt with multicultural challenges in one of four ways: adaptation (acknowledging cultural gaps openly and working around them), structural intervention (changing the shape or makeup of the team), managerial intervention (setting norms early or bringing in a higher-level manager), and exit (removing a team member when other options have failed). Which strategy is best depends on the particular circumstances--and each has potential complications. In general, though, managers who intervene early and set norms; teams and managers who try to engage everyone on the team; and teams that can see challenges as stemming from culture, not personality, succeed in solving culture-based problems with good humor and creativity. They are the likeliest to harvest the benefits inherent in multicultural teams.
Shelley, P; Powney, B
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.
Margerison, Charles; Mccann, Dick; Davies, Rod
The key features of the Aircrew Team Management Workshop which was designed for and in consultation with Trans Australia Airlines are outlined. Five major sections are presented dealing with: (1) A profile of the airline and the designers; (2) Aircrew consultation and involvement; (3) Educational design and development; (4) Implementation and instruction; and (5) Evaluation and assessment. These areas are detailed.
This thesis looked into volunteer team management in a project in AIESEC in Finland through the action research method. AIESEC in Finland is a non-profit non-government organization with a purpose of “peace and fulfilment of humankinds potential” through development of the youth’s future leadership. AIESEC was not a commissioning party; the project was the basis for the thesis without the supervision of the company. The thesis is based on a project that the author was in charge of, in ...
Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-‐based tool for incident tracking is presented.
Anne E. Black
This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...
Kleij, R. van der; Kleinhuis, G.; Young, H.J.
Computer security incident response teams (CSIRTs) respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad-hoc basis, in close cooperation with other teams, and in
Swift, James S.
An analysis of the factors that have led to team management, including classical principles of management, the human relations or behavioral school of management, and the systems theory both closed and open. (JF)
The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...
Bearman, Chris; Grunwald, Jared A; Brooks, Benjamin P; Owen, Christine
Emergency situations are by their nature difficult to manage and success in such situations is often highly dependent on effective team coordination. Breakdowns in team coordination can lead to significant disruption to an operational response. Breakdowns in coordination were explored in three large-scale bushfires in Australia: the Kilmore East fire, the Wangary fire, and the Canberra Firestorm. Data from these fires were analysed using a top-down and bottom-up qualitative analysis technique. Forty-four breakdowns in coordinated decision making were identified, which yielded 83 disconnects grouped into three main categories: operational, informational and evaluative. Disconnects were specific instances where differences in understanding existed between team members. The reasons why disconnects occurred were largely consistent across the three sets of data. In some cases multiple disconnects occurred in a temporal manner, which suggested some evidence of disconnects creating states that were conducive to the occurrence of further disconnects. In terms of resolution, evaluative disconnects were nearly always resolved however operational and informational disconnects were rarely resolved effectively. The exploratory data analysis and discussion presented here represents the first systematic research to provide information about the reasons why breakdowns occur in emergency management and presents an account of how team processes can act to disrupt coordination and the operational response. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Van der Kleij, Rick; Kleinhuis, Geert; Young, Heather
Computer security incident response teams (CSIRTs) respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad hoc basis, in close cooperation with other teams, and in time constrained environments. It could be argued that under these working conditions CSIRTs would be likely to encounter problems. A needs assessment was done to see to which extent this argument holds true. We constructed an incident response needs model to assist in identifying areas that require improvement. We envisioned a model consisting of four assessment categories: Organization, Team, Individual and Instrumental. Central to this is the idea that both problems and needs can have an organizational, team, individual, or technical origin or a combination of these levels. To gather data we conducted a literature review. This resulted in a comprehensive list of challenges and needs that could hinder or improve, respectively, the performance of CSIRTs. Then, semi-structured in depth interviews were held with team coordinators and team members of five public and private sector Dutch CSIRTs to ground these findings in practice and to identify gaps between current and desired incident handling practices. This paper presents the findings of our needs assessment and ends with a discussion of potential solutions to problems with performance in incident response.
Rick Van der Kleij
Full Text Available Computer security incident response teams (CSIRTs respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad hoc basis, in close cooperation with other teams, and in time constrained environments. It could be argued that under these working conditions CSIRTs would be likely to encounter problems. A needs assessment was done to see to which extent this argument holds true. We constructed an incident response needs model to assist in identifying areas that require improvement. We envisioned a model consisting of four assessment categories: Organization, Team, Individual and Instrumental. Central to this is the idea that both problems and needs can have an organizational, team, individual, or technical origin or a combination of these levels. To gather data we conducted a literature review. This resulted in a comprehensive list of challenges and needs that could hinder or improve, respectively, the performance of CSIRTs. Then, semi-structured in depth interviews were held with team coordinators and team members of five public and private sector Dutch CSIRTs to ground these findings in practice and to identify gaps between current and desired incident handling practices. This paper presents the findings of our needs assessment and ends with a discussion of potential solutions to problems with performance in incident response.
Midthaug, Mari Bratterud
The purpose of this thesis is to explore the relationship between team size (number of team members) and team performance in management teams. There is a lack of empirical research exploring the potential links between these two elements within management teams. Further, little attention has been paid to potential mechanisms affecting this relationship. In this study, team psychological safety has been examined as a potential mediator in the size-performance relationship, hypothesizing that t...
Isaac, Gayle; Moore, Brian
Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…
The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...
Do you have a poor-performing employee on your medical practice team? If so, you're not alone. Unfortunately, this is a problem that many medical practice managers face. This article describes the best strategies for managing your team's weakest link. It explores common yet very difficult circumstances that cause low employee performance and that test the patience, heart, and skills of a practice manager. It guides readers through a process of self-discovery to determine whether their negative biases or grudges may be causing employees to perform poorly. It suggests several possible other reasons for weak employee performance, including problems with the job, practice, leadership, communication, and fit between the employee and the job. This article also suggests the best strategy for communicating concerns about performance to the weakest-link employee. It offers guidance to practice managers about protecting their time and energy when handling a poor performer. It provides a simple formula for calculating the cost of a low-performing employee, 10 possible personal reasons for the employee's poor work performance, specific questions to ask to uncover the reasons for poor performance, and an eight-rule strategy for confronting poor performance effectively. Finally, this article offers practice managers a practical strategy for handling resistance from their weakest link, illustrated with a sample dialogue.
Doris Padmini Selvaratnam; Aini Aman; Muhamad Maziz Mahyuddin Bin Kamaludin; Gary Lynn; Richard Reilly
Team trust has been cited as a contributing factor towards team performance. This paper looks at the antecedents of team trust and to what extent they influence team trust. The antecedents of team trust are team factors like team autonomy, team stability and team member experience; and the management practices are top management involvement and management support. The results demonstrated that team factors and management practices influence team trust individually. The key find...
In this article, the author discusses current challenges to the idea of teamwork in fine arts teams, redefines the terms team and collaboration using a business management perspective, discusses the success of effective teams in the business world and the characteristics of those teams, and proposes the implementation of the business model of…
Team learning is a cure for bureaucracy; it facilitates team innovation and team performance. But team learning occurs only when necessary conditions were met. This research focused on differences of team learning influential factors between self-management team and superior-direction team. Four variables were chosen as predictors of team learning though literature review and pilot interview. The 4 variables are team motivation, team trust, team conflict and team leadership. Selected 54 self ...
Analysts. Cognitive prompts can reduce overconfidence and information bias. One such strategy is the “Five-Why Analysis,” developed by Toyota and used...building trust among CSIRTs and MTS members (including those from other CSIRTs and agencies), as well as developing an environment of psychological safety...recommendations for optimal CSIRT performance. 15. SUBJECT TERMS Cyber Incident Response, Response Teams, Cognitive Task Analysis 16. SECURITY
Lehtonen, Kenneth E.; Barrett, Larry
Orbiting 380 miles above the earth, NASA s Hubble Space Telescope (HST) has returned a wealth of scientific data about our universe and galaxies beyond highlighted by spectacular images of the birth and death of stars, colliding galaxies, and other extra-worldly events. Despite its tremendous success for almost two decades, the HST ground support system experienced down-to-earth problems prior to the turn of the century, namely budgetary ones. To keep HST operating efficiently to 201 2 and beyond, the Vision 2000 project was conceived with the primary goal of substantially reducing the costs of operating and maintaining the spacecraft ground systems. Taking advantage of this atypical management opportunity, a set of Product Development Teams (PDTs) were established, whose charter was to re-engineer the ground system, and in doing so, reduce the remaining life-of-mission operating and maintenance costs, while providing improved reliability and increased capabilities.
Brown, Karen A
Students today are likely to be assigned to project teams or to be project managers almost immediately in their first job. Managing Projects: A Team-Based Approach was written for a wide range of stakeholders, including project managers, project team members, support personnel, functional mangers who provide resources for projects, project customers (and customer representatives), project sponsors, project subcontractors, and anyone who plays a role in the project delivery process. The need for project management is on the rise as product life cycles compress, demand for IT systems increases, and business takes on an increasingly global character. This book adds to the project management knowledge base in a way that fills an unmet need—it shows how teams can apply many of the standard project management tools, as well as several tools that are relatively new to the field. Managing Projects: A Team-Based Approach offers the academic rigor found in most textbooks along with the practical attributes often foun...
implemented in the local organization? How are organizational culture, vision and images aligned with the team processes to accomplish the task? Does professional (functional) expertise influence team collaboration and finally how do individual experiences and coping strategies matter? The US and Japan...
Weerheim, Wilke; Van Rossum, Lisa; Ten Have, Wouter Dirk
Purpose: Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is crucial to
Weerheim, W. (Wilke); Van Rossum, L. (Lisa); Ten Have, W.D. (Wouter Dirk)
textabstractPurpose: Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is
Amir Mohammad Colabi
Full Text Available Although there are many potential benefits associated with the use of virtual product development teams, exploiting these benefits requires an appropriate management. Managing virtual product development team is a critical issue as many of these teams fail to accomplish their goals. Review of previous literature shows that body of knowledge in managing virtual product development teams is fragmented and inconsistent. The main objective of this paper is to categorize the previous research on the subject of virtual product development team management in order to integrate the research into a thematic model and to enable recommendations for future research. So, this study reviews and summarizes empirical research in the field, also conceptual and qualitative papers, experiences, reports and explorative case studies. Results show that there are three fields of research in this area, including: Virtual production and Virtual team in Product Development, Managing virtual team in R&D and product development, Managing global virtual product development teams. In order to organize previous studies in this area, a thematic map is proposed which shows the structure and sequence of research. Finally, a comprehensive discussion on the future directions in this field is proposed.
Andersen, V.; Bove, T.
Valuable improvements in performance have been obtained by 'Crew Resource Management' (CRM) courses performed in the domain of aviation related to the crew in a cockpit, and in the maritime domain related to the crew on the bridge of large ships. CRM courses are currently being adapted...
Andreatta, Pamela; Marzano, David
Interdisciplinary team factors are significant contributors to clinical performance and associated patient outcomes. Quality of care and patient safety initiatives identify human factors associated with team performance as a prime improvement area for clinical patient care. The majority of references to interdisciplinary teams in obstetrics and gynecology in the literature recommends the use of multidisciplinary approaches when managing complex medical cases. The reviewed literature suggests that interdisciplinary team development is important for achieving optimally efficient and effective performance; however, few reports provide specific recommendations for how to optimally achieve these objectives in the process of providing interdisciplinary care to patients. The absence of these recommendations presents a significant challenge for those tasked with improving team performance in the workplace. The prescribed team development programs cited in the review are principally built around communication strategies and simulation-based training mechanisms. Few reports provide descriptions of optimal team-based competencies in the various contexts of obstetric and gynecology teams. However, team-based evaluation strategies and empirical data documenting the transfer of team training to applied clinical care are increasing in number and quality. Our findings suggest that research toward determining team factors that promote optimal performance in applied clinical practice requires definition of specific competencies for the variable teams serving obstetrics and gynecology.
Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...
Augar, Naomi; Woodley, Carolyn J.; Whitefield, Despina; Winchester, Maxwell
Purpose: The purpose of this paper is to develop an understanding of academics' approaches to managing team assessment at an Australian University with a view to informing policy development and assessment design. Design/methodology/approach: The research was conducted using a single exploratory case study approach focussing on the team assessment…
Sims, Henry P., Jr.; Dean, James W., Jr.
This article reviews the quality circle concept, shows why its characteristics appeal to American executives, and examines some of its limitations. It looks at self-managing teams and discusses the reasons that adoptions have been relatively few. It then shows what organizational conditions are necessary for quality circles to evolve into teams.…
Benoliel, Pascale; Somech, Anit
Purpose: There has been an increasing trend toward the creation of senior management teams (SMTs) which are characterized by a high degree of functional heterogeneity. Although such teams may create better linkages to information, along with the benefits of functional heterogeneity comes the potential for conflicts that stem from the value…
Grosse, Christine Uber
Suggests that business students need to be prepared to manage the communication of intercultural teams. Discusses strategies for success such as: developing a network of good relationships built on trust and understanding; showing respect for other cultures and languages; and understanding how diversity strengthens the team. (SG)
Schermerhorn, John R., Jr.
The author examines a team development approach to management that creates shared commitments to performance improvement by focusing the attention of managers on individual workers and their task accomplishments. It uses the "high-performance equation" to help managers confront shared beliefs and concerns about performance and develop realistic…
This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.
National Highway Traffic Safety Administration (DOT), Washington, DC.
This document presents materials covering the television campaign against drunk driving called "TEAM" (Techniques for Effective Alcohol Management). It is noted that TEAM's purpose is to promote effective alcohol management in public facilities and other establishments that serve alcoholic beverages. TEAM sponsors are listed, including…
V. S. Kruglyk
Full Text Available During the work performance students should get the maximal approach to the process of real project execution, so the project should include the need to use the latest technology, integration of data or services with different developments, architecture design, interaction of the team members and others. Implementation of graduation projects is the useful activity for the acquisition and consolidation of key IT competencies. Since the task of educational projects is maximal close to real one, students participate almost in all typical stages of commercial product’s development, and do so successfully. This is also confirmed practically: students, who were actively engaged in some projects at the university, have key positions in IT companies of the city and country after that. The main objective of the paper is to describe the organization of a common group students’ work on a degree project, implementation peculiarity of such projects, recommendations for improving the quality of projects. Thus, the paper is devoted to the peculiarities of the joint students’ work on a project during diploma execution in IT specialties, as the final part of the acquisition and consolidation process of key IT competencies of future programmers. The problem of choosing work topic, project concept, work organization in a group, implementation process organization has been considered. Also the specific stages of software development have been considered: development of interface, choice of technology, product quality, project disposal to the next developers, project completion.
Schaafstal, A.M.; Johnston, J.H.; Oser, R.L.
Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of great public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM
Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.
Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.
Bilstad, Julie Brat
This study is a response to the research and request presented by Bang and Midelfart (2010), to further investigate the effect dialogue can have on management team s effectiveness. The purpose of the study was to investigate and explain the effect of team psychological safety on task performance and team member satisfaction, with dialogue as a mediator in this relationship. 215 Norwegian and Danish management teams in the private and public sector were studied. As expected, team psychological...
Isabella, Lynn A.
This article chronicles the unique manner in which a second-year MBA elective course in managing teams has been crafted using existing first-year learning teams as its core. The design and orchestration of this course are detailed, as are the challenges posed, in delivering a course that not only teaches about teams and team dynamics but does so…
Vijfeijken, van H.T.G.A.; Kleingeld, P.A.M.; Tuijl, van H.F.J.M.; Algera, J.A.; Thierry, H.
Abstract: Purpose – To evaluate a proposed prescriptive model for the design of effective combinations of performance goals and pay-for-performance plans for the performance management of teams. Design/methodology/approach – The idea underlying the model – in which task, goal, and reward
Recently, a number of positions with corporate social responsibility (CSR) in the position title have been introduced to the top management teams (TMTs) of some of the world’s largest corporations. I explore this phenomenon. I revisit 10 such positions identified in a previous study to add...
Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney
Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…
Becoming a manager of former peers is a common occurrence in medical practice management, but it can be awkward and challenging. This article describes the specific staff management challenges that recently promoted practice managers encounter. It urges promoted managers to seek support outside the practice through new friendships, mentoring, and leadership networks. This article also describes how best to announce the promotion and suggests that new managers hold one-on-one meetings with each employee. It offers the agenda for those meetings and for the manager's first whole-team leadership kickoff meeting. This article also describes smart first tasks for a promoted practice manager and considers the possibility that some employees may not come on board with the changing social and leadership structures in the practice, and what to do about them. Finally, this article suggests that preparation to become a medical practice manager should start early. It offers a strategy for handling former peers who continue to overshare personal information with the manager. It describes how to handle four common authority challenges newly promoted practice managers may face, with sample dialogue. And it suggests a social media strategy medical practice managers can use when they are connected electronically to their former peers.
Bach, Fréderiue; Bloch, Frédéric
The mobile geriatric team of Cochin hospital in Paris is responsible for the management and orientation of fragile elderly patients over the age of 75 admitted to emergency departments. It carries out a multi-disciplinary assessment, contributes to the creation of the care project and life project of geriatric patients and is involved in organising the patient's return home. This article focuses on the role of the social assistant through two clinical cases.
Moore, Zena; Butcher, Gillian; Corbett, Lisa Q; McGuiness, William; Snyder, Robert J; van Acker, Kristien
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
Brett, Jeanne M; Friedman, Ray; Behfar, Kristin
You are leading a negotiating team for your company. When you sit down with the other party, someone on your side of the table blurts out: "Just tell us--what do we need to do to get more of your business?" And in that moment, you know you've lost the upper hand. Gaffes like this are more common than most businesspeople would care to admit, management professors Brett, Friedman, and Behfar have found in their research. Even though team members are all technically on the same side, they often have different priorities and imagine different ideal outcomes: Business development just wants to close the deal. Finance is most concerned about costs. Legal is focused on patents and intellectual property. The authors recommend taking four steps, either singly or in tandem, to align those goals: Map out each person's priorities, work out conflicts directly with departments, employ a mediator if that doesn't work, and use data to resolve differences. Once you are all on the same page, you can take steps to make sure everyone is coordinated during the negotiations themselves. Try simulating the negotiation beforehand, assigning roles to team members that take advantage of their strengths, and establishing the signals you will use to communicate with one another during the session. The payoff from working as a cohesive group is clear. With access to greater expertise and the ability to assign members to specialized roles, teams can implement more-complex strategies than a sole negotiator could ever pull off.
Canyon, Deon V
Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.
Full Text Available Day by day globalization covers new areas of life and calls for continuous learning and adjusting to new cultural dimensions. Managers are expected to display adaptation to new ways of working, cultural sensitivity, cultural intelligence and to posses multicultural competencies communication skills. Understanding the impact of cultural diversity on the communication within the organization is essential for the success of a company. Especially in multinational companies, when departments working on the same projects are located in different countries, the managers rely more and more on cultural- specific country characteristics in order to chose the best negotiation and communication techniques. The aim of this paper is to show how the country specific cultural characteristics impact on the success or failure of a business and the organizations’ challenge with preparing managers for success in international business environment. The paper is based on literature review and on authors’ experience in managing multicultural project teams, in international environment.
... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...
Lumadi, M. W.
This study explores factors which have a negative impact, on the role of the School Management Team (SMT) that serves as the fulcrum of the curriculum management process. The SMT is compelled to execute its responsibilities in an efficient and effective manner thus keeping a delicate balance between the often-conflicting pressures from parents,…
Berlo, M.P.W. van; Stroomer, S.; Bosch, K. van den
Een rampenplan of bedrijfsnoodplan bestaat veelal slechts uit een lijst met telefoonnummers, of het is een plan dat niet is geactualiseerd. Bovendien is het trainen van crisismanagement-teams lastig omdat crises vaak een onvoorspelbaar karakter hebben. in deze bijdrage worden twee methoden
Kratzer, J.; Leenders, R.Th.A.J.; van Engelen, J.M.L.
Creative performance in R&D is of vital importance to organizations. Because R&D usually is organized in teams, the management of creative performance inherently refers to the team level creative performance. Over the last decades, R&D teams have become increasingly virtual. In this article we
Overwork, at first glance, seems like a problem that affects only the employee. But for medical practices and those who manage them, the problem is far greater than that. Chronically overworked employees may not be meeting their goals. They may be making more mistakes and letting things slip through the cracks. Ultimately, patients may have less-than-ideal experiences in a practice where the employees are stretched thin. And turnover may skyrocket in practices where employees are chronically overworked. This article offers practice managers 20 practical and affordable strategies they can use to manage a chronically overworked medical practice team. It suggests an effective technique they can use to tell their bosses that their employees are overworked. This article also suggests the costs to the practice of a chronically overworked staff, including a hidden cost many people overlook. It provides four coping strategies practice managers can teach to their overworked employees. It summarizes research exploring how overwork affects employees' sleep and eating habits, and additional research linking long hours of overwork to diminished productivity. Finally, this article provides five strategies practice managers can use to make their overworked employees feel valued.
Paunova, Minna; Lee, Yih-Teen
Arguing that it is necessary to look into specific global leadership processes in specific contexts, this article focuses on collective global leadership in self-managed multicultural teams using an input-process-output model. Building on a study of nationally and culturally diverse self-managed...... teams, our work demonstrates that collective global leadership in these teams is critical for team performance (output). Our study also examines some of the affective or attitudinal antecedents of collective global leadership in self-managed multicultural teams (process) and their members’ goal...... orientations (input). Our findings suggest that a team learning orientation may greatly help multicultural teams overcome the liability of cultural diversity, create a positive intra-team environment, and enable collective global leadership. Our research also suggests that team performance orientation...
Døving, Erik; Martin-Rubio, Irene
Purpose – The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach – The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings – The leadership behaviour (consideration, initiation of structure) displayed by the team leader plays a key role in facilitating team learning. Te...
Eakin, William L.
As Total Quality Management teams work to improve organizational processes, several types of facilitators emerge: the director, the workhorse, and the cheerleader. Experience at the University of Kansas illustrates how different facilitator styles can affect team learning. (MSE)
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...
Shively, Robert J.; Lachter, Joel B.
Automation is playing an increasingly important role in many operations. It is often cheaper faster and more precise than human operators. However, automation is not perfect. There are many situations in which a human operator must step in. We refer to these instances as contingencies and the act of stepping in contingency management. Here we propose coupling Human Autonomy Teaming (HAT) with contingency management. We describe two aspects to HAT, bi-directional communication, and working agreements (or plays). Bi-directional communication like Crew Resource Management in traditional aviation, allows all parties to contribute to a decision. Working agreements specify roles and responsibilities. Importantly working agreements allow for the possibility of roles and responsibilities changing depending on environmental factors (e.g., situations the automation was not designed for, workload, risk, or trust). This allows for the automation to "automatically" become more autonomous as it becomes more trusted and/or it is updated to deal with a more complete set of possible situations. We present a concrete example using a prototype contingency management station one might find in a future airline operations center. Automation proposes reroutes for aircraft that encounter bad weather or are forced to divert for environmental or systems reasons. If specific conditions are met, these recommendations may be autonomously datalinked to the affected aircraft.
Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...
In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry
Fieseler, Christian; Meckel, Miriam; Ranzini, Giulia
The article is a short piece based on our EACD survey on the identity management practices of marketing and communication professeionals on how communications teams can harness the power of online impression management
Doving, Erik; Martin-Rubio, Irene
Purpose: The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach: The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings: The…
Humes, Michelle; Reilly, Anne H.
In today's global environment, intercultural teams may become the most effective teams in an organization when their diversity is managed as an asset. However, because of miscommunication and conflict, intercultural teams often become dysfunctional. This experiential group exercise demonstrates how cultural dimensions such as individualism and…
Drd. ec. Mirela Udrea
Full Text Available The achievement of strategic objectives of any economic organization cannot be real withoutturning to account the professional potential of all its employees, of their abilities and knowledge.Team work, as a method of activities organization, is a requirement in order to obtain success. The teamwork based on solidarity and cohesion is more performant than team work based on individualism andcompetition.The confidence is the basic principle in order to build a performant team, within the team (confidencebetween the members of team and, also, the confidence of the whole team in their leader (manager. Theworking style of a manager has an influence on the team working style leaded by him.Manager of future will be a decisive progress factor through his open-minded personality for noveltyand his involvement, and the prevalent feature of his activities will be orientation to excellency .
Gerowitz, M B
This study assesses the contributions of the leader power and top management team characteristics to perceived strategic capability. Low age heterogeneity and low tenure heterogeneity were found to have a positive association with perceived adaptability. High diversity in educational specialization was also found to be positively associated with adaptability. Top management perceptions of CEO power were, however, lower among high adaptors. Implications for leadership research, senior management recruitment, and the design of management development for top management teams are discussed.
Moreira, Mario E
Adapting Configuration Management for Agile Teams provides very tangible approaches on how Configuration Management with its practices and infrastructure can be adapted and managed in order to directly benefit agile teams. Written by Mario E. Moreira, author of Software Configuration Management Implementation Roadmap , columnist for CM Crossroads online community and writer for the Agile Journal, this unique book provides concrete guidance on tailoring CM for Agile projects without sacrificing the principles of Configuration Management.
Gupta, Vineeta; Woodman, Clare
This article describes a strategy to reduce the high levels of stress experienced by community nurses in a children's palliative care team. The development, use and effectiveness of a problem-solving team intervention are illustrated by direct quotations from the nurses themselves.
Purpose - This study seeks to identify the relationship between leader behaviour and the effectiveness of the members of a self-managing team (SMT) in terms of perceived individual performance and emotional exhaustion. In particular, it aims to examine the moderating role of individual team tenure.
Tomas, Marina; Castro, Diego
This article presents a research study that focuses on how women manage research teams. More specifically, the study aims to ascertain the perception of female researchers who are leaders of research groups in social sciences with regard to the formation, operation and management of their research teams. Fifteen interviews were carried out, eight…
Naranjo Gil, D.; Hartmann, F.; Maas, V.S.
This study examines the role of top management team (TMT) heterogeneity in facilitating strategic change. Based on the upper echelons literature, we argue that heterogeneous management teams are better able to handle the simultaneous and conflicting demands of refocusing the organization
Rusu, Lazar; Lin, Yifeng; Hodosi, Georg
Worldwide job market for database developers (DBDs) is continually increasing in last several years. In some companies, DBDs are organized as a special team (DBDs team) to support other projects and roles. As a new role, the DBDs team is facing a major problem that there are not any management guidelines for them. The team manager does not know which kinds of tasks should be assigned to this team and what practices should be used during DBDs work. Therefore in this paper we have developed a set of management guidelines, which includes 8 fundamental tasks and 17 practices from software development process, by using two methodologies Capability Maturity Model (CMM) and agile software development in particular Scrum in order to improve the DBDs team work. Moreover the management guidelines developed here has been complemented with practices from authors' experience in this area and has been evaluated in the case of a software company. The management guidelines for DBD teams presented in this paper could be very usefully for other companies too that are using a DBDs team and could contribute towards an increase of the efficiency of these teams in their work on software development projects.
Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.
This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer
Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen
Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.
Orchard, John W; Waldén, Markus; Hägglund, Martin; Orchard, Jessica J; Chivers, Ian; Seward, Hugh; Ekstrand, Jan
Australian Football League (AFL) teams in northern (warmer) areas generally have higher rates of injury than those in southern (cooler) areas. Conversely, in soccer (football) in Europe, teams in northern (cooler) areas have higher rates of injury than those in southern (warmer) areas, with an exception being knee anterior cruciate ligament (ACL) injuries, which are more common in the southern (warmer) parts of Europe. This study examined relative injury incidence in the AFL comparing 9,477 injuries over 229,827 player-weeks from 1999–2012. There was a slightly higher injury incidence for teams from warmer parts of Australia (relative risk [RR] 1.05, 95% confidence interval [CI] 1.01–1.10) with quadriceps strains (RR 1.32, 95% CI 1.10–1.58), knee cartilage injuries (RR 1.42, 95% CI 1.16–1.74), and ankle sprains (RR 1.17, 95% CI 1.00–1.37) all being more likely in warmer region teams. Achilles injuries followed a reverse pattern, tending to be more common in cooler region teams (RR 0.70, 95% CI 0.47–1.03). In conclusion, common findings from the AFL and European soccer are that ankle sprains and ACL injuries are generally more likely in teams playing in warmer climate zones, whereas Achilles tendinopathy may be more likely in teams playing in cooler zones. These injuries may have climate or surface risk factors (possibly related to types and structure of grass and shoe-surface traction) that are universal across different football codes. PMID:24379731
Andelman, S.; Baru, C.; Chandra, S.; Fegraus, E.; Lin, K.; Unwin, R.
currently partnering with the San Diego Super Computer Center to build the data management infrastructure. Data collected from the three core protocols as well as others are currently made available through the TEAM Network portal, which provides the content management framework, the data scheduling and management framework, an administrative framework to implement and manage TEAM sites, collaborative tools and a number of tools and applications utilizing Google Map and Google Earth products. A critical element of the TEAM Network data management infrastructure is to make the data publicly available in as close to real-time as possible (the TEAM Network Data Use Policy: http://www.teamnetwork.org/en/data/policy). This requires two essential tasks to be accomplished, 1) A data collection schedule has to be planned, proposed and approved for a given TEAM site. This is a challenging process since TEAM sites are geographically distributed across the tropics and hence have different seasons where they schedule field sampling for the different TEAM protocols. Capturing this information and ensuring that TEAM sites follow the outlined legal contract is key to the data collection process and 2) A stream-lined and efficient information management system to ensure data collected from the field meet the minimum data standards (i.e. are of the highest scientific quality) and are securely transferred, archived, processed and be rapidly made publicaly available, as a finished consumable product via the TEAM Network portal. The TEAM Network is achieving these goals by implementing an end-to-end framework consisting of the Sampling Scheduler application and the Data Management Framework. Sampling Scheduler The Sampling Scheduler is a project management, calendar based portal application that will allow scientists at a TEAM site to schedule field sampling for each of the TEAM protocols implemented at that site. The sampling scheduler addresses the specific requirements established in the
Juan A. Marin-Garcia; Mª Elena Zarate-Martinez
Human Resource Management relevance in Knowledge Management has been studied in academic literature mostly from the point of view of recruitment, selection, wages and salaries and career development processes. We have found few publications that are focused in the behaviour of the group of people who generate, share and transfer that knowledge while working in a team. The aim of this paper is to propose a framework that describes the relation between knowledge management and team work,, integ...
Trantham, Doug; Sherry, Anne
Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.
The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...
Building a strong, cohesive, and talented managerial team is a critical endeavor for imaging administrators, as the job will be enhanced if supported by a group of high-performing, well-developed managers. For the purposes of this article, leadership and management are discussed as two separate, yet equally important, components of an imaging administrator's role. The difference between the two is defined as: leadership relates to people, management relates to process. There are abundant leadership and management theories that can help imaging administrators develop managers and ultimately build a better team. Administrators who apply these theories in practical and meaningful ways will improve their teams' leadership and management aptitude. Imaging administrators will find it rewarding to coach and develop managers and witness transformations that result from improved leadership and management abilities.
Svane Hansen, Tine; Hope, Alexander John; Moehler, Robert C.
for organisations to move towards establishing permanent Global Virtual Teams in order to leverage knowledge sharing and cooperation across distance. To close this gap, this paper will set the scene for a research project investigating the changed preconditions for organisations. As daily face-to-face communication......The rise and spread of information communication technologies (ICT) has enabled increasing use of geographically dispersed work teams (Global Virtual Teams). Originally, Global Virtual Teams were mainly organised into temporary projects. Little research has focused on the emergent challenge...... generation of self-lead digital natives, who are already practising virtual relationships and a new approach to work, and currently joining the global workforce; and improved communication technologies. Keywords: Global Virtual teams, ICT, leadership, motivation, self-management, millenials....
Berlo, M.P.W. van; Dommele, R. van; Schneider, P.; Veerdonk, I. van de; Braakhekke, E.; Hendriks van de Weem, N.; Dijkman, E. van; Wartna, S.
Training of multidisciplinary crisis management teams is becoming more common practice. Nevertheless, the value of these trainings and exercises is questionable. Scenarios are quite often realistic and challenging to the trainees: the team members are heavily engaged in doing their jobs in a
Entrepreneurship is increasingly viewed as a plural rather than singular endeavour. This paper develops a conceptual framework of team-based entrepreneurial learning, challenging the myth of the entrepreneurial "Lone Ranger" and revealing the significance of power structures in the SME management team in mediating what is and is not learnt.…
Introduction: Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team's performance, roles and experiences following the training. Findings: The disasters most commonly experienced by the district ...
Oeij, P.R.A.; Vroome, E.M.M. de; Dhondt, S.; Gaspersz, J.B.R.
Complexity of projects is hotly debated and a factor which affects innovativeness of team performance. Much attention in the past is paid to technical complexity and many issues are related to natural and physical sciences. A growing awareness of the importance of socio-organisational issues is
Describes differences between total quality management and self-directed teams in terms of job design, decision making, flexibility, supervision, labor relations, quality, customers, and training. Offers suggestions for which method to choose when. (SK)
Full Text Available In the world marketplace some firms compete successfully and others fail to gain global competitive advantage. Some researchers argue that innovation strategy is the answer to successfully meeting today’s and tomorrow’s global business challenges. An important aspect of the innovation strategy is managing global teams effectively. Thus, firms of tomorrow will be characterized by values such as teamwork, innovation, cultural diversity, and a global mindset. The rapid globalization of business, and increasing competition will continue to drive the need for effective teamwork and/in innovation management. The purpose of our research is to gain insight into global team management and its role as a major component of innovation strategy. We discuss the changing and developing functions of teamwork, examine the characteristics of global teams, and finally offer a process to achieve effective global team management.
Leede, de Jan; Stoker, Janka
Reports on an explanatory multiple case-study of companies with self-managing teams. Reasons for introducing self-managing teams; Cooperation between self-managing teams and engineering development; Conclusion.
Sockalingam, Sanjeev; Tehrani, Hedieh; Kacikanis, Anna; Tan, Adrienne; Hawa, Raed; Anderson, Ruthie; Okrainec, Allan; Abbey, Susan
The high incidence of delirium in surgical units is a serious quality concern, given its impact on morbidity and mortality. While successful delirium management depends upon interdisciplinary care, training needs for surgical teams have not been studied. A needs assessment of surgical units was conducted to determine perceived comfort in managing delirium, and interprofessional training needs for team-based care. We administered a survey to 106 General Surgery healthcare professionals (69% response rate) with a focus on attitudes towards delirium and team management. Although most respondents identified delirium as important to patient outcomes, only 61% of healthcare professionals indicated that a team-based approach was always observed in practice. Less than half had a clear understanding of their role in delirium care, while just over half observed team communication of delirium care plans during handover. This is the first observation of clear gaps in perceived team performance in a General Surgery setting.
Full Text Available John W Orchard,1 Markus Waldén,2 Martin Hägglund,3 Jessica J Orchard,1 Ian Chivers,4 Hugh Seward,5 Jan Ekstrand21School of Public Health, University of Sydney, Sydney, NSW, Australia; 2Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Linköping, Sweden; 3Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden; 4Native Seeds, Cheltenham, VIC, Australia; 5Australian Football League Medical Officers Association, Melbourne, VIC, AustraliaAbstract: Australian Football League (AFL teams in northern (warmer areas generally have higher rates of injury than those in southern (cooler areas. Conversely, in soccer (football in Europe, teams in northern (cooler areas have higher rates of injury than those in southern (warmer areas, with an exception being knee anterior cruciate ligament (ACL injuries, which are more common in the southern (warmer parts of Europe. This study examined relative injury incidence in the AFL comparing 9,477 injuries over 229,827 player-weeks from 1999–2012. There was a slightly higher injury incidence for teams from warmer parts of Australia (relative risk [RR] 1.05, 95% confidence interval [CI] 1.01–1.10 with quadriceps strains (RR 1.32, 95% CI 1.10–1.58, knee cartilage injuries (RR 1.42, 95% CI 1.16–1.74, and ankle sprains (RR 1.17, 95% CI 1.00–1.37 all being more likely in warmer region teams. Achilles injuries followed a reverse pattern, tending to be more common in cooler region teams (RR 0.70, 95% CI 0.47–1.03. In conclusion, common findings from the AFL and European soccer are that ankle sprains and ACL injuries are generally more likely in teams playing in warmer climate zones, whereas Achilles tendinopathy may be more likely in teams playing in cooler zones. These injuries may have climate or surface risk factors (possibly related to types and structure of grass and shoe-surface traction that are
Full Text Available Background. Rugby league is a physically demanding team sport and the National Rugby League is the highest-level competition of rugby league in Australia. Frequent tackles and collisions between players result in a high incidence of injury to players. Concussion injuries have been the source of much debate, with reporting varying greatly depending on the definition used. Method. Injury records of 239 players from one professional National Rugby League were analysed during a continuous period of 15 years, with particular interest in the incidence and recurrence of concussions and the change in incidence over time. Result. A total of 191 concussions were recorded, affecting 90 players. The incidence of concussion injuries was found to be 28.33 per 1000 player match hours, with an increase over time (P=0.0217. Multiple concussions were recorded for 51 players. Conclusion. A statistically significant increase in the incidence of concussion injuries was found, without a concurrent increase in the number of head injuries or total injuries. New rules which mandate removal of players from the field may be beneficial for protection of players on the long term, although they risk being counterproductive, if they make players less likely to report their symptoms during matches.
To provide information on waste management planning and preparedness before a homeland security incident, including preparing for the large amounts of waste that would need to be managed when an incident occurs, such as a large-scale natural disaster.
Brunner, Markus; Gore, Sinclair M; Read, Rebecca L; Alexander, Ashlin; Mehta, Ankur; Elliot, Michael; Milross, Chris; Boyer, Michael; Clark, Jonathan R
The purpose of this study was for us to present our findings on the prospectively audited impact of head and neck multidisciplinary team meetings on patient management. We collected clinical data, the pre-multidisciplinary team meeting treatment plan, the post-multidisciplinary team meeting treatment plans, and follow-up data from all patients discussed at a weekly multidisciplinary team meeting and we recorded the changes in management. One hundred seventy-two patients were discussed in 39 meetings. In 52 patients (30%), changes in management were documented of which 20 (67%) were major. Changes were statistically more likely when the referring physician was a medical or radiation oncologist, when the initial treatment plan did not include surgery, and when the histology was neither mucosal squamous cell cancer nor a skin malignancy. Compliance to the multidisciplinary team meeting treatment recommendation was 84% for all patients and 70% for patients with changes in their treatment recommendation. Head and neck multidisciplinary team meetings changed management in almost a third of the cases. © 2014 Wiley Periodicals, Inc.
Koning, L. de; Kuijt-Evers, L.; Theunissen, N.; Rijk, R. van; Huis in 't Veld, M.
When a crisis occurs, people from different organizations, on different hierarchical levels have to deal with unexpected situations that require coordinated effort. The goal of this research is to improve multidisciplinary cooperation for crisis management teams. We developed a tool, the Multi-mono
van der Vegt, G.S.; Bunderson, S.; Kuipers, B.
This study considers how turnover in self-managing work teams influences the team interaction processes that promote effective task accomplishment. Drawing from research on self-managing work teams and group process, the authors propose that team turnover affects performance in self-managing teams
Juan A. Marin-Garcia
Full Text Available Human Resource Management relevance in Knowledge Management has been studied in academic literature mostly from the point of view of recruitment, selection, wages and salaries and career development processes. We have found few publications that are focused in the behaviour of the group of people who generate, share and transfer that knowledge while working in a team. The aim of this paper is to propose a framework that describes the relation between knowledge management and team work,, integrating Nonaka and Takeuchi, Leonard- Barton and Heisig framework proposals, as well as to outline some reflexions for further researches.
Building Team Spirit in Organization Management Through a System Approach. ... able to function and attain a dynamic equilibrium for desired level of maximum productivity. It thus helps the manager to pull the various components of the organization together with the awareness, desire and commitment for a common goal.
Sloman, M; Asmare, E; Gopalan, A; Lupu, E; Dulay, N
Unmanned Autonomous Vehicles (UAVs) are increasingly deployed for missions that are deemed dangerous or impractical to perform by humans in many military and disaster scenarios. Collaborating UAVs in a team form a Self- Managed Cell (SMC) with at least one commander. UAVs in an SMC may need to operate independently or in sub- groups, out of contact with the commander and the rest of the team in order to perform specific tasks, but must still be able to eventually synchronise state information...
Hansen, Anders Peder Lysholm
This paper presents a systematic literature review of scientific papers on cross-functional sourcing teams in top journals within Purchasing and Supply Management. The review identifies four common research topics within the field; Determining factors of sourcing team success, Performance...... management/goals of sourcing teams, Behavior and decisions in sourcing teams and Involvement of purchasing in sourcing teams. Further research on Performance Management and how to create a holistic, teams based perspective in cross-functional sourcing teams is suggested....
Eisenhardt, K M; Kahwajy, J L; Bourgeois, L J
Top-level managers know that conflict over issues is natural and even necessary. Management teams that challenge one another's thinking develop a more complete understanding of their choices, create a richer range of options, and make better decisions. But the challenge--familiar to anyone who has ever been part of a management team--is to keep constructive conflict over issues from degenerating into interpersonal conflict. From their research on the interplay of conflict, politics, and speed in the decision--making process of management teams, the authors have distilled a set of six tactics characteristic of high-performing teams: They work with more, rather than less, information. They develop multiple alternatives to enrich debate. The establish common goals. They make an effort to inject humor into the workplace. They maintain a balanced corporate power structure. They resolve issues without forcing a consensus. These tactics work because they keep conflict focused on issues; foster collaborative, rather than competitive, relations among team members; and create a sense of fairness in the decision-making process. Without conflict, groups lose their effectiveness. Managers often become withdrawn and only superficially harmonious. The alternative to conflict is not usually agreement but rather apathy and disengagement, which open the doors to a primary cause of major corporate debacles: groupthink.
Singer, Sara J; Hayes, Jennifer; Cooper, Jeffrey B; Vogt, Jay W; Sales, Michael; Aristidou, Angela; Gray, Garry C; Kiang, Mathew V; Meyer, Gregg S
Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety. The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training. Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity. Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas. Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.
The role of UX manager is of vital importance -- it means leading a productive team, influencing businesses to adopt user-centered design, and delivering valuable products customers. Few UX professionals who find themselves in management positions have formal training in management. More often than not they are promoted to a management position after having proven themselves as an effective and successful practitioner.Yet as important as the position of manager is to the advancement of the field there are no books that specifically address the needs of user experience managers. Though informat
Purpose: Although conflict has traditionally been considered destructive, recent studies have indicated that conflict management can contribute to effective teamwork. The present study explores conflict management as a team phenomenon in schools. The author examined how the contextual variables (task interdependence, goal interdependence) are…
Full Text Available This paper focuses on a longitudinal approach in exploring leadership in Self-Managed Project Teams (SMPT. SMPT has been known to contribute to organizations by improving productivity and increasing organizational performance. Therefore, understanding the dynamics of leadership in this type of team can be seen as one of the important factors to ensure the success of organizations. Leading a team which manages itself is a challenge as increased autonomy and control is given to the team which eliminates the existence of a leader. It is important to understand the extent of how the external leader is involved within SMPT and whether the external leader approaches highlighted in the literature are applicable in such a situation and how these approaches change during work processes. This study comprises of evidence collected through semi-structured interviews in two small and medium sized organizations in Malaysia. Weekly telephone interviews as well as face-to-face interviews were conducted which provides contextual data for the research. In this research, the evidence suggested that SMPT transform from self-managed toward leader-managed resulting from several factors, such as conflict handling strategies. Specifically, it was found that avoiding conflicts, rather than confronting, transform the team into being leader dependent.
van de Ven, Joost; van Deursen, Frank J H M; van Runnard Heimel, Pieter J; Mol, Ben Willem J; Oei, S Guid
To evaluate the effectiveness of simulation team training for the management of shoulder dystocia. Primary outcome measures were the number of reported cases of shoulder dystocia, as well as fetal injury that occurred from it. Secondary outcome is documentation of manoeuvres used to alleviate shoulder dystocia. Retrospective cohort study in a teaching hospital in the Netherlands, in a 38 month period before and after implementation of team training. We compared 3492 term vaginal cephalic deliveries with 3496 deliveries before and after team training. Incidence of shoulder dystocia increased from 51 to 90 cases (RR 1.8 (95% CI: 1.3-2.5)). Fetal injury occurred in 16 and eight cases, respectively (RR 0.50 (95% CI: 0.21-1.2)). Before team training started, the all-fours manoeuvre was never used, while after team training it was used in 41 of 90 cases (45%). Proper documentation of all manoeuvres used to alleviate shoulder dystocia significantly increased after team training (RR 1.6 (95% CI: 1.05-2.5)). Simulation team training increased the frequency of shoulder dystocia, facilitated implementation of the all-fours technique, improved documentation of delivery notes and may have a beneficial effect on the number of children injured due to shoulder dystocia.
Joy Elly Tulung
Full Text Available Based on ”upper echelons theory”, this paper investigates the relation between top management team composition and BPD performance. For top management team characteristics, we employ age, level of education, background of education, gender, and functional background, while for measured the BPD performance we employ return on asset (ROA, return on equity (ROE, capital adequacy ratio (CAR, net interest margin (NIM, loan to deposit ratio (LDR, non-performing loan (NPL and operation expenses to operation income (BOPO. The results show that all characteristics have positive significant influences on BPD performance.
To analyze the relationship between the characteristics of top management teams and the different use of management information and control systems (MICS) to implement policies that encourage cooperation and activity coordination in public hospitals. Data were collected through a questionnaire sent to each member of the top management teams of 231 Spanish public hospitals (chief executive director, medical director, nursing director and director for financial and social issues). A total of 457 valid questionnaires were returned, composing 86 full top management teams (37.23%). Top management team diversity was positively related to the interactive use of MICS. Management teams composed of younger members and members with longer service used MICS interactively. Top management teams with a predominantly clinical education and experience used MICS interactively, while top teams with a predominantly administrative education and experience used MICS diagnostically. The results also showed that cooperation and coordination in hospitals were positively related to the interactive use of MICS and were negatively related to the diagnostic use of MICS. The interactive use of MICS is an important mediator in the relationship between top team diversity and policies focused on hospital decentralization. Top management teams with diverse characteristics (e.g. age, length of service, education and experience) use management information interactively to enhance activity coordination and resource allocation in hospitals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
Palilingan, V. R.; Batmetan, J. R.
Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.
At the request of the NASA Administrator a team was formed to review the Space Shuttle Program and propose a new management system that could significantly reduce operating costs. Composed of a group of people with broad and extensive experience in spaceflight and related areas, the team received briefings from the NASA organizations and most of the supporting contractors involved in the Shuttle Program. In addition, a number of chief executives from the supporting contractors provided advice and suggestions. The team found that the present management system has functioned reasonably well despite its diffuse structure. The team also determined that the shuttle has become a mature and reliable system, and--in terms of a manned rocket-propelled space launch system--is about as safe as today's technology will provide. In addition, NASA has reduced shuttle operating costs by about 25 percent over the past 3 years. The program, however, remains in a quasi-development mode and yearly costs remain higher than required. Given the current NASA-contractor structure and incentives, it is difficult to establish cost reduction as a primary goal and implement changes to achieve efficiencies. As a result, the team sought to create a management structure and associated environment that enables and motivates the Program to further reduce operational costs. Accordingly, the review team concluded that the NASA Space Shuttle Program should (1) establish a clear set of program goals, placing a greater emphasis on cost-efficient operations and user-friendly payload integration; (2) redefine the management structure, separating development and operations and disengaging NASA from the daily operation of the space shuttle; and (3) provide the necessary environment and conditions within the program to pursue these goals.
Hosokawa, Yuri; Adams, William M; Belval, Luke N; Davis, Robert J; Huggins, Robert A; Jardine, John F; Katch, Rachel K; Stearns, Rebecca L; Casa, Douglas J
To investigate the influence of estimated wet bulb globe temperature (WBGT) and the International Institute of Race Medicine (IIRM) activity modification guidelines on the incidence of exertional heat stroke (EHS) and heat exhaustion (HEx) and the ability of an on-site medical team to treat those afflicted. Medical records of EHS and HEx patients over a 17-year period from the New Balance Falmouth Road Race were examined. Climatologic data from nearby weather stations were obtained to calculate WBGT with the Australian Bureau of Meteorology (WBGT A ) and Liljegren (WBGT L ) models. Incidence rate (IR) of EHS, HEx, and combined total of EHS and HEx (COM) were calculated, and linear regression analyses were performed to assess the relationship between IR and WBGT A or WBGT L . One-way ANOVA was performed to compare differences in EHS, HEx, and COM incidence to four alert levels in the IIRM guidelines. Incidence of EHS, HEx, and COM was 2.12, 0.98, and 3.10 cases per 1000 finishers. WBGT A explained 48, 4, and 46% of the variance in EHS, HEx, and COM IR; WBGT L explained 63, 13, and 69% of the variance in EHS, HEx, and COM IR. Main effect of WBGT A and WBGT L on the alert levels were observed in EHS and COM IR (p < 0.05). The cumulative number of EHS patients treated did not exceed the number of cold water immersion tubs available to treat them. EHS IR increased as WBGT and IIRM alert level increased, indicating the need for appropriate risk mitigation strategies and on-site medical treatment.
Hosokawa, Yuri; Adams, William M.; Belval, Luke N.; Davis, Robert J.; Huggins, Robert A.; Jardine, John F.; Katch, Rachel K.; Stearns, Rebecca L.; Casa, Douglas J.
To investigate the influence of estimated wet bulb globe temperature (WBGT) and the International Institute of Race Medicine (IIRM) activity modification guidelines on the incidence of exertional heat stroke (EHS) and heat exhaustion (HEx) and the ability of an on-site medical team to treat those afflicted. Medical records of EHS and HEx patients over a 17-year period from the New Balance Falmouth Road Race were examined. Climatologic data from nearby weather stations were obtained to calculate WBGT with the Australian Bureau of Meteorology (WBGTA) and Liljegren (WBGTL) models. Incidence rate (IR) of EHS, HEx, and combined total of EHS and HEx (COM) were calculated, and linear regression analyses were performed to assess the relationship between IR and WBGTA or WBGTL. One-way ANOVA was performed to compare differences in EHS, HEx, and COM incidence to four alert levels in the IIRM guidelines. Incidence of EHS, HEx, and COM was 2.12, 0.98, and 3.10 cases per 1000 finishers. WBGTA explained 48, 4, and 46% of the variance in EHS, HEx, and COM IR; WBGTL explained 63, 13, and 69% of the variance in EHS, HEx, and COM IR. Main effect of WBGTA and WBGTL on the alert levels were observed in EHS and COM IR (p < 0.05). The cumulative number of EHS patients treated did not exceed the number of cold water immersion tubs available to treat them. EHS IR increased as WBGT and IIRM alert level increased, indicating the need for appropriate risk mitigation strategies and on-site medical treatment.
The Role of Council Health Management Team in the Improvement of Health Services Quality: The Case of Kinondoni and Ilala Municipalities in Dar es ... poor working equipment, lack of commitment on the part of members of the CHMT, lack of effective CHMTs' supervision, as well as the lack of good networking and ...
Background: Multidisciplinary Team meetings (MDTs) in cancer management emphasize collaborative decision making and treatment planning among core members of the specialties relevant to an index case, who come together to share their knowledge and make recommendations for an 'all-inclusive' patient ...
Gilboa, Avi; Tal-Shmotkin, Malka
This article examines empirically and systematically whether a string quartet (SQ) ensemble is perceived as a self-managed team (SMT). SMTs, which were initially employed in the industrial world, are groups of employees that have a total responsibility for a defined project. The hypothesis that the SQ would exhibit more typical SMT characteristics…
Hansen, Anders Peder Lysholm
The purpose of this development paper is to outline the main ideas of a Ph.d.-project research proposal,which deals with the influence of Performance Management on the behaviour and decisions of Sourcing Category Team members. The background for the project is described, as well as the main theory...
Experience is a key shaper of thought and action in the health care workplace and a fundamental component of management and professional policies dealing with improving quality of care. Physicians rely on experience to structure social interaction, to determine authority relations, and to resist organizational encroachments on their work and autonomy. However, an overreliance on experience within physician teams may paradoxically undermine learning, participation, and entrepreneurship, affecting organizational performance. Approximately 100 hours of direct observation of normal workdays for physician teams (n = 17 physicians) in two different work settings in a single academic medical center located in the Northeastern part of the United States. Qualitative data were collected from physician teams in the medical intensive care unit and trauma/general surgery settings. Data were transcribed and computer analyzed through an interactive process of open coding, theoretical sampling, and pattern recognition that proceeded longitudinally. Three particular experience-based schemas were identified that physician teams used to structure social relations and perform work. These schemas involved using experience as a commodity, trump card, and liberator. Each of these schemas consisted of strongly held norms, beliefs, and values that produced team dynamics with the potential for undermining learning, participation, and entrepreneurship in the group. Organizations may move to mitigate the negative impact of an overreliance on experience among physicians by promoting bureaucratic forms of control that enable physicians to engage learning, participation, and entrepreneurship in their work while not usurping existing and difficult-to-change cultural drivers of team behavior.
Holloway, Stacie; Lord, Katharine; Bethelmie-Bryan, Beverly; Shepard, Marian W; Neely, Jessica; McLemore, Morgan; Reddy, Satyanarayan K; Montero, Aldemar; Jonas, William S; Gladney, Sara Pierson; Khanwani, Shyam L; Reddy, Silpa C; Lahiry, Anup K; Heffner, Leonard T; Winton, Elliott; Arellano, Martha; Khoury, Hanna Jean
Treatment of chronic myeloid leukemia (CML) has seen dramatic progress in recent years with the development of tyrosine kinase inhibitors (TKIs). To take maximum advantage of therapy with TKIs, compliance and good understanding of monitoring response to therapy are essential. We established a team that included a hematologist, a physician assistant (PA), and a nurse who work closely with a social worker, a pharmacist, and a research coordinator to assist patients throughout their journey with CML. The patient and the referring community oncologist were incorporated into this team. This coordinated team care approach takes advantage of each member's specific skills to provide patients with education about CML, encourage patients' strong involvement in tracking/monitoring results/response to therapy, and support patients with issues that arise throughout the long course of the disease. A low rate of noncompliance with clinic visits (3%) was an indirect measure of the impact of this approach. The inclusion of the referring oncologist in the team extended the tracking of monitoring results to the community practice. We conclude that a coordinated team care approach is feasible in the management of patients with CML. This approach provided patients with education and a good understanding of response to therapy and improved relations with the health care team. Copyright Â© 2012 Elsevier Inc. All rights reserved.
... 7 Agriculture 15 2010-01-01 2010-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
The present study purpose was to investigate the unique role and activities of school principals in managing their senior management team (SMT) boundaries. The study examined how school principals' internal and external activities mediate the relationship of principals' personal factors from the Big Five typology, the team and contextual…
Ma, Maggie Jiao
Full Text Available This Crew Resource Management (CRM video storytelling project asks students to work in a team (4-5 people per team to create (write and produce a video story. The story should demonstrate lacking and ill practices of CRM knowledge and skills, or positive skills used to create a successful scenario in aviation (e. g. , flight training, commercial aviation, airport management. The activity is composed of two parts: (1 creating a video story of CRM in aviation, and (2 delivering a group presentation. Each tem creates a 5-8 minute long video clip of its story. The story must be originally created by the team to educate pilot and/or aviation management students on good practices of CRM in aviation. Accidents and incidents can be used as a reference to inspire ideas. However, this project is not to re-create any previous CRM accidents/incidents. The video story needs to be self-contained and address two or more aspects of CRM specified in the Federal Aviation Administration’s Advisory Circular 120-51. The presentation must include the use of PowerPoint or similar software and additional multimedia visual aids. The presentation itself will last no more than 17 minutes in length; including the actual video story (each group has additional 3 minutes to set up prior to the presentation. During the presentation following the video each team will discuss the CRM problems (or invite audience to identify CRM problems and explain what CRM practices were performed, and should have been performed. This presentation also should describe how each team worked together in order to complete this project (i. e. , good and bad CRM practiced
Eseryel, U. Yeliz; Eseryel, Deniz
While software development teams are becoming more and more distributed around the globe, most software development methodologies used by global teams prescribe self-managing teams. Transformational leadership is the key to successful information systems development and use for competitive
Lecturer Ph. D. Niculina Vargolici
Full Text Available The new economic context, marked by the crisis and by radical transformations of the labor market, generates the need for more and more sophisticated skills for the assistant manager. That is because the efficiency of the secretarial activity implies both strategic skills and complex abilities, starting from knowledge about the specific activity of the company/institution where the person works as assistant manager, to connected areas such as: management, marketing, human resources, brand communication, company’s culture etc. Whether the manager changes his job together with the “boss”, or the boss is changed and he is bond to adapt to new conditions, a strong team spirit between the manager and his assistant is one of the most important elements that contribute to the productivity and efficiency of the both. The loyalty to the boss and to the company where he works, his adaptation capacity, his competence and his professionalism make the today’s assistant manager a key factor of the managerial team. The essence of the assistant manager job consists in making more efficient the managerial activities, namely, to make it respond to the expectations expressed or not of the manager, or even to anticipate them.
Bird, P.; Keller, P.; Manning, P.; Nolan, M.; Ricci, A.; Turnbull, F.; Varadinek, H.
Report of the Material Management Sustainable Energy Development (SED) Team was presented, outlining strategic directions and initiative for embedding SED principles in the materials management function. Six principles underlying SED were prescribed, accompanied by a framework for analysis. Excerpts from position papers used in the formulation of SED recommendations and initiatives were provided. The general theme of the recommendations was: (1) materials management activities should be review to ensure consistency with SED, (2) strategic alliances should be developed where appropriate and (3) staff in the Fossil Business Unit should promote SED among industry suppliers
Mallo Sainz, Javier; González Frutos, Pablo; Veiga Fernandez, Santiago; Navarro Cabello, Enrique
The aim of this study was to investigate the injury incidence and injury characteristics of a Spanish sub-elite professional football team during four consecutive seasons. A team was followed prospectively from the season 2003-2004 to 2006-2007 and individual player exposure and time loss injuries were recorded during all club training sessions and matches. A total of 313 time-loss injuries were recorded. The mean injury incidence was 10.9 injuries/1000 hours (5.2 injuries/1000 training hours...
Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.
ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...
Full Text Available One of the major issues occurring in every contemporary organization is the issue of the efficiency of work and obtaining maximum results from work done. Most often when the issue of increasing the efficiency of work is laid the question of teams and teamwork in various projectя of the company comes to the foreground and frequently no proper differentiation is made between a “group of people” and a “team” and this brings to a large number of misunderstandings of managers and employees with regard to the designation and benefits of team organization of work. There are clear traceable differences between the perception of the concept of “team” and the implementation of teamwork by European and Bulgarian companies and it is good to make the differentiation between them with a view to the HR management.
Hsiang-Tsai Chiang; Mei-Chih Lin
The paper examines cognition from the viewpoint of internal management teams of private universities against satisfaction with school performance, applying the SEM model. Empirical results show that the boardâ€™s operational effectiveness and attendance rate for internal important meetings held on campus have a significantly positive relationship with implementing effectiveness and satisfaction with school administrative performance. The satisfaction with school administrative performance and...
Nielsen, Bo Bernhard; Nielsen, Sabina
This research reexamines the equivocal relationship between top management team (TMT) diversity and firm performance. Combining upper echelons theory with insights from institutional theory, we establish a new, timely dimension of TMT diversity—nationality diversity—and develop an integrated...... generally, our research demonstrates that the consequences of TMT diversity depend on the (1) specific attributes of diversity being considered and (2) firm and industry conditions under which strategic decisions take place....
Faisal R. Ali
Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.
Team management in the 21 st century: A human relations theory angle. ... a team is about understanding human relation, that is, the manager understanding the ... The problem ranges from membership isolation to lack of communication and ...
Kaplan, Robert E.; And Others
Although simulation is among the least common of the many methods consultants employ to stimulate team development, realistic simulation can help in the diagnosis of management teams. Simulations fill a gap in the repertoire of data collection methods for organizational diagnosis and development by affording an opportunity for direct observation…
Alexandra, Meggie; Theola, Devina
Tujuan dari penelitian ini adalah untuk mengetahui apakah Empowering Empowering Leadership berpengaruh atau tidak terhadap Team Performance Management dengan Team Cohesion sebagai variabel intervening di restoran Hachi-Hachi Surabaya. Teknik analisa yang digunakan dalam penelitian ini adalah analisa statistik deskriptif dan analisa Structural Equation Modeling (SEM) dengan alat penelitian berupa Partial Least Square (PLS). Hasil penelitian menunjukkan bahwa Empowering Leadership berpengaruh t...
Doman, Marguerite; Besmer, Andrew; Olsen, Anne
In this article, we discuss the use of Pellerin's Four Dimension Leadership System (4-D) as a way to manage teams in a classroom setting. Over a 5-year period, we used a modified version of the 4-D model to manage teams within a senior level Software Engineering capstone course. We found that this approach for team management in a classroom…
Scott-Ladd, Brenda; Chan, Christopher C. A.
This article reports on a study investigating strategies that students can use to develop skills in managing team learning. Two groups of second-year management students participated in a semester-long action research project over two semesters. The students were educated on team development, team processes and conflict management and how to…
G. Troilo; P. Guenzi
Sales organizations are increasing their use of sales teams, but team selling is an under- researched area. In this perspective, the role of sales teams’ leaders deserves special attention. Sales teams have many characteristics in common with sport teams. Hence, sales managers often look to sport for inspirational examples and useful models of teamwork. Based on interviews with 31 coaches of professional sport teams, we developed a conceptual model providing sales managers with some useful le...
Boone, Christophe; Wezel, Filippo C.; van Witteloostuijn, Arjen; Baum, JAC; Dobrev, SD; VanWitteloostuijn, A
The "upper echelon" literature has mainly produced static empirical studies on the impact of top management team composition on organizational outcomes, ignoring the dynamics of industrial demography. Organizational ecology explicitly studied the dynamics of organizational diversity at the
Coetzee, Susanna Catherina
Changes in South Africa's political and economic sphere demand the democratisation of the workplace, participation and empowerment of the work force. Flatter hierarchical structures, as a result of downsizing, enhance involvement but also demand that workers function in a more autonomous manner. The use of self-managing work teams has increased in response to these competitive challenges. Self-managing work teams are groups of employees who are fully responsible for a well-d...
Драч, Ірина Іванівна
The article described the specific features that define the independent status of the competence-based management training of future specialists in the management of educational activities. The use of principles of team in the implementation of a new management paradigm is justified. The advantages of using a matrix organizational structure are characterized
The use of paralytic medications in the performance of RSI intubation is a high risk intervention used by many HEMS crews. There is no margin for error in RSI intubation as the results can be fatal. Operating room access for airway management training has become more difficult, and is not representative of the environment in which HEMS crews typically function. LifeEvac of Virginia designed and implemented an SST airway management program to provide a realistic, consistent training platform. The dynamic program incorporates standardized scenarios, and real life challenging cases that this and other programs have encountered. SST is done in a variety of settings including the helicopter, back of ambulances, staged car crashes and simulation centers. The result has been the indoctrination of a well defined, consistent approach to every airway management intervention. The SST program facillitates enhancement of technical skills. as well as team dynamics and communication.
Stanger, Michael A.
The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...
This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...
UTPS-type models were designed to adequately support planning activities typical of the 1960s and 1970s. However, these packages were not designed to model intelligent transportation systems (ITS) and support incident management planning. To ov...
Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark
.... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...
Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine
To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Integrative literature review. CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. © 2016 John Wiley & Sons Ltd.
Full Text Available When exposed to the theoretic leadership concepts, it is rather rare that managers - either already acting or pursuing this role – don’t identify themselves as leaders. A leader is a person who motivates , supports and listens. To be a leader means to mobilize human resources , to establish a direction emerged from a personal vision on the evolution of things, to have the power to transform this vision into reality. And yet, real leaders are far more rare than most managers are ready to admit. Both have their added value within an organization and in practice it’s rather challenging to see things moving ahead without having both roles pulling together. So far, a leader's skills are necessary to deal with the ambiguities and uncertainties with which they are accustomed. Another aspect is the strategic positioning in case of conflict . This paper aims to identify the influences of a leader in team building.
Full Text Available Most children in hospital have pain. Seeing your child in pain or discomfort is incredibly difficult. Pain in children is a public health concern of major significance in most parts of the world. We have learned that unrelieved pain causes the body to release certain chemicals that may actually delay healing, so it's important to work with child's nurses and doctors to help children for control the pain. On the other side, medication is not the only way to relieve pain. Pain in children should always be managed and pain expression is dependent on the child’s age, cognitive development, and socio cultural context and it is important to pay particular attention to developmental variations in any behavioural manifestations of pain. In this study to explain some ways for parents and healthcare team to manage pain in children.
Fresco, A.; Gunther, W.
A nuclear power plant's maintenance program is the principal vehicle through which age-related degradation is managed. Over the past two years, the NRC [Nuclear Regulatory Commission] has evaluated the maintenance program of every nuclear power plant in the U.S. The reports issued on these in-depth team inspections have been reviewed to ascertain the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear power plant systems, structures, and components. Selected results of this review are presented in this paper, including examples of inspection and monitoring techniques successfully used by utilities to detect degradation due to aging. Attributes of plant maintenance programs where the NRC inspectors felt that improvement was needed to properly address the aging issue are also discussed. 6 refs., 1 tab
Mallo, Javier; González, Pablo; Veiga, Santiago; Navarro, Enrique
The aim of this study was to investigate the injury incidence and injury characteristics of a Spanish sub-elite professional football team during four consecutive seasons. A team was followed prospectively from the season 2003-2004 to 2006-2007 and individual player exposure and time loss injuries were recorded during all club training sessions and matches. A total of 313 time-loss injuries were recorded. The mean injury incidence was 10.9 injuries/1000 hours (5.2 injuries/1000 training hours and 44.1 injuries/1000 match hours). The injury incidence during competitive matches was higher (p 28 days absence) was 0.4 injuries/1000 hours. The thigh was the most commonly (35%) injured region and caused 29% of all competitive match absence. Muscle injuries in the four main groups of the lower limbs (hamstrings, adductors, quadriceps and calf muscles) caused 43% of competitive match unavailability. The results of this study show that the risk to sustain a major injury in the course of the season was low for sub- elite footballers in comparison to elite players. Thigh strains were the first cause of absence in competition due to injury. Key points The incidence of major injuries (absence greater than 4 weeks) was lower in a Spanish sub-elite football team than in elite European teams. The risk of sustaining an injury was 2.5 fold higher (p < 0.001) in official than in friendly matches. Lower limb muscular (hamstrings, quadriceps, hip adductors and calf muscles) and joint (knee and ankle) injuries were the main causes of match unavailability. PMID:24149566
Full Text Available The growing emphasis on off-site and off-shore clinical data management activities mandates a paramount need for adequate solutions geared toward on-time, quality deliverables. The author has been leading large teams that have been involved in successful global clinical data management endeavors. While each study scenario is unique and has to be approached as such, there are several elements in defining strategy and team structure in global clinical data management that can be applied universally. In this article, key roles, practices, and high-level procedures are laid out as a road map to ensure success with the model.
After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident
Smets, L.P.M.; Langerak, F.; Tatikonda, M.V.
Successful collaboration between new product development (NPD) teams maintained by competitors (so-called horizontal NPD collaboration) requires the use of formal modes of management control that simultaneously coordinate the teams' interdependent development activities and encourage their
Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...
Mitchell, Rebecca; Boyle, Brendan; Parker, Vicki; Giles, Michelle; Chiang, Vico; Joyce, Pauline
While there is increasing pressure to work collaboratively in interprofessional teams, health professionals often continue to operate in uni-professional silos. Leader inclusiveness is directed toward encouraging and valuing the different viewpoints of diverse members within team interactions, and has significant potential to overcome barriers to interprofessional team performance. In order to better understand the influence of leader inclusiveness, we develop and investigate a model of its e...
Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex
To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright Â© 2016 Elsevier España, S.L.U. All rights reserved.
Kuziemsky, Craig E; Yazdi, Sara
Numerous studies and strategic plans are advocating more team based healthcare delivery that is facilitated by information and communication technologies (ICTs). However before we can design ICTs to support teams we need a solid conceptual model of team processes and a methodology for using such a model in healthcare settings. This paper draws upon success in the supply chain management domain to develop a reference ontology of healthcare teams and a methodology for modeling teams to instantiate the ontology in specific settings. This research can help us understand how teams function and how we can design ICTs to support teams.
Full Text Available Various phenomena generated by the new context of globalization have focused our research interest towards studying in what ways management of Intercultural Work teams (IWT could and should contribute to the increase of their performance at work. Despite the recognition of the fact that many MNCs fail in the management of IWTs, there is still a significant knowledge gap about their non-functionalities. Managerial literature „blames” national and organizational culture differences for the failure of this process. This is because each member brings his own style of work, with his own way of ensuring effective cooperation, making difficult to identify a clear recipe of a team organization and management in intercultural context. Teamwork, managing work teams made the subject of numerous researchers from many fields, denoting so difficult exercise in practice. However, we have identified high performance IWTs whose members are from different countries. Therefore, we assume that their management identified and used methods and instruments able to ensuring IWT performance. If we look at international research, intercultural teams management models have a reductionist and not holistic approach, namely stochastic in terms of selection of specific cultural dimensions cultural models specific to the interest of the researcher. In contrast, in Romania, intercultural management and intercultural management teams performance is less studied. The research presented below is set up to be a part of a pilot study, an exploratory research of how intercultural management assigned dimensions are directly related to the concept of EIA performance dimensions assigned. Our assumption for the empirical research is the following: work team performance (effective, efficient, with a high degree of satisfaction of its members is the result of application performance management in the context of a particular style of interaction specific team. Because the dependent
Heale, Roberta; Dickieson, Patti; Carter, Lorraine; Wenghofer, Elizabeth F
To determine the perceptions of nurse practitioners (NPs) about the level of functioning of their interprofessional teams. Interprofessional teams are a global trend, and nurses play leadership roles in their management. Little is known about the impact of specific barriers to team functioning and the role of the nurse manager on team functioning. Ninety-eight NPs at a conference completed the Interprofessional Team Functioning Survey (ITFS). The survey items with the lowest mean scores were related to organisational systems. These items included workplace policies that support interprofessional teamwork, in particular, orientation to the interprofessional team. Items that generated lower mean scores were adequate time to work as a member of the interprofessional team, team dynamics, collaboration among team members and the sharing of responsibility. Organisational and team relational issues can be addressed through organisational management strategies. Nurse managers have an important role in facilitating high functioning interprofessional teams. Strategies for managers to support interprofessional team functioning emerged. These strategies include ensuring that there are appropriate policies, orientation of new members, allocation of time to support interprofessional teamwork, leadership to enhance team collaboration and clear delineation of responsibilities of each member. © 2013 John Wiley & Sons Ltd.
Biraud, S.; Chan, S.; Dengel, S.; Polonik, P.; Hanson, C. V.; Billesbach, D. P.; Torn, M. S.
The goal of AmeriFlux is to develop a network of long-term flux sites for quantifying and understanding the role of the terrestrial biosphere in global climate and environmental change. The AmeriFlux Management Program (AMP) Tech Team at LBNL strengthens the AmeriFlux Network by (1) standardizing operational practices, (2) developing calibration and maintenance routines, and (3) setting clear data quality goals. In this poster we will present results and recent progress in three areas: IRGA intercomparison experiment in cooperation with UC Davis, and main manufacturers of sensors used in the AmeriFlux network (LI-COR, Picarro, and Campbell Scientific). Gill sonic anemometers characterization in collaboration with John Frank and Bill Massman (US Forest Service) following the discovery of a significant firmware problem in commonly used Gill Sonic anemometer, Unmanned aerial systems (UAS), and sensors systematically used at AmeriFlux sites to improve site characterization.
Rocha, Hermano Alexandre Lima; Santos, Ana Kelly Lima da Cruz; Alcântara, Antônia Celia de Castro; Lima, Carmen Sulinete Suliano da Costa; Rocha, Sabrina Gabriele Maia Oliveira; Cardoso, Roberto Melo; Cremonin, Jair Rodrigues
To measure the effectiveness of the bed management process that uses a web-based application with Kanban methodology to reduce hospitalization time of hospitalized patients. Before-after study was performed. The study was conducted between July 2013 and July 2017, at the Unimed Regional Hospital of Fortaleza, which has 300 beds, of which 60 are in the intensive care unit (ICU). It is accredited by International Society for Quality in Healthcare. Patients hospitalized in the referred period. Bed management with an application that uses color logic to signal at which stage of high flow the patients meet, in which each patient is interpreted as a card of the classical Kanban theory. It has an automatic user signaling system for process movement, and a system for monitoring and analyzing discharge forecasts. Length of hospital stay, number of customer complaints related to bed availability. After the intervention, the hospital's overall hospital stay time was reduced from 5.6 days to 4.9 days (P = 0.001). The units with the greatest reduction were the ICUs, with reduction from 6.0 days to 2.0 (P = 0.001). The relative percentage of complaints regarding bed availability in the hospital fell from 27% to 0%. We conclude that the use of an electronic tool based on Kanban methodology and accessed via the web by a bed management team is effective in reducing patients' hospital stay time.
Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine; Hultin, Magnus
To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. An emergency room in an urban Scandinavian level one trauma centre. A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Otter, den, A.F.H.J.; Lima, C.P
In this paper the sharing of knowledge in architectural design teams using a Project Website is discussed. The results of multiple case studies, being part of a recently finished PhD research project to communication and performance of design teams using a Project Website, show that systems for sharing of knowledge in such teams are hard to change and better systems are difficult to implement for various reasons. Sharing of knowledge in such teams is important for collective understanding of ...
de Dreu, C.K.W.; van Vianen, A.E.M.
Past research has revealed that team effectiveness and satisfaction suffer when teams experience relationship conflict - conflict related to interpersonal issues, political norms and values, and personal taste. This study examined how teams should respond to these conflicts. Three types of conflict
Shea, Timothy P.; Sherer, Pamela D.; Quilling, Rosemary D.; Blewett, Craig N.
Virtual teams are becoming commonplace in business today so our business school students should have experience in effectively working in virtual teams. Based on a month-long virtual team project conducted by the authors between classes in South Africa and the United States, this paper discusses the opportunities and challenges of using global…
Paperet diskutere selvstyrende teams på postsorterignscentre og pakkesorteringscentre i Post Danmark. De enkelte teams består både af en kernearbejdskraft, med særlige ansvarsopgaver. Typisk har de koordinatorfunktioner. Samtidig er der i hvert team en gruppe af midlertidig ansatte og deltidsansa...
Ananthakrishnan, R.; Foster, I.
Large and highly distributed climate data demands new approaches to data organization and lifecycle management. We need, in particular, catalogs that can allow researchers to track the location and properties of large numbers of data files, and management tools that can allow researchers to update data properties and organization during their research, move data among different locations, and invoke analysis computations on data--all as easily as if they were working with small numbers of files on their desktop computer. Both catalogs and management tools often need to be able to scale to extremely large quantities of data. When developing solutions to these problems, it is important to distinguish between the needs of (a) large communities, for whom the ability to organize published data is crucial (e.g., by implementing formal data publication processes, assigning DOIs, recording definitive metadata, providing for versioning), and (b) individual researchers and small teams, who are more frequently concerned with tracking the diverse data and computations involved in what highly dynamic and iterative research processes. Key requirements in the latter case include automated data registration and metadata extraction, ease of update, close-to-zero management overheads (e.g., no local software install); and flexible, user-managed sharing support, allowing read and write privileges within small groups. We describe here how new capabilities provided by the Globus Online system address the needs of the latter group of climate scientists, providing for the rapid creation and establishment of lightweight individual- or team-specific catalogs; the definition of logical groupings of data elements, called datasets; the evolution of catalogs, dataset definitions, and associated metadata over time, to track changes in data properties and organization as a result of research processes; and the manipulation of data referenced by catalog entries (e.g., replication of a dataset to
Clark, Brenda G.; Brown, Robert J.; Ploquin, Jodi L.; Kind, Anneke L.; Grimard, Laval
Purpose: To assess efficacy of an incident learning system in the management of error in radiation treatment. Materials and methods: We report an incident learning system implementation customized for radiation therapy where any 'unwanted or unexpected change from normal system behaviour that causes or has the potential to cause an adverse effect to persons or equipment' is reported, investigated and learned from. This system thus captures near-miss (potential) and actual events. Incidents are categorized according to severity, type and origin. Results: Our analysis spans a period of 3 years with an average accrual of 11.6 incidents per week. We found a significant reduction in actual incidents of 28% and 47% in the second and third year when compared to the first year (p < 0.001), which we attribute to the many interventions prompted by the analysis of incidents reported. We also saw a similar significant reduction in incidents generated at the treatment unit correlating with the introduction of direct treatment parameter transfer and electronic imaging (p < 0.001). Conclusions: Implementation of an incident learning system has helped us to establish a just environment where all staff members report deviations from normal system behaviour and thus generate evidence to initiate safety improvements.
Full Text Available The aim of this study was to investigate the injury incidence and injury characteristics of a Spanish sub-elite professional football team during four consecutive seasons. A team was followed prospectively from the season 2003-2004 to 2006-2007 and individual player exposure and time loss injuries were recorded during all club training sessions and matches. A total of 313 time-loss injuries were recorded. The mean injury incidence was 10.9 injuries/1000 hours (5.2 injuries/1000 training hours and 44.1 injuries/1000 match hours. The injury incidence during competitive matches was higher (p 28 days absence was 0.4 injuries/1000 hours. The thigh was the most commonly (35% injured region and caused 29% of all competitive match absence. Muscle injuries in the four main groups of the lower limbs (hamstrings, adductors, quadriceps and calf muscles caused 43% of competitive match unavailability. The results of this study show that the risk to sustain a major injury in the course of the season was low for sub- elite footballers in comparison to elite players. Thigh strains were the first cause of absence in competition due to injury.
Nijstad, B.A.; Berger-Selman, F.; de Dreu, C.K.W.
Research among lower level teams suggests that minority dissent stimulates team innovation. We consider the role of CEO transformational leadership in the dissent-innovation relation and study this in Top Management Teams (TMTs). We propose that transformational leaders create a psychologically safe
Nijstad, Bernard A.; Berger-Selman, Floor; De Dreu, Carsten K. W.
Research among lower level teams suggests that minority dissent stimulates team innovation. We consider the role of CEO transformational leadership in the dissent-innovation relation and study this in Top Management Teams (TMTs). We propose that transformational leaders create a psychologically safe
This study looks at how an information and communication technologies (ICT)-rich environment impacts team conflict and conflict management strategies. A case study research method was used. Three teams, part of a graduate class in instructional design, participated in the study. Data were collected through observations of team meetings, interviews…
Fincher, Mark; Katsinas, Stephen; Bush, V. Barbara
Many colleges and universities are expected to produce more graduates while responding to an increasing level of racial and ethnic diversity among students. While the importance of diversity within executive management leadership teams may be accepted among nonprofit higher education institutions, the connection between diversity among the…
Lagarde, Sjoerd M.; Omloo, Jikke M. T.; de Jong, Koen; Busch, Olivier R. C.; Obertop, Hugo; van Lanschot, J. Jan B.
BACKGROUND: Postoperative chyle leakage is a rare but well-recognized complication after esophageal surgery. The aim of this study was to identify its incidence and potentially predisposing factors and to assess the consequences and management. METHODS: A consecutive series of 536 patients who
Eggert, G M; Zimmer, J G; Hall, W J; Friedman, B
This randomized controlled study compared two types of case management for skilled nursing level patients living at home: the centralized individual model and the neighborhood team model. The team model differed from the individual model in that team case managers performed client assessments, care planning, some direct services, and reassessments; they also had much smaller caseloads and were assigned a specific catchment area. While patients in both groups incurred very high estimated healt...
Otter, den A.F.H.J.; Lima, C.P
In this paper the sharing of knowledge in architectural design teams using a Project Website is discussed. The results of multiple case studies, being part of a recently finished PhD research project to communication and performance of design teams using a Project Website, show that systems for
Laughridge, James F.
Within the dynamic globalized operating environment, organizations are increasingly relying on virtual teams to solve their most difficult problems, leverage their expertise and expand their presence. The use of virtual teams by organizations continues to increase greatly as the technologies supporting them evolve. Despite improvements in…
The recent increase in research collaboration creates the need to better understand the interaction between individual researchers and the collaborative team. The paper elaborates the conceptualisation of research teams as complex systems which emerge out of the local interactions of individual
Opstrup, Niels; Villadsen, Anders Ryom
in the top management teams of public organizations, and its relation to financial performance. Theory suggests that management diversity can be a positive asset for organizations. It may allow for the use of more diverse knowledge and human skill sets. The results of this study suggest that organizations......, however, may only be able to leverage these advantages if they have a supporting management structure. In a longitudinal study of top management teams in Danish municipalities, the study finds gender diversity in top management teams to be associated with higher financial performance, but only...
Most medical practice managers who take a new job will inherit an existing team. Those first few days on the job are critical because they can determine whether or not the new manager will succeed. This article provides a game plan for new medical practice managers so they get off on the right foot with their inherited teams. It suggests strategies for learning about the team's culture and for demonstrating visibly that there is a new manager in the job. It offers guidelines about introducing the new manager to the inherited team, discussing past experiences, and establishing new expectations. This article further provides practical tips for serving as a role model, gaining allies, and dealing with troublemakers quickly and effectively. It suggests strategies for speaking about the previous practice manager and for creating excitement with the inherited team. Finally, this article offers a set of 15 questions a new manager can ask members of the inherited team to get to know them, an additional 25-point team assessment instrument, and a step-by-step strategy for raising the bar for mediocre, lackluster, or dysfunctional inherited teams.
Tatyana Gennadevna Pronyushkina
Full Text Available This article discusses the management of production team, in particular the developed theoretical model of socio-psychological support work processes for management of production team. The author of the research are formulated the purpose and objectives of social-psychological work on management of the production team. Developed in the study a theoretical model aimed at determining the conditions and the identification of features of effective management of the enterprise taking into account the socio-psychological characteristics of its staff. Tasks include: definition of the main characteristics of the production team and their severity, the analysis of these characteristics and identifying opportunities for their transformation, development of recommendations for management of social-psychological work on effects on the characteristics of the collective enterprise.Practical study of the activities of a number of businesses have shown the need to improve socio-psychological support of management processes production team: introducing a social and psychological planning team and develop the practice of sociological research on the state of the team, to ensure the smoothing of relations between workers and management through periodic meetings, creations of conditions for feedback, maintaining healthy competition among team members.
Boone, C; Van Olffen, W; Van Witteloostuijn, A; De Brabander, B
We propose that executive team power strengthens a cycle of "homosocial reproduction" that is interrupted only when teams face such compelling needs for diversity as poor organizational performance, high corporate diversification, and tough market competition. Hypothesis tests in data from major
Wooten, Kevin C; Dann, Sara M; Finnerty, Celeste C; Kotarba, Joseph A
The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle.
Ruiz-Jiménez, Jenny María; Fuentes-Fuentes, María del Mar
The paper analyzes the influence of management capabilities on the innovation performance of technology-based SMEs and the role that gender diversity in the top management team plays in this relationship. We use a sample of 205 Spanish SMEs from technology sectors and a hierarchical regression analysis to test our hypotheses. The results confirm that management capabilities affect both product and process innovation positively. In addition, gender diversity in the top management team moderate...
Full Text Available The interactions between the project manager and team members may be affected by several variables, such as culture, leadership style of the project manager, and the complexity of the developed tasks. Focused in this context, the objective of this paper is to investigate and describe how the culture issue can affect the anagement of global project teams. It is a qualitative, descriptive study conducted in a large multinational company in the automotive sector. The results of this research show that cultural issues can influence both positively and negatively the management of project global teams and the managers of these projects have to deal with several management challenges that require the adoption of certain ways of dealing with culture impacts in managing their teams to minimize potential problems in this context.
Cooper, Lynne P.
This study was conducted to better understand how New Product Development (NPD) team members apply their experiences to meet the task needs of their project. Although "experience" is highly valued in team members, little research has looked specifically at experiences as a type of knowledge, and how this knowledge is used in work settings. This research evaluated nearly 200 instances where team members referenced past experiences during team meetings. During these experience exchanges, team members structured the sharing of their experiences to include three common elements: the source of the experience, the nature of the experience, and the degree of relevance to the current work of the team. The experiences fell into four categories: people (relationships), process, product, and politics. This paper describes how team members structured, applied, and integrated their individual experiences and presents the resulting implications for knowledge management systems that wish to exploit experience knowledge.
Liu, Feng-Chuan; Cheng, Kai-Lin; Chao, Minston; Tseng, Hsu-Min
This paper aims to provide empirical evidence concerning the impact of team climate on knowledge sharing behavior and the mediating effects of individuals' altruistic intentions in the context of healthcare settings. Questionnaire data were collected from 212 administrators employed at a medical center in Taiwan. Team climate was assessed by the Team Climate Inventory composed of four factors, participative safety, support for innovation, vision, and task orientation. The proposed hypotheses were tested using structural equation modeling. The influence of the team innovation climate on knowledge sharing behavior was evident. Furthermore, individuals' altruistic intentions played a full mediating role in the relationship between team innovation climate and knowledge sharing behavior. These results contribute to the field of the people-orientated perspective in knowledge management. The full mediating effect of employees' altruistic intentions provides healthcare team managers the direction to accelerate knowledge sharing behavior.
Milton, John G; Radunskaya, Ami E; Lee, Arthur H; de Pillis, Lisette G; Bartlett, Diana F
The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics background and an experimentally oriented biology student. The team mentors typically ranked the students' performance very good to excellent over a range of attributes that included creativity and ability to conduct independent research. However, the research teams experienced problems meeting prespecified deadlines due to poor time and project management skills. Because time and project management skills can be readily taught and moreover typically reflect good research practices, simple modifications should be made to undergraduate curricula so that the promise of initiatives, such as MATH-BIO 2010, can be implemented.
Management : A New Model for Customer - Supplier Relationships Ronald P. Higuera "Audrey J. Dorofee Julie A. Walker Ray C. Williams July 1994 ""•// 94...N/A N/A N/A 11. TITLE (Include Secuity Claaaificatioa) Team Risk Management : A New Model for Customer -Supplier Relationships 12. PERSONAL AUTHOR(S...by block number) FIELD GROUP SUB. GR. Customer - Supplier Relationships Risk Team Risk Management 19. ABSTRACT (cominus on = if necesaryd id’y by block
Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N
Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.
Almeida, Ana Carina M.; de Farias Junior, Ivaldir H.; de S. Carneiro, Pedro Jorge
The growing demand for qualified professionals is making software companies opt for distributed software development (DSD). At the project conception, communication and synchronization of information are critical factors for success. However problems such as time-zone difference between teams, culture, language and different development processes among sites could difficult the communication among teams. In this way, the main goal of this paper is to describe the solution adopted by a Brazilian team to improve communication in a multisite project environment. The purposed solution was based on the best practices described in the literature, and the communication plan was created based on the infrastructure needed by the project. The outcome of this work is to minimize the impact of communication issues in multisite projects, increasing productivity, good understanding and avoiding rework on code and document writing.
Doll, Dietrich; Kauf, Peter; Wieferich, Katharina; Schiffer, Ralf; Luedi, Markus M
Team performance has been studied extensively in the perioperative setting, but the managerial impact of interprofessional team performance remains unclear. We hypothesized that the interplay between anesthesiologists and surgeons would affect operating room turnaround times, and teams that worked together over time would become more efficient. We analyzed 13,632 surgical cases at our hospital that involved 64 surgeons and 48 anesthesiologists. We detrended and adjusted the data for potential confounders including age, American Society of Anesthesiologists physical status, and surgical list (scheduled cases of specific surgical specialties). The surgical lists were categorized as ear, nose, and throat surgery; trauma surgery; general surgery; and gynecology. We assessed the relationship between turnaround times and assignment of different anesthesiologists to specific surgeons using a Monte Carlo simulation. We found significant differences in team performances among the different surgical lists but no team learning. We constructed managerial decision tables for the assignment of anesthesiologists to specific surgeons at our hospital. We defined a decision algorithm based on these tables. Our analysis indicated that had this algorithm been used in staffing the operating room for the surgical cases represented in our data, median turnaround times would have a reduction potential of 6.8% (95% confidence interval 6.3% to 7.1%). A surgeon is usually predefined for scheduled surgeries (surgical list). Allocation of the right anesthesiologist to a list and to a surgeon can affect the team performance; thus, this assignment has managerial implications regarding the operating room efficiency affecting turnaround times and thus potentially overutilized time of a list at our hospital.
Loosemore, Michael; Lightfoot, Joseph; Palmer-Green, Deborah; Gatt, Ian; Bilzon, James; Beardsley, Chris
There has been no comprehensive injury report of elite-level amateur boxers in competition and training. We reviewed injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2009. Longitudinal, prospective injury surveillance over 5 years of the GB boxing squad from 2005 to 2009. 66 boxers passed through the squad. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training, and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 h. More injuries affected the hand than any other body location. This was the case overall, in training and competition individually, and for both new and recurrent injuries. More injuries occurred during training than during competition, and most injuries were new rather than recurrent. Total injury rate during competition was 828 per 1000 h and hand injury rate in competition was 302 injuries per 1000 h. Hand injury rate in competition was significantly higher than at the other locations. The incidence of concussion is comparatively low. Injury prevention should aim to protect the hands and wrists of elite amateur boxers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Full Text Available Purpose: Along with mutual funds’ scale and quantity expanding for our country, it is common for fund management companies hiring new managers or the original fund managers mobilizing from one to another. The high liquidity of fund managers makes different managers regroup to manage the funds that belong to the same fund management company in each fund year. The characteristics of these different management team will influence the fund performance, and also affect the earnings of the fund management company and portfolio investors. The purpose of this paper is as follows. First, evaluating the effect of management team characteristics on portfolio characteristics: risk, performance, and extremity. Second, testing the hypothesis that the ranking of mid-year performance have effect on investment style extremity and research what relationship exists between this phenomenon and management team characteristics in depth.Design/methodology/approach: On the analysis of the relationships between the management team characteristics and portfolio characteristics, a series of OLS regressions is run where the time series regression model (the factor model and cross-sectional regression are included based on using the STATA, EVIEWS and MATLAB. The validity and practicability of the model will be verified in the paper. All of the above are aimed at achieving portfolio optimization and realizing the maximization of the interests of fund management companies and investors.Findings: The main findings are as follows. Teams with more doctors or MBA (CPA and CFA hold more risky portfolios, while teams with long team tenure hold less. More members and large gender diversity have negative effect on performance, and the opposite is age diversity. Teams with more members and long tenure tend to hold less extreme style decisions, but age diversity is related to more. Besides, tournament hypothesis does exist in China investment funds industry especially when the
Joy Elly Tulung
Full Text Available Based on ”upper echelons theory”, this paper investigates the relation between top management team composition and BPD performance. For top management team characteristics, we employ age, level of education, background of education, gender, and functional background, while for measured the BPD performance we employ return on asset (ROA, return on equity (ROE, capital adequacy ratio (CAR, net interest margin (NIM, loan to deposit ratio (LDR, non-performing loan (NPL and operation expenses to operation income (BOPO. The results show that all characteristics have positive significant influences on BPD performance.Keywords: Top Management Team,BPD Performance, Upper Echelons Theory
Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio
To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.
Bar-El, Yaron; Tzafrir, Sara; Tzipori, Idan; Utitz, Liora; Halberthal, Michael; Beyar, Rafael; Reisner, Shimon
Mass casualty incidents are probably the greatest challenge to a hospital. When such an event occurs, hospitals are required to instantly switch from their routine activity to conditions of great uncertainty and confront needs that exceed resources. We describe an information system that was uniquely designed for managing mass casualty events. The web-based system is activated when a mass casualty event is declared; it displays relevant operating procedures, checklists, and a log book. The system automatically or semiautomatically initiates phone calls and public address announcements. It collects real-time data from computerized clinical and administrative systems in the hospital, and presents them to the managing team in a clear graphic display. It also generates periodic reports and summaries of available or scarce resources that are sent to predefined recipients. When the system was tested in a nationwide exercise, it proved to be an invaluable tool for informed decision making in demanding and overwhelming situations such as mass casualty events.
Choi, Youngsoo; Ro, Heejung
The development of positive attitudes in team-based work is important in management education. This study investigates hospitality students' attitudes toward group projects by examining instructional factors and team problems. Specifically, we examine how the students' perceptions of project appropriateness, instructors' support, and evaluation…
Van Der Voort, Geoffrey; Wood, Lesley
This article reports on a first cycle of a larger action research study conducted to determine how Circuit Teams could support School Management Teams of underperforming high schools towards whole-school development. Although it is a mandated requirement by the Department of Education, none of the four schools involved in the study had developed a…
Background: An interdisciplinary team approach concept has been proposed for management of oro.facial cleft in the last two decades. Our objective was to evaluate the practice of the team approach concept and practices of the specialists involved in oro.facial cleft care in Africa. Materials and Methods: A snapshot survey ...
Jong, de A.; Ruyter, de J.C.; Wetzels, M.G.M.
The increasing implementation of self-managing teams (SMTs) in service delivery suggests the importance of developing confidence beliefs about a team's collective competence. This research examined causality in the linkage between employee confidence beliefs and performance for boundary-spanning
Kuipers, B.J.; Stoker, J.I.
Several theories have been developed that prescribe the team development of self-managing work teams (SMWTs). Some of these have led to models with successive linear developmental phases. However, both the theory and the empirical data show little support for these models. Based on an extensive
Jong, de A.; Ruyter, de J.C.; Wetzels, M.G.M.
This paper proposes and tests a model of antecedents and consequences of group potency in self-managing teams in retail banking. Based on data collected from boundary-spanning service employees organized in 60 teams and their customers, our findings reveal a significant positive impact of group
House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.
The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms
House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))
The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.
van Knippenberg, D.; Dawson, J.F.; West, M.A.; Homan, A.C.
Faultline theory suggests that negative effects of team diversity are better understood by considering the influence of different dimensions of diversity in conjunction, rather than for each dimension separately. We develop and extend the social categorization analysis that lies at the heart of
Richard Alynn Henker
Full Text Available IntroductionA crisis team management (CTM simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2, crisis team training (3, and TeamSTEPPs© models (4. The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance.MethodsEach of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5. CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course.ResultsOf the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve (p < 0.05 for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information.ConclusionTeaching of non-technical skills can be effective in a setting with scarce
Henker, Richard Alynn; Henker, Hiroko; Eng, Hor; O'Donnell, John; Jirativanont, Tachawan
A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance. Each of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5). CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course. Of the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve ( p < 0.05) for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information. Teaching of non-technical skills can be effective in a setting with scarce resources in a Southeastern Asian country.
This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)
Jensen, Jessica; Youngs, George
This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.
Schumacher, Marinita; Stal-Le Cardinal, Julie; Bocquet, Jean-Claude
Virtual instruments and tools are future trends in Engineering which are a response to the growing complexity of engineering tasks, the facility of communication and strong collaborations on the international market. Outsourcing, off-shoring, and the globalization of organisations’ activities have resulted in the formation of virtual product development teams. Individuals who are working in virtual teams must be equipped with diversified competencies that provide a basis for virtual team building. Thanks to the systemic approach of the functional analysis our paper responds to the need of a methodology of competence management to build virtual teams that are active in virtual design projects in the area of New Product Development (NPD).
.../B/A/Anthem Blue Cross & Blue Shield Enterprise Provider Data Management Team Including On-Site... & Blue Shield, Enterprise Provider Data Management Team, Including On-Site Leased Workers From Kelly... Of Kentucky, Enterprise Provider Data Management Team, Louisville, Kentucky TA-W-74,895B Wellpoint...
Hassell, J T; Games, A D; Shaffer, B; Harkins, L E
To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P group (P team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.
Tan, Zaldy S; Damron-Rodriguez, JoAnn; Cadogan, Mary; Gans, Daphna; Price, Rachel M; Merkin, Sharon S; Jennings, Lee; Schickedanz, Heather; Shimomura, Sam; Osterweil, Dan; Chodosh, Joshua
As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress. Registrants were organized into teams of five members, with at least one member of each profession per team. The teams rotated through all stations, completing assigned tasks through interprofessional collaboration. A total of 117 professionals (51 physicians, 11 nurses, 20 pharmacists, 24 social workers, 11 others) successfully completed the program. Change scores showed significant improvements in overall competence in dementia assessment and intervention (very low = 1; very high = 5; average change 1.12, P managing medication (average change 0.86, P team-based interprofessional competency training is a team teaching model that can be used to enhance competency in dementia screening and management in medical, nursing, pharmacy, and social work practitioners. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
Bashshur, Michael R; Hernández, Ana; González-Romá, Vicente
The authors argue that over time the difference between team members' perception of the organizational support received by the team (or team climate for organizational support) and their manager's perception of the organizational support received by the team has an effect on important outcomes and emergent states, such as team performance and team positive and negative affect above and beyond the main effects of climate perceptions themselves. With a longitudinal sample of 179 teams at Time 1 and 154 teams at Time 2, the authors tested their predictions using a combined polynomial regression and response surface analyses approach. The results supported the authors' predictions. When team managers and team members' perceptions of organizational support were high and in agreement, outcomes were maximized. When team managers and team members disagreed, team negative affect increased and team performance and team positive affect decreased. The negative effects of disagreement were most amplified when managers perceived that the team received higher levels of support than did the team itself.
Effective ageing management is an important element for ensuring the safety of nuclear power plant. The IAEA Ageing Management Assessment Team (AMAT) programme provides advice and assistance to utilities or individual NPPs to strengthen and enhance the effectiveness of ageing management programs (AMPs). Such AMPs are required by an increasing number of safety utilities and implemented by an increasing number of utilities, often as a part of NPP life or life cycle management programs that involve the integration of ageing management and economic planning. The guidelines in this report are primarily intended for IAEA-led AMAT team members as a basic structure and common reference for peer reviews of AMPs
Full Text Available ABSTRACT The work presented in this paper is focused on creating of predictive models that help in the process of incident resolution and implementation of IT infrastructure changes to increase the overall support of IT management. Our main objective was to build the predictive models using machine learning algorithms and CRISP-DM methodology. We used the incident and related changes database obtained from the IT environment of the Rabobank Group company, which contained information about the processing of the incidents during the incident management process. We decided to investigate the dependencies between the incident observation on particular infrastructure component and the actual source of the incident as well as the dependency between the incidents and related changes in the infrastructure. We used Random Forests and Gradient Boosting Machine classifiers in the process of identification of incident source as well as in the prediction of possible impact of the observed incident. Both types of models were tested on testing set and evaluated using defined metrics.
government and discovered that managing project team is indispensable in local governments .... subordinate; improve employee motivation; improve communication between .... or events required in completing the project. This will help to.
Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain
This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.
Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A
Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.
Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger
On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)
Ma, Maggie Jiao; Denando, John
This Crew Resource Management (CRM) video storytelling project asks students to work in a team (4-5 people per team) to create (write and produce) a video story. The story should demonstrate lacking and ill practices of CRM knowledge and skills, or positive skills used to create a successful scenario in aviation (e. g. , flight training, commercial aviation, airport management). The activity is composed of two parts: (1) creating a video story of CRM in aviation, and (2) delivering a group pr...
Zhang, L.; Li, Y.; Wu, Q.
Integrated Project Delivery (IPD) is a newly-developed project delivery approach for construction projects, and the level of collaboration of project management team is crucial to the success of its implementation. Existing research has shown that collaborative satisfaction is one of the key indicators of team collaboration. By reviewing the literature on team collaborative satisfaction and taking into consideration the characteristics of IPD projects, this paper summarizes the factors that influence collaborative satisfaction of IPD project management team. Based on these factors, this research develops a fuzzy linguistic method to effectively evaluate the level of team collaborative satisfaction, in which the authors adopted the 2-tuple linguistic variables and 2-tuple linguistic hybrid average operators to enhance the objectivity and accuracy of the evaluation. The paper demonstrates the practicality and effectiveness of the method through carrying out a case study with the method.
Hoogendoorn, Mark; Jonker, Catholijn M.; Maanen, Peter-Paul van; Sharpanskykh, Alexei
Within the field of incident management split second decisions have to be made, usually on the basis of incomplete and partially incorrect information. As a result of these conditions, errors occur in such decision processes. In order to avoid repetition of such errors, historic cases, disaster plans, and training logs need to be thoroughly analysed. This paper presents a formal approach for such an analysis that pays special attention to spatial and temporal aspects, to information exchange, and to organisational structure. The formal nature of the approach enables automation of analysis, which is illustrated by case studies of two disasters
Full Text Available The internationalization of Brazilian companies brings a new reality: the need for implementation of global projects that bring, in turn, the challenge of managing multicultural teams. Since this is a recent phenomenon with little theoretical development, this study sought to understand the relationships between cultural characteristics and management teams of global projects in Brazilian multinationals. To carry this discussion forward, we studied six cases of Brazilian multinational companies, with the aim of deepening the understanding of the management of global teams, involving the planning, deployment, development and management of human resources. Among the projects studied, it was found that there is very little concern with the specific issue of multiculturalism and little inter-cultural incentive to the development of team members, which ends up hindering the construction of a global mindset, important for the Brazilian multinational companies to perform successfully abroad. Faced with this situation, each of the managerial processes mentioned were presented with a number of actions to be undertaken by the project manager in three different dimensions: the project itself, the organization and the global environment. The work contributes, thus, to enable Brazilian multinational companies to manage their global teams in order to maximize the advantages of global teams, such as increased creativity and innovative capacity, but avoid the problems that multiculturalism can bring, ranging from conflicts between people to project failure.
A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)
Experience suggests that effective and appropriate responses of an organization's management after a traumatic incident can help mitigate the reactions of primary, secondary, and tertiary victims. This commentary addresses the managerial response of Southwest Airlines to the trauma induced by September 11. It highlights the effectiveness of the unity between the company, the unions, and the Critical Incident Response Team, as well as the types of interventions that were highly regarded by flight attendants and pilots who received such services. This commentary also defines the phenomenon known as fear of flight.
Lorena Isabel Barona López
Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.
Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo
Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.
Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)
Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.
Eggert, G M; Zimmer, J G; Hall, W J; Friedman, B
This randomized controlled study compared two types of case management for skilled nursing level patients living at home: the centralized individual model and the neighborhood team model. The team model differed from the individual model in that team case managers performed client assessments, care planning, some direct services, and reassessments; they also had much smaller caseloads and were assigned a specific catchment area. While patients in both groups incurred very high estimated health services costs, the average annual cost during 1983-85 for team cases was 13.6 percent less than that of individual model cases. While the team cases were 18.3 percent less expensive among "old" patients (patients who entered the study from the existing ACCESS caseload), they were only 2.7 percent less costly among "new" cases. The lower costs were due to reductions in hospital days and home care. Team cases averaged 26 percent fewer hospital days per year and 17 percent fewer home health aide hours. Nursing home use was 48 percent higher for the team group than for the individual model group. Mortality was almost exactly the same for both groups during the first year (about 30 percent), but was lower for team patients during the second year (11 percent as compared to 16 percent). Probable mechanisms for the observed results are discussed.
Jenny María Ruiz-Jiménez
Full Text Available The paper analyzes the influence of management capabilities on the innovation performance of technology-based SMEs and the role that gender diversity in the top management team plays in this relationship. We use a sample of 205 Spanish SMEs from technology sectors and a hierarchical regression analysis to test our hypotheses. The results confirm that management capabilities affect both product and process innovation positively. In addition, gender diversity in the top management team moderates this relationship positively. In other words, management capabilities have a greater influence on both product and process innovation when the management team is more balanced in number of men and women. This study contributes to better understanding of the factors that explain how management capabilities translate into greater organizational achievements and argues the need to analyze the role of top management teams and their composition more extensively, especially in the context of technology SMEs. The study also contributes new evidence to the small number of studies that analyze the effect of gender diversity in top management teams on innovation.
Belal Hashem Alnsour
Full Text Available Jordanian companies need virtual project teams that can use advanced technology to solve problems and make specialist multi perspective decisions when working across different and distance location. The main mission of the team is to make decisions through interdependent specialists and perspectives. In terms of its use and application, the virtual project team is a difficult challenge for Jordan corporations. This study aims to explore such applications and to detect which factors face virtual project teams in the Jordanian situation. The author focused on how to explore and gain a deeper understanding from a virtual team’s perspective, and team members’ opinions of the factors in the organization that support or hinder the mission. More specifically, this research sought to discover precisely which factors in an organization support virtual project teams, and how they can develop a support system which enables their work in an Arab environment. The main objective was to identify the effects of all factors on the efficiency of virtual teams. The research used empirical case studies from three Jordanian corporations in the communication sector which operate in a high-tech environment, and used surveys to collect data. Structured interviews with both management and team members during the study discovered that the use of virtual teams within Jordanian companies is still limited, and detected that the main factors which hinder their development in many corporations is the level of trust in the ability of virtual teams, together with the high level of centralized decision making in Jordanian corporations. Additionally, communication and coordination affect the execution of work processes and methods for virtual teams, together with a general weakness which exists in terms of infrastructure, resources and technology within the corporation, which then impacts on the efficiency of virtual team work.
Bunderson, J. Stuart; van der Vegt, Gerben S.
The promise and perils of heterogeneity in team member characteristics has been and continues to be one of the central questions in research on management teams. We review the literature on member heterogeneity within management teams, with a focus on summarizing and integrating research on both
Each year highway traffic incidents, such as crashes, place responders on and beside roadways with : dangerous high-speed traffic. The unexpected conditions of an incident scene have the potential to surprise : unsuspecting or inattentive drivers, po...
Brown, R O; Carlson, S D; Cowan, G S; Powers, D A; Luther, R W
Current hospital cost containment pressures have prompted a critical evaluation of whether nutritional support teams render more clinically effective and efficient patient care than nonteam management. To address this question with regard to enteral feeding, 102 consecutive hospitalized patients who required enteral nutritional support (ENS) by tube feeding during a 3 1/2-month period were prospectively studied. Fifty patients were managed by a nutritional support team; the other 52 were managed by their primary physicians. Choice of enteral formula, formula modifications, frequency of laboratory tests, and amounts of energy and protein received were recorded daily. In addition, each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. Team-managed (T) and nonteam-managed (NT) patients received ENS for 632 and 398 days, respectively. The average time period for ENS was significantly longer in the team-managed patients (12.6 +/- 12.1 days vs 7.7 +/- 6.2 days, p less than 0.01). Significantly more of the team patients attained 1.2 X basal energy expenditure (BEE) (37 vs 26, p less than 0.05). Total number of abnormalities in each group was similar (T = 398, NT = 390); however, the abnormalities per day were significantly lower in the team group (T = 0.63 vs NT = 0.98, p less than 0.01). Mechanical (T = 0.05 vs NT = 0.11, p less than 0.01), gastrointestinal (T = 0.99 vs NT = 0.14, p less than 0.05), and metabolic (T = 0.49 vs NT = 0.72, p less than 0.01) abnormalities per day all were significantly lower in the team-managed patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Terblanche, Lourie; van Wyk, André
Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...
Marres, Geertruid; Bemelman, Michael; van der Eijk, John; Leenen, Luke
. Collaboration with the NVIC and infrastructural adjustments enable us to not only care for patients with physical trauma, but also to provide centralized care of patients under quarantine conditions for, say, MRSA, SARS, smallpox, chemical or biological hazards. Triage plays an important role in medical disaster management and is therefore key to organization and infrastructure. Caps facilitate role distribution and recognizibility. The PBR resulted in more accurate registration and real-time availability of patient and group information. Infrastructure and a plan is not enough; training, research and evaluation are necessary to continuously work on disaster preparedness. The MIH in Utrecht (Netherlands) is a globally unique facility that can provide immediate emergency care for multiple casualties under exceptional circumstances. Resulting from the cooperation between a large academic medical institution, a trauma center, a military hospital and the NVIC, the MIH offers not only a good and complete infrastructure but also the expertise required to provide large-scale emergency care during disasters and major incidents.
Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R
Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.
Bosch, Marije; Halfens, Ruud J G; van der Weijden, Trudy; Wensing, Michel; Akkermans, Reinier; Grol, Richard
Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score ≤ 18) and preventive quality management at ward level. No associations were found between organizational culture, team climate, or preventive quality management at the ward level and the prevalence of nosocomial pressure ulcers. Institutional quality management was positively correlated with preventive quality management at ward level (adj. β 0.32; p organizational culture, team climate, or preventive quality management at the ward level. These results would therefore not subscribe the widely suggested importance of these factors in improving health care. However, different designs and research methods (that go beyond the cross-sectional design) may be more informative in studying relations between such complex factors and outcomes in a more meaningful way. Copyright ©2010 Sigma Theta Tau International.
Full Text Available A project management methodology that defines basic processes, tools, techniques, methods, resources and procedures used to manage a project is necessary for effective and successful IT project management. Each company needs to define its own methodology or adapt some of the existing ones. The purpose of the research is to evaluate the possibilities of adapting IT project development methodology according to the company, company employee characteristics and their mutual relations. The adaptation process will be illustrated with a case study at an IT company in Latvia where the developed methodology is based on Agile Scrum, one of the most widespread Agile methods.
Guenthner, Daniel H
A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.
de Oliveira Manoel, Airton Leonardo; Turkel-Parrella, David; Duggal, Abhijit; Murphy, Amanda; McCredie, Victoria; Marotta, Thomas R
Patients with aneurysmal subarachnoid hemorrhage are at high risk of complications, including rebleeding, delayed cerebral ischemia, cerebral infarction, and death. This review presents a practical approach for managing this condition and its complications. Copyright © 2015 Cleveland Clinic.
Brinckmann, Jan; Gemuenden, Hans Georg; Salomo, Søren
This article draws on the resource-based view to analyze the role founding teams' financial management competencies play for firm growth. Prior research stressed the importance of acquiring external financial resources. In this study, we broaden the understanding of financial management in new......-assessments of their financial management competencies at start-up. We apply the partial least squares approach to determine the effects of the different financial management competencies on firm growth....... firms. We explore the relevance of strategic financial planning competence, external financing competence, competence in financing from cash flow, and controlling competence of entrepreneurial teams for the growth of new technology-based firms. A total of 212 founding teams provided self...
Peek-Asa, Corinne; Casteel, Carri; Rugala, Eugene; Romano, Steve; Ramirez, Marizen
We examined threat management investigations conducted by a large multinational company. The company provided a database, removing any identifiers, of investigations by the corporate Threat Management Teams in 2009 and 2010. Rates were calculated using worker population data. During the 2-year study period, the company investigated threat management cases at a rate of 13.9 per 10,000 employees per year. Cases that activated a Threat Management Team were more likely to lead to corrective action (odds ratio = 2.0; 95% confidence interval = 1.08 to 3.87) and referral to the Employee Assistance Program (odds ratio = 4.8; 95% confidence interval = 3.00 to 7.77), but were not related to likelihood of termination. When the multidisciplinary teams were involved, cases were more likely to result in some type of action but were not more likely to lead to termination.
Department of Health and Social Services - Reports to o r f rom, o r in vestigations, b y t he D elaware D epartment o f Transportation...Satyrium kingi) Rare Skipper ( Problema bulenta) Mulberry Wing (Poanes massasoit chermocki) 5-20 Natural Resources Management Mammals...Schools T2.20.1.DE. Radon Management According to Guidelines for Persons Qualified to Provide Radon Services of the Delaware Health and Social Services
Abrahamsen, Håkon B
Major incidents are complex, dynamic and bewildering task environments characterised by simultaneous, rapidly changing events, uncertainty and ill-structured problems. Efficient management, communication, decision-making and allocation of scarce medical resources at the chaotic scene of a major incident is challenging and often relies on sparse information and data. Communication and information sharing is primarily voice-to-voice through phone or radio on specified radio frequencies. Visual cues are abundant and difficult to communicate between teams and team members that are not co-located. The aim was to assess the concept and feasibility of using a remotely piloted aircraft (RPA) system to support remote sensing in simulated major incident exercises. We carried out an experimental, pilot feasibility study. A custom-made, remotely controlled, multirotor unmanned aerial vehicle with vertical take-off and landing was equipped with digital colour- and thermal imaging cameras, a laser beam, a mechanical gripper arm and an avalanche transceiver. We collected data in five simulated exercises: 1) mass casualty traffic accident, 2) mountain rescue, 3) avalanche with buried victims, 4) fisherman through thin ice and 5) search for casualties in the dark. The unmanned aerial vehicle was remotely controlled, with high precision, in close proximity to air space obstacles at very low levels without compromising work on the ground. Payload capacity and tolerance to wind and turbulence were limited. Aerial video, shot from different altitudes, and remote aerial avalanche beacon search were streamed wirelessly in real time to a monitor at a ground base. Electromagnetic interference disturbed signal reception in the ground monitor. A small remotely piloted aircraft can be used as an effective tool carrier, although limited by its payload capacity, wind speed and flight endurance. Remote sensing using already existing remotely piloted aircraft technology in pre
Márcio Lopes Pimenta
Full Text Available The growth of industries and the strong economic base in Brazil require improvements and adaptations in business processes. Cross-functional teams (CFT may help to companies achieve these improvements. This research looks at characterizing CFT according to application processes, structures, objectives and impacts, considering the context of demand planning and related processes. In-depth interviews with 22 managers were performed in three Brazilian manufacturing companies. A framework to characterize CFT and respective impacts is proposed, including elements such as: procedures, context and goals, power distribution, impacts on cross-functional integration, impacts on teams' performance and on organization's performance. One significant managerial finding is that effective and efficient CFTs need balanced distribution of power among members by effectively establishing and structuring the team. By doing this, managers may observe positive impacts on inter-functional integration and in firm's results. Moreover, teams should permanently perform joint planning to predict unfavorable situations, improve communication and mutual understanding.
Kuziemski, Arkadiusz; Czerniak, Beata; Frankowska, Krystyna; Gonia, Ewa; Salińska, Teresa; Motuk, Andrzej; Sobociński, Zbigniew
In 2006 the Board of the Jan Biziel Hospital in Bydgoszcz decided to include procedures of health services in the implementation process within the confines of ISO 9001:2000 certification. The hospital infection control team that has operated in the hospital since 1989 performed the analysis of the forms of activities to date and on that basis the team prepared original plan of quality management. In April 2007, this plan was successfully accepted by the certifying team. The aim of this study is to present the aforementioned plan which is the result of 18 years experience of the team. At the same time, I hope that this study will be very helpful for all professionals interested in hospital epidemiology, especially in the context of implementing quality management systems.
The system of Chinese universities R&D as a branch of the system of the whole country R&D, has a great effect on the development and innovation of the country's science and technique. Consequently, it's important to construct an effective management team with high diathesis for University R&D management. Based on the statistics of the…
Sweeney, David S.; Cifuentes, Lauren
Instructional design models describe in detail methodologies for designing effective instruction. Several widely adopted models include suggestions for managing instructional design projects. However, these suggestions focus on how to manage the instructional design steps rather than the instructional design and development team process. The…
Full Text Available The focus of the cost management literature is almost exclusively on technical issues, with scant attention to its social, political and organisational dimensions. In this paper the authors document research examining the design team as a temporary management structure, with emphasis on the efficacy of the cost management system as a vehicle for attaining client objectives with respect to time, cost and quality. Soft systems methodology is used to explore the perceptions of stakeholders to the cost management system, thus developing conceptual models of the theory and practice of cost management. Significant differences were found to exist between the perceptions of individual stakeholders concerning design team participants, participants’ roles, and the very purpose of the cost management system. Recommendations are made for structural, attitudinal and procedural changes to the cost management system in order to facilitate its effective functioning in the achievement of the client’s needs and objectives.
Williams, Geraint; O'Malley, Michael; Nocera, Antony
The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team. 2010 Elsevier Ltd. All rights reserved.
Naradko, Anthony M.
The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…
Pillai, Satish K; Nyenswah, Tolbert; Rouse, Edward; Arwady, M Allison; Forrester, Joseph D; Hunter, Jennifer C; Matanock, Almea; Ayscue, Patrick; Monroe, Benjamin; Schafer, Ilana J; Poblano, Luis; Neatherlin, John; Montgomery, Joel M; De Cock, Kevin M
The ongoing Ebola virus disease (Ebola) outbreak in West Africa is the largest and most sustained Ebola epidemic recorded, with 6,574 cases. Among the five affected countries of West Africa (Liberia, Sierra Leone, Guinea, Nigeria, and Senegal), Liberia has had the highest number cases (3,458). This epidemic has severely strained the public health and health care infrastructure of Liberia, has resulted in restrictions in civil liberties, and has disrupted international travel. As part of the initial response, the Liberian Ministry of Health and Social Welfare (MOHSW) developed a national task force and technical expert committee to oversee the management of the Ebola-related activities. During the third week of July 2014, CDC deployed a team of epidemiologists, data management specialists, emergency management specialists, and health communicators to assist MOHSW in its response to the growing Ebola epidemic. One aspect of CDC's response was to work with MOHSW in instituting incident management system (IMS) principles to enhance the organization of the response. This report describes MOHSW's Ebola response structure as of mid-July, the plans made during the initial assessment of the response structure, the implementation of interventions aimed at improving the system, and plans for further development of the response structure for the Ebola epidemic in Liberia.
Unfortunately, cliques aren't a problem that you left behind in high school. Workplace cliques can be just as or even more troubling for you today, especially if they have the potential to affect your career, employee morale and performance, and your medical practice more broadly. This article describes workplace cliques in detail. It provides examples of exclusionary and ostracizing behaviors that are often associated with cliques. And it describes the prevalence and effects of cliques in today's workplace. This article also provides practice managers with 10 tips for discouraging and managing cliques. It describes five common workplace cliques: management, veteran, prior relationship, status, and homophily. It offers medical staff employees 10 strategies for working effectively alongside of a clique. Finally this article describes the pitfalls and risks of belonging to a workplace clique.
Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke
Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this
Orach, Christopher Garimol; Mayega, Roy William; Woboya, Vincent; William, Bazeyo
Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team's performance, roles and experiences following the training. The disasters most commonly experienced by the district teams were epidemics of diseases in humans (7 of 12), animals (epizoonotics) (3 of 12) and crops (3 of 12); hailstorms and floods (3 of 12). The capabilities viewed most useful for management of disasters were provision of health care services (9/12) and response management (8 of 12). The capability domains most often consulted during the disasters were general response management (31%), health services (29%) and water and sanitation (17%). The skills areas perceived to be vital following the training were response to epidemics 10/12, disaster management planning 8/12, hazards and vulnerability analysis 7/12 and principles of disaster planning 7/12 respectively. Main challenges mentioned by district teams were inadequacy of finance and logistics, lack of commitment by key partners towards disaster preparedness and response. The most common disaster experienced disasters related to outbreaks of diseases in man, animals and crops. The most frequently applied capabilities were response management and provision of emergency health services. The activities most frequently implemented following disaster management teams training were conducting planning meetings, refinement of plans and dissemination of skills gained. The main challenges were related to limited budget allocations and legal frameworks for disaster management that should be addressed by both central and local governments.
Managers in organizations are continuously confronted by an array of ambiguous data and -vaguely felt stimuli which they must somehow order, explicate and imbue with meaning before they decide on how to respond. This study of -162 -members of organizations' top management teams employed a cross-level analysis to investigate how individual-, group- and organizational-level factors relate to how managers diagnose strategic issues. Findings show that managers' cognitive style, the...
Halilovic, Jenana; Christensen, Cinda L; Nguyen, Hien H
Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.
Jordan, Debra J.
Research shows that well-managed conflicts can enrich a group, if good (cognitive) conflict is encouraged and bad (affective) conflict is discouraged. A model developed to understand how disabled people are treated at work suggests that there is a need to change beliefs about, as well as behavior towards, disabled people. Implications for camp are…
Full Text Available Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.Keywords: OPAT, quality, safety, program management
Gerowitt, B.; Melander, B.; Krawczyk, R.
The research-network PRODIVA focuses on a better utilization of crop diversification for weed management in North European arable cropping systems. The goal is to maintain diverse arable weed vegetation that is manageable in the long-term and could fulfil other necessary systemfunctions including...... support of beneficial organisms. The partners in PRODIVA will synthesize knowledge from terminated and running research projects and set-up selected new experiments on cover crops and variety resp. crop mixtures. Moreover, we will interact with partners from farming practice and extension services...... in organic agriculture. Regional fields will be surveyed for weeds to safeguard the relevance of the experimental research. Current cropping practices and their influence on weed pressure and weed diversity will be identified. The project will involve relevant stakeholders from the participating countries...
dace, Phoxinus erythrogaster (j) Colorado pikeminnow, Ptychocheilus lucius (k) loach minnow, Tiaroga cobitis 5-13 Natural Resources Management...writing by the Department, off-site at a readily available location. ST.4.38.NM. Corrective actions must be ta ken u pon a release involving a...cause a public nuisance or threat to human health, safety and welfare, or the environment. Verify th at when c ontaminated s oil is ta ken o ff s ite
Bergman, Amanda; Mashouri, Mastaneh
Organizational changes are inevitable, yet up to 70% fail. Technological development and competition in a volatile environment require more flexible organizations. As such, implementing self-managed teams (SMTs) has become a more common approach. The fact that SMTs ought to be self-managed has further raised a debate, since it is argued that some form of manager still is required. Therefore, the following research question was proposed; How does the interplay of influences unfold between the ...
Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D
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. © 2016 World Obesity.
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
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
An empirical study of the 2001-2002 data from 356 Chinese companies listed in the Shanghai and Shenzhen stock exchanges indicates that within the social context of China the characteristics of a firm's top management team have a different impact on firm performance from those of foreign countries. Also, the tenure heterogeneity and functional experience heterogeneity of the top management team are inversely related to firm performance. This paper analyzes and discusses the findings in detail and points out areas for future research.
Perreault, Lucille; Vaillancourt, Lise; Filion, Catherine; Hadj, Camélia
Lean management has proven to be a sustainable method to ensure a high level of patient care through innovation and teamwork. It involves a set of six tools that allow for visual management shared among team members. The team focuses their efforts on the improvement of organizational indicators in a standardized and engaging way, resulting in the sustainability of improvements. This article outlines the program's rollout at Montfort Hospital (l'Hôpital Montfort). In only a few months, two pilot units accomplished close to 50 improvements each. In addition, the organizational employee satisfaction questionnaire showed very positive results. Copyright © 2014 Longwoods Publishing.
re not to b e c onfused with 1-3 Air Emissions Management conventional c ombustion de vices with e nclosed f ireboxes and c ontrolled a ir t...Added April 2002]. • Clean Lumber - wood or wood products that have been cut or shaped and include wet, air-dried, and kiln -dried wood pr oducts... conventional pulverized coal and micropulverized coal (40 CFR 60.1940) [Added April 2002]. • Modification or Modified CISWI Unit - a CISWI unit you have
Supplement REGULATORY REQUIREMENTS: REVIEWER CHECKS: February 2010 NR.15. WATER R ESOURCE MANAGEMENT NR.15.1.ID. Facilities m ust apply f...epartment o f W ater R esources . The Department o f W ater Resources, D epartment o f Lands, a nd t he U .S. Army C orps o f E ngineers have developed a j...test on the underground gasoline storage tanks using the test methods identified. (NOTE: R equired t est methods ar e: 1 . C alifornia Air R esources B
Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less
A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.
Burritt, James G.; Berkey, Edgar [Longenecker and Associates, Las Vegas, NV 89135 (United States)
Managing complex projects requires a capable, effective project manager to be in place, who is assisted by a team of competent assistants in various relevant disciplines. This team of assistants is known as the Integrated Project Team (IPT). he IPT is composed of a multidisciplinary group of people who are collectively responsible for delivering a defined project outcome and who plan, execute, and implement over the entire life-cycle of a project, which can be a facility being constructed or a system being acquired. An ideal IPT includes empowered representatives from all functional areas involved with a project-such as engineering design, technology, manufacturing, test and evaluation, contracts, legal, logistics, and especially, the customer. Effective IPTs are an essential element of scope, cost, and schedule control for any complex, large construction project, whether funded by DOE or another organization. By recently assessing a number of major, on-going DOE waste management projects, the characteristics of high performing IPTs have been defined as well as the reasons for potential IPT failure. Project managers should use IPTs to plan and execute projects, but the IPTs must be properly constituted and the members capable and empowered. For them to be effective, the project manager must select the right team, and provide them with the training and guidance for them to be effective. IPT members must treat their IPT assignment as a primary duty, not some ancillary function. All team members must have an understanding of the factors associated with successful IPTs, and the reasons that some IPTs fail. Integrated Project Teams should be used by both government and industry. (authors)
Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H
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. 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. 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 factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.
Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John
This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.
Kallas, Kathryn D
The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.
Full Text Available The use of knowledge management (KM and communication tools in an applied scientific arena where research is performed and knowledge must be managed within and across multidisciplinary teams and organizations is a challenge. Teams of scientists and engineers from up to 17 different technical specialties required knowledge management tools for developing multiple environmental impact statements under challenging circumstances. Factors that contributed to the success of the KM tools included 1 pairing of project staff with Knowledge Systems staff to determine system requirements, 2 the use of the tools by the team as they were being developed thus allowing many opportunities for feedback and interaction, 3 developing the tools to approximate the overall project structure and work flow already in place, 4 providing immediate assistance to the project team as they learned to use the new KM tools, and 5 replacing earlier practices with the new KM approach by "burning the bridges" to past practices after the team had learned to use the new KM tools.
The goal of any operation is to complete tasks efficiently and effectively. Working safely is completely consistent with efficient, reliable operations. Working in an unsafe manner is not effective or ultimately efficient. If someone is hurt, work stops. Following the steps advocated by Team Resource Management (TRM) leads to more safe, efficient, effective work habits. TRM is a method used by teams (i.e., leaders and workers) to conduct technical business. It is used by the aviation industry to improve reliability and safety through formalizing the way it does business. High reliability organizations do exist. They conduct thousands of high-consequence operations a year, essentially error-free. Naval air carriers, air traffic control, and commercial aviation are some of these kinds of organizations. How did they get that way? What kinds of people staff them? Can we become a high reliability organization? This workshop will look at these questions. When we are done, it will be up to you to determine if we have the right stuff. The goals of this workshop are to: Describe Team Resource Management and its purpose; Describe Performance Shaping Factors (PSFs) and their role in predicting and managing team performance and errors; Describe the principles for managing human error; Describe TRMs 12 rules-of-thumb (the Dirty Dozen) and use of safety nets; Conduct Operational Risk Management (ORM); Demonstrate ways to keep TRM working
MILITARY PERSONNEL DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database Report to...to DSAID’s system speed and ease of use; interfaces with MCIO databases ; utility as a case management tool; and users’ ability to query data and... Managing Its Sexual Assault Incident Database What GAO Found As of October 2013, the Department of Defense’s (DOD) Defense Sexual Assault Incident
Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin
Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.
Cabrera, Susan F.; Sauer, Stephen J.; Thomas-Hunt, Melissa C.
This study examined how external evaluators' assessments of a management team and its leader are impacted by congruence between the leader's gender and the gender typing of the industry in which the team works. We experimentally tested our theory using industries that are either male typed or gender neutral, with teams led by male and female…
... (The Environmental Assessment and Management (TEAM) Guide), the ECAMP-ANG supplement was developed to examine Air Force Instructions, Air Force Manuals, and Air Force Policies in conjunction with the TEAM Guide...
Opstrup, Niels; Ryom Villadsen, Anders
Recent research has illustrated how human demographic diversity influences the outcomes of public sector organizations. Most studies focus on workforce diversity and little is known about how managerial diversity affects organizational outcomes. This study focuses on top management team gender...... diversity. Theory suggests that diversity can lead to varied outcomes. It may provide knowledge and new ideas used for organizational development. However, team diversity is likely to slow down decision making and make consensus more difficult to reach. In a longitudinal study of top management teams...... in Danish municipalities this study finds diversity to be associated with an increased use of contracting but also higher budgetary instabilities. These results are interpreted in light of existing theory and implications are suggested....
Stewart, Greg L; Courtright, Stephen H; Barrick, Murray R
The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how peer-based rational control, which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and interacts with the more commonly studied normative control force of group cohesion to explain both individual and collective performance in teams. On the basis of data from 587 factory workers in 45 self-managing teams at 3 organizations, peer-based rational control corresponded with higher performance for both individuals and collective teams. Results further demonstrated that the rational and normative mechanism of peer-based control interacted to explain performance at both the individual and team levels. Increased peer-based rational control corresponded with higher individual and collective performance in teams with low cohesion, but the positive effects on performance were attenuated in cohesive teams.
Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J
To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.
Wallo, Andreas; Kock, Henrik; Nilsson, Peter
Purpose: The purpose of this article is to present the results of a study of an industrial company's top management team (TMT) that fought to survive an economic crisis. Specifically, the article seeks to focus on describing the TMT's composition, group processes, and work during a period of high external pressure; analysing the TMT's work in…
Annosi, Maria Carmela; Giustiniano, Luca; Brunetta, Federica; Magnusson, Mats
New organization designs emerge continuously in highly dynamic innovation context to improve readiness to change. The adoption of self-managing teams operating cross-functionally on a bulk of products, together with the reduction of vertical layers in the organization, seems to be a common strategy
Estrada Vaquero, Isabel; Martin-Cruz, Natalia; Perez-Santana, Pilar
Teams working in multi-partner R&D alliances need a climate that fosters learning, creativity, and innovation to succeed in the joint development of new products. The strategic human resource management (HRM) literature recognizes that aligning human resources practices and those with the corporate
Borredon, Liz; Deffayet, Sylvie; Baker, Ann C.; Kolb, David
Drawing from the reflective teaching and learning practices recommended in influential publications on learning styles, experiential learning, deep learning, and dialogue, the authors tested the concept of "learning teams" in the framework of a leadership program implemented for the first time in a top French management school…
Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.
This article examines antecedents and consequences of the adoption level of standardized information technology (IT) versus customized IT in self-managing teams (SMTs) in a financial services institution. Linkages between specified antecedents and the adoption levels of standardized and customized
Keene, Michael A.
The management of product development teams is a challenging task, especially when success hinges on the ability to guide technical and nontechnical personnel through an effective decision-making process. The "Tale of Two Rocks" exercise illustrates how differing motivations and beliefs about new technologies can affect the decisions…
van de Ven, Joost; van Deursen, Frank J.H.M.; van Runnard Heimel, Pieter J.; Mol, Ben Willem J.; Oei, S. Guid
Objectives: To evaluate the effectiveness of simulation team training for the management of shoulder dystocia. Primary outcome measures were the number of reported cases of shoulder dystocia, as well as fetal injury that occurred from it. Secondary outcome is documentation of manoeuvres used to
Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.
In this article, the authors examine antecedents and consequences of the service climate in boundary-spanning self-managing teams (SMTs) that deliver financial services. Using data from members of 61 SMTs and their customers, the authors show a differential impact of the SMT service climate on
Smith, Harold, III; Smarkusky, Debra; Corrigall, Elizabeth
Industry has indicated the desire for academic programs to produce graduates that are well-versed in collaborative problem solving and general project management concepts in addition to technical skills. The primary focus of a curriculum is typically centered on the technical training with minimal attention given to coalescing team and project…
Bosch, M.; Halfens, R.J.; Weijden, T.T. van der; Wensing, M.J.P.; Akkermans, R.P.; Grol, R.P.
BACKGROUND: Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. AIMS: To determine if the type of
Troisi, Jordan D.
The use of student management teams (SMTs) is a relatively new teaching technique designed to increase the quality of college courses and student performance and engagement within those courses. However, to date, little systematic, empirical research has validated the effectiveness of using SMTs. To test the effectiveness of this technique, the…
Troisi, Jordan D.
The use of Student Management Teams (SMTs) is a relatively new teaching technique designed to increase students' motivation and involvement with the planning and execution of college courses. However, to date, little systematic, empirical research has validated the effectiveness of using SMTs. To test the effectiveness of this technique, the…
Mhozya, C. M.
This study, which was funded by the office of research and development (ORD) in the University of Botswana, surveyed 65 primary schools in South Central region in Botswana, which aimed at establishing the perceptions of senior management teams dominant leadership style. The study was done in three phases; the first phase started in June 2008 to…
This paper deals with the leeway organizations have to develop and design self-managing teams by using a model containing four model verbs: must, may, can and will. ''Must'' refers to the need for local decision making and is considered to be the result of diversity in enviromental demand and
In this paper, we investigate how management team characteristics might influence LBO syndication decision, which might be able to alleviate risks and uncertainties arising from the pre-deal screening and the post-deal value-added services. By using a unique hand-collected dataset, we find that
Jong, de A.; Ruyter, de J.C.
In this article, we develop a conceptual model of adaptive versus proactive recovery behavior by self-managing teams (SMTs) in service recovery operations. To empirically test the conceptual model a combination of bank employee, customer, and archival data is collected. The results demonstrate
Recently, a number of positions with corporate social responsibility (CSR) in the position title have been introduced to the top management teams (TMTs) of some of the world’s largest corporations. I explore this phenomenon. I revisit 10 such positions identified in a previous study to add...
Harmancioglu, Nukhet; Grinstein, A.; Goldman, Arieh
Research on organizational market information processing in marketing has not yet examined a key issue associated with information collection: the role of top management team (TMT) involvement. Research in marketing has typically studied market information collection efforts from the perspective of
Barker, James R.
Describes how an (industrial) organization's control system evolved in response to a managerial change from hierarchical, bureaucratic control to concertive control via self-management teams. The organization's members developed a system of value-based normative rules that controlled their actions more powerfully and completely than did the former…
Kopczak, L.R.; Fransoo, J.C.
In this article, we describe the Global Project Coordination Course, a course in which project teams composed of three students from each of two overseas universities execute company-sponsored projects dealing with global supply chain management issues. The $75,000 to $100,00 contributed in total by
Janssen, O.; Van de Vliert, E.; Veenstra, C
A literature-based model defining how task and person conflict modify the relationship between positive goal interdependence and decision-making effectiveness in management teams is presented. The model assumes that positive interdependence fosters effective decision making behaviors only if person
Mihalache, R.O.; Jansen, J.J.P.; Volberda, H.W.; van den Bosch, F.
This study proposes top management team (TMT) shared leadership as an important enabler of organizational ambidexterity. Moreover, we examine both how and when TMT shared leadership enhances organizational ambidexterity by considering two TMT processes as mediators (i.e., cooperative conflict
Full Text Available The main aim of this paper is to present a pilot proposal of a model of “Virtual Development Management System” (ViDeMaS which will facilitate more effective management and development of virtual teams. Management and development of virtual teams is not a simple concept. It comprises a body of knowledge from a number of fields and scientific disciplines. The complexity of the concept may not be simplified as it is absolutely essential for full understanding of its nature. In order to gain better orientation in the concept, different perspectives will be used in the description of the model, which will enable us to achieve the goal of the work and to present the main results of the work (creation of a model for Virtual Development Management System. The present paper thus describes from different perspectives the proposal of a sufficiently detailed and complex model that may be utilized both on theoretical and application level.
High reliability organizations do exist. They have been defined as those organizations that conduct thousands of high-consequence operations a year, essentially error-free. Naval air carriers, air traffic control, and commercial aviation are some of these kinds of organizations. How did they get that way? What kinds of people staff them? Can we become a high reliability organization? This workshop will look at these questions. When we are done, it will be up to you to determine whether we have the right stuff. There are six goals for this workshop: Describe Team Resource Management and its purpose; Describe Performance Shaping Factors (PSFs) and their role in predicting and managing team performance and errors; Describe the principles for managing human error; Describe TRMs 12 rules-of-thumb (the Dirty Dozen) and use of safety nets; Conduct Operational Risk Management (ORM); Demonstrate ways to keep TRM working
Stephens, John Paul; Lyddy, Christopher J.
Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes. PMID:27047407
Stephens, John Paul; Lyddy, Christopher J
Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes.
Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U
Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.
Prenestini, Anna; Calciolari, Stefano; Lega, Federico; Grilli, Roberto
Health care organizations are pressured to improve the cost-effectiveness of service delivery. Clinical governance is an important trigger to improve care quality and safety and rank high in the reform agenda of health systems. The senior management team culture plays a major role in establishing clinical governance practices, because it strongly influences the values, attitudes, and behaviors of the members of an organization. The aim of this study was to investigate the relationship between senior management team culture and clinical governance in the public health care organizations of three Italian regions. The assessment of senior management culture was conducted using the Competing Values Framework and a corresponding instrument adapted for the Italian context. Clinical governance was assessed using an ad hoc instrument focused on the senior management team's perception and attitude toward clinical governance. The survey achieved a 54% response rate. The results of four different models demonstrate that organizations characterized by different dominant cultures are associated with significant differences in attitudes toward clinical governance. In particular, on average, dominant cultures with a prevailing external focus are associated with a more positive attitude toward clinical governance. The selection and appointments of top managers should consider the style of leadership that is most apt to facilitate the growth of rational and developmental cultures. Furthermore, the training of top managers and leading doctors should reinforce leadership aptitude and approaches that are consistent with the desired organizational cultures.
Llewellyn-Jones, Glyn; Pereira, John
There is little information about the role of the radiologist at multidisciplinary team meetings; in particular their influence on patient management. To evaluate the influence of radiologists on clinical patient management during multidisciplinary meetings. Prospective data were collected over a 5-week period from multidisciplinary team meetings across four paediatric clinical domains. Radiological input was recorded for each case discussion, including the type of influence and its potential effect on clinical patient management. One hundred and forty paediatric cases were reviewed. Radiological advice was requested from the radiologist for 25.7% (N = 36) of cases. In 17.9% (N = 25) this advice was judged to have influenced clinical patient management. There were two cases where new imaging findings were discovered. Radiologists influence clinical patient management during multidisciplinary team meetings primarily by providing differential diagnoses and guidance regarding future imaging, with respect to both the necessity and the modality. Occasionally, when imaging is reviewed at these meetings, new findings are discovered that impact on patient management. © 2016 The Royal Australian and New Zealand College of Radiologists.
Ineffective communication among the health care team is a leading cause of errors in the patient care setting. Studies assessing training related to communication and teamwork in the clinical team are prevalent, however, teamwork training at the administrative level is lacking. This includes individuals in leadership positions such as health care risk managers. The purpose was to determine the impact of an educational intervention on the knowledge and attitudes related to communication and teamwork in the health care risk management population. The educational intervention was an adaptation of a national teamwork training program and incorporated didactic content as well as video vignettes and small group activities. Measurement of knowledge and attitudes were used to determine the impact of the education program. Knowledge and attitudes were assessed pre- and postcourse. Findings indicate that teamwork education tailored to the needs of the specific audience resulted in knowledge gained and improved attitudes toward the components of teamwork. The attitudes that most significantly improved were related to team structure and situation monitoring. There was no improvement in participants' attitudes toward leadership, mutual support, and communication. Team training has been shown to improve safety culture, patient satisfaction, and clinical outcomes. Including risk managers in training on teamwork, communication, and collaboration can serve to foster a common language among clinicians and management. In addition, a measurement related to implementation in the health care setting may yield insight into the impact of training. Qualitative measurement may allow the researcher to delve deeper into how these health care facilities are using team training interventions. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.
Klemenc-Ketis, Zalika; Poplas-Susič, Antonija
To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients. We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements. © 2017 John Wiley & Sons Ltd.
Wickramasinghe, Leelani K; Schattner, Peter; Hibbert, Marienne E; Enticott, Joanne C; Georgeff, Michael P; Russell, Grant M
To investigate whether General Practice Management Plans (GPMPs), Team Care Arrangements (TCAs) and reviews of these improve the management and outcomes of patients with diabetes when supported by cdmNet, a web-based chronic disease management system; and to investigate adherence to the annual cycle of care (ACOC), as recommended in diabetes guidelines. A before-and-after study to analyse prospectively collected data on 577 patients with type 1 or 2 diabetes mellitus who were managed with a GPMP created using cdmNet between June 2008 and November 2012. Completion of the clinical tests in the ACOC (process outcome) and values of six of these clinical measurements (clinical outcomes). Significant improvements were seen after creation of a GPMP in the proportion of ACOC clinical tests completed (57.9% v 74.8%, P < 0.001), total cholesterol level (P < 0.01), low-density lipoprotein (LDL) cholesterol level (P < 0.001) and body mass index (BMI) (P < 0.01). Patients using GPMPs and TCAs also improved their glycated haemoglobin (HbA1c) level (P < 0.05). Patients followed up with irregular reviews had significant improvements in the proportion of ACOC clinical tests completed (59.2% v 77.6%, P < 0.001), total cholesterol level (P < 0.05), and BMI (P < 0.01), but patients with regular reviews had greater improvements in the proportion of ACOC clinical tests completed (58.9% v 85.0%, P < 0.001), HbA(1c) level (57.7 v 53.0 mmol/mol, P < 0.05), total cholesterol level (4.8 v 4.5 mmol/L, P < 0.05), LDL cholesterol level (2.8 v 2.4 mmol/L, P < 0.01) and diastolic blood pressure (76.0 v 74.0 mmHg, P < 0.05). There were significant improvements in process and clinical outcomes for patients on a GPMP or a GPMP and TCA, particularly when these were followed up by regular reviews. Patients using cdmNet were four times more likely to have their GPMP or TCA followed up through regular reviews than the national average.
A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...
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
Outpatient chronic hemodialysis facilities often serve large populations of patients in an open and sometimes fast-paced environment. Any sizeable group of people will contain a sample of mental illnesses -and the end-stage renal disease diagnosis can be accompanied by co-occurring or comorbid mental illness. Thus, it is important for professional teams to be able to effectively manage related issues arising in the dialysis clinic. Guided by Medicare mandates, dialysis clinics all employ a masters level social worker to respond to the myriad psychosocial needs of this population; MSWs are trained to recognize the signs and symptoms of mental illnesses, and can help guide the team response.
Thibault, Catherine; Guillouët, Sonia; Havin, Marie-Pierre
The certification assessment is an important stage in the life of a healthcare facility. However, instilling a quality culture within a team to lead it towards performance is a long-term endeavour. This cannot work without the existence of a partnership between the paramedical and medical teams, nor without the support of the hospital led by senior quality managers. The challenge is to not limit the quality culture to the certification assessment, which aims to highlight the areas in which the institution conforms and those in which it is failing, but rather to adopt a continuous improvement approach. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Tillett, E; Loosemore, M
Devise and implement evidence-based guidelines for the prevention and management of travellers' diarrhoea (TD), and establish the incidence of TD during an elite sporting trip to India. Literature review and audit. Youth Commonwealth Games in India 2008. All members of the Team England Squad. Hygiene guidelines included only drinking bottled water, eating hot food and regular hand washing with alcohol gel. Ciprofloxacin was offered to non-athlete team members as prophylaxis but not to athletes due to its possible association with tendon disease. Following implementation of these guidelines, the incidence of travellers' diarrhoea (TD) in the whole squad was 24/122 (20%), compared with 7/14 (50%) on the reconnaissance trip (preguidelines). In those taking prophylactic ciprofloxacin, the incidence was 4/33 (12%), compared with 20/89 (23%) in those not taking ciprofloxacin. No athlete missed their event due to TD. The incidence of TD was less during the event than on the reconnaissance trip. The relative contribution to this reduction in strict hygiene guidelines as compared with potentially improved catering hygiene arrangements is unknown. Prophylactic ciprofloxacin also reduced the incidence of TD but it is probably not appropriate for use in elite athletes. Rifaximin may be an alternative for this group.
Almutawa, M; Scott, M; George, K P; Drust, B
To compare the incidence, severity and nature of injuries sustained by Saudi National Team footballers during match-play and training on natural grass and 3rd generation (3G) artificial turf. Injury data was collected on all Saudi National Team players competing at the Gulf Cup (Yemen December 2010: 3G) and the Asian Cup (Qatar January 2011; grass). A total of 49 players were studied (mean ± SD; Age 27 ± 4 yr; body mass 71.4 ± 6.7 kg; height 176.8 ± 6.3 cm; professional playing experience 9 ± 3 yr) of which 31 competed at the Gulf Cup, 32 at the Asian Cup (14 at both). A prospective cohort design was used to investigate the incidence, nature and severity of injuries sustained with data collected using a standardised injury questionnaire. All data were collected by the team physiotherapist with the definition of injury set at any injury that required player and clinician contact. Injury and exposure data were collected and reported for games, training and all football activity. A total of 82 injuries [incidence - 56.1 per 1000 h total game and training exposure] were recorded at the Asian Cup (grass) and 72 injuries [incidence - 37.9 per 1000 h total game and training exposure] were recorded at the Gulf Cup (3G). Incidence data for training, game and all football exposure injury rates were higher when playing on grass. The vast majority of injuries on both surfaces were very minor that, whilst requiring medical attention, did not result in loss of match/training exposure. Injuries that resulted in 1-3 days absence from training or game play had similar incidence rates (Grass: 7.4 vs. 3G: 7.4 injuries per 1000 h exposure). More severe injuries were less frequent but with a higher incidence when playing on grass. Lower limb injuries were the most common in both tournaments with a higher incidence on grass (Grass: 14.2 vs. 3G: 7.9 injuries per 1000 h exposure). Muscle injuries were the most frequent of all injuries with similar incidence rates on
de Leede, Jan; Nijhof, A.H.J.; Fisscher, O.A.M.
Concepts that include the participation and empowerment of workers are becoming increasingly important nowadays. In many of these concepts, the formal responsibility is delegated to teams. Does this imply that the normative responsibility for the actions of teams is also delegated? In this article
Konstantin Maschke; Dodo zu Knyphausen-Aufseß
This paper reviews research findings on entrepreneurial top management teams within the last 20 years. It concentrates on team-based management factors and their influence on a new ventures growth and ability to raise capital. This paper integrates recent findings and provides an overview of the current state of research. Moreover, it contributes to the overall topic by proposing five clusters of major team-specific influences, derives determinants of success and failure, and reveals recomme...
Rodriguez, Amanda I; Zupancic, Steven; Song, Michael M; Cordero, Joehassin; Nguyen, Tam Q; Seifert, Charles
Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach. To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system. Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other. A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation. Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns. Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained
Knowledge management represents an emerging domain becoming more and more important. Concepts like knowledge codification and personalisation, knowledge life-cycle, social and technological dimensions, knowledge transfer and learning management are integral parts. Focus goes here in the process of knowledge transfer for the case of ad hoc teams. The social dimension of knowledge transfer plays an important role. No single individual actors involved in the process, but a collective one, representing the organisation. It is critically important for knowledge to be managed from the life-cycle point of view. A complex communication network needs to be in place to supports the process of knowledge transfer. Two particular concepts, the bridge tie and transactive memory, would eventually enhance the communication. The paper focuses on an informational communication platform supporting the collaborative work on knowledge transfer. The platform facilitates the creation of a topic language to be used in knowledge modelling, storage and reuse, by the ad hoc teams.
Wong, V W; Manoharan, M; Mak, M
Hyperglycaemia is commonly observed in patients with diabetes mellitus (DM) while receiving enteral nutrition (EN) in hospital, and hyperglycaemia has been shown to be associated with poor clinical outcomes. The aim of this study was to assess the glycaemic status of patients with DM who received EN during hospital admission and evaluate the impact of intervention by a specialist diabetes team (SDT) on glycaemic control and clinical outcomes of these patients. A retrospective review of patients with DM who required EN during hospital admission was conducted. We compared patient characteristics, glycaemic profile and clinical outcomes between patients who were managed by SDT and those who were managed by the admitting team. Seventy-four patients with DM on EN were included in this study, of whom 27 were managed by SDT while on EN. Compared with patients managed by the admitting team, those who were reviewed by SDT had better glycaemic control during the period of EN as well as during the 24 h after EN was ceased. These patients also had shorter length-of-stay in hospital and lower in-patient mortality. Our findings confirmed that there was a role for SDT in managing patients with DM who received EN during their hospital admission. These patients had improved glycaemic control while receiving EN and had better clinical outcomes. Further prospective studies will be required to validate the findings of this study.
Within the Seattle metropolitan area, traffic incident management (TIM) operations provide a multi-jurisdictional and coordinated strategy to detect, respond to, and clear traffic incidents so that traffic flow can be restored quickly and safely. The...
Shokory, Suzyanty Mohd; Suradi, Nur Riza Mohd
The current study examines the impact of transformational and transactional leadership of project manager on the extra-role performance of project team members. In addition, this study also identifies factor dominant to extra-role performance of project team members when the transformational and transactional leadership of project managers are analyzed simultaneously. The study involved 175 of project team members from 35 project teams (each project team consists of different contracting companies registered in the Selangor (N = 175 from 35 contractors company). A multilevel analysis with hierarchical linear modeling (HLM) approach was used in this study. The analysis showed that transformational and transactional leadership of the project manager is a positive significant with extra-role performance project team members when analyzed separately. However when the two constructs (transformational leadership and transactional leadership of project manager) were analyzed simultaneously, transformational leadership was found to have more impact on extra-role performance project team members compared to transactional leadership. These findings explained that although transformational and transactional leadership of project managers can improve extra-role performance project team members, but this study has proved that transformational leadership of project managers affect extra-role performance project team members more as compared to transactional leadership.
This presentation describes a team approach, at the totalproject level that focused team members with common objectives, for the transition to start-up and operation of the project. The Integrated Management Team (IMT) approach has been successful for this US Department of Energy (DOE) environmental restoration project at the Hanford Site in Richland, Washington. The $53.8-million project will collect, treat, and dispose of low-level mixed waste water discharges from the Hanford Site. Construction is scheduled for completion in September 1994 and facility start-up in June 1995. The project challenge is for leadership that is committed to the transition from construction to operation of the environmental restoration project
Salomo, Søren; Keinschmidt, Elko J.; de Brentani, Ulrike
Globalization is a major market trend today, one characterized by both increased international competition as well as extensive opportunities for firms to expand their operations beyond current boundaries. Effectively dealing with this important change, however, makes the management of global new...... resources, team, and performance. For the empirical analysis, data are collected through a survey of 467 corporate global new product programs (North America and Europe, business-to-business). A structural model testing for the hypothesized effects was substantially supported. The results show that creating...... product development (NPD) a major concern. To ensure success in this complex and competitive endeavor, companies must rely on global NPD teams that make use of the talents and knowledge available in different parts of the global organization. Thus, cohesive and well-functioning global NPD teams become...
Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher
Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Liu, Wu; Gong, Yaping; Liu, Jun
Drawing upon the notion of managerial discretion from upper echelons theory, we theorize which external contingencies moderate the relationship between collective organizational citizenship behavior (COCB) and unit performance. Focusing on business unit (BU) management teams, we hypothesize that COCB of BU management teams enhances BU performance and that this impact depends on environmental uncertainty and BU management-team decision latitude, 2 determinants of managerial discretion. In particular, the positive effect of COCB is stronger when environmental uncertainty or the BU management-team decision latitude is greater. Time-lagged data from 109 BUs of a telecommunications company support the hypotheses. Additional exploratory analysis shows that the positive moderating effect of environmental uncertainty is further amplified at higher levels of BU management-team decision latitude. Overall, this study extends the internally focused view in the micro OCB literature by introducing external contingencies for the COCB-unit-performance relationship. (c) 2014 APA, all rights reserved.
Background: Aggressive behavior and incidents in psychiatric wards are ... Results: Seventy five people were admitted in the acute psychiatric wards during this ... Although the study sample is small and convenience-based, the dearth of ...
The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair
Buetow, E.; Memmert, G.; Storck, R.; Weymann, J.; Matthies, M.; Vogt, K.J.
Regarding surface facilities two incidents of MAVA (failure of the filter in the exhaust gas system, fire in the bituminization system) and one incident in the Krypton storage and regarding underground systems the water inlet in the pit building have been evaluated. According to the calculations only the two nuclides Tc-99 and J-129 can involve a considerable exposure. The barrier system of overlying rocks and the pit system as a whole is largely redundant and diverse. (DG) [de
Minnick, Joanne M; Bebarta, Vikhyat S; Stanton, Marietta; Lairet, Julio R; King, James; Torres, Pedro; Aden, James; Ramirez, Rosemarie
Most critically ill injured patients are transported out of the theater by Critical Care Air Transport Teams (CCATTs). Fever after trauma is correlated with surgical complications and infection. The purposes of this study are to identify the incidence of elevated temperature in patients managed in the CCATT environment and to describe the complications reported and the treatments used in these patients. We performed a retrospective review of available records of trauma patients from the combat theater between March 1, 2009, and March 31, 2010, who were transported by the US Air Force CCATT and had an incidence of hyperthermia. We then divided the cohort into 2 groups, patients transported with an elevation in temperature greater than 100.4°F and patients with no documented elevation in temperature. We used a standardized, secure electronic data collection form to abstract the outcomes. Descriptive data collected included injury type, temperature, use of a mechanical ventilator, cooling treatment modalities, antipyretics, intravenous fluid administration, and use of blood products. We also evaluated the incidence of complications during the transport in patients who had a recorded elevation in temperature greater than 100.4°F. A total of 248 trauma patients met the inclusion criteria, and 101 trauma patients (40%) had fever. The mean age was 28 years, and 98% of patients were men. The mechanism of injury was an explosion in 156 patients (63%), blunt injury in 11 (4%), and penetrating injury in 45 (18%), whereas other trauma-related injuries accounted for 36 patients (15%). Of the patients, 209 (84%) had battle-related injuries and 39 (16%) had non-battle-related injuries. Traumatic brain injury was found in 24 patients (24%) with an incidence of elevated temperature. The mean temperature was 101.6°F (range, 100.5°F-103.9°F). After evaluation of therapies and treatments, 80 trauma patients (51%) were intubated on a mechanical ventilator (P cooling interventions
Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.
In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law
Ogunleye, Ayodele; Osunlana, Adedayo; Asselin, Jodie; Cave, Andrew; Sharma, Arya Mitra; Campbell-Scherer, Denise Lynn
Despite opportunities for didactic education on obesity management, we still observe low rates of weight management visits in our primary care setting. This paper describes the co-creation by front-line interdisciplinary health care providers and researchers of the 5As Team intervention to improve obesity prevention and management in primary care. We describe the theoretical foundations, design, and core elements of the 5AsT intervention, and the process of eliciting practitioners' self-identified knowledge gaps to inform the curricula for the 5AsT intervention. Themes and topics were identified through facilitated group discussion and a curriculum relevant to this group of practitioners was developed and delivered in a series of 12 workshops. The research question and approach were co-created with the clinical leadership of the PCN; the PCN committed internal resources and a practice facilitator to the effort. Practice facilitation and learning collaboratives were used in the intervention For the content, front-line providers identified 43 topics, related to 13 themes around obesity assessment and management for which they felt the need for further education and training. These needs included: cultural identity and body image, emotional and mental health, motivation, setting goals, managing expectations, weight-bias, caregiver fatigue, clinic dynamics and team-based care, greater understanding of physiology and the use of a systematic framework for obesity assessment (the "4Ms" of obesity). The content of the 12 intervention sessions were designed based on these themes. There was a strong innovation values fit with the 5AsT intervention, and providers were more comfortable with obesity management following the intervention. The 5AsT intervention, including videos, resources and tools, has been compiled for use by clinical teams and is available online at http://www.obesitynetwork.ca/5As_Team . Primary care interdisciplinary practitioners perceive important
Dr. Susila Sumartiningsih
Full Text Available ABSTRACT The purpose of this research is to analyze the empiric of management strategic Driving Factor DF and Pull Factor PF to team learning cohesion among nursing program in Banten Provinsion. The study was designed in the quantitative descriptive correlational study and the method was a cross sectional. The total sampling n192 were manager n3 lecturers n45 and students n144 at nursing program study among Banten provice in Indonesia. The data were analyzed by using the Chi-Square.Theresults were showngood category 83.33 in DF and PF of Management Stratgict Implementataion and high category 59.72 in Team Learning Cohesion. There was not a statistically significant relationship p 0.543 p amp8805 0.05 between the DF and PF of team learning cohesion in implementation of Management Stratgic. In view of this it can be concluded that the nursing lecturer should be able to be a good motivator in order to encourage the student academic achievement.
Jorge Ramon D'Acosta Rivera
Full Text Available Several studies relate organizational outcomes to the performance of top management teams (TMT. Some of these studies suggest that the process of strategic choice is influenced by the cognitive background and values of the executives in those teams, and have focused on the composition of TMT, using demographic variables as proxies for deep-level characteristics. The aim of this descriptive and exploratory study was to verify directly the influence of deep-level characteristics – the dissimilarities of TMT members’ individual values – on the team outcomes. This research was carried out using a quantitative method within a public university management lab environment located in the city of São Paulo, applying two value surveys validated in Brazil on TMT composed of Business Management and Accounting undergraduates submitted to a business game situation, resulting in a non-probabilistic sample formed of 32 teams comprising 186 students with valid responses. Through multiple linear regression technique, two statistically significant regression models were found. It was found that the improved performance of TMT occurs when members differ in the importance assigned to values related to openness to change and have similar appreciation of values related to rules and to security in life (conservation values and the pursuit of power (prestige, giving evidence that this can occur not only in a laboratory environment, but also in the business environment, where time pressures and competition are even more severe and, therefore, more subject to deep-level subjective characteristics.
Full Text Available Amy Streater,1,2 Donna Maria Coleston-Shields,2 Jennifer Yates,2 Miriam Stanyon,2 Martin Orrell2 1Research and Development, North East London NHS Foundation Trust, Ilford, 2Institute of Mental Health, University of Nottingham, Nottingham, UK Background: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1 conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2 conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice.Methods: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis.Results: The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8% of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors.Conclusion: Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required
Lee, Yih-Teen; Paunova, Minna
understudied. Drawing on social exchange theory, we propose and test an individual-level two-stage process model of generalised exchange linking LGO and leadership recognition in self-managed teams. Specifically, we posit that learning-oriented individuals will tend to feel safer in self-managed teams, which......Defined as a mental framework for how individuals interpret and respond to achievement situations, learning goal orientation (LGO) has received increasing attention in organisational research. However, its effect on leadership, especially in contexts absent of formal leadership, remains......, but that contextual role behavior alone does not mediate the effect of LGO on leadership recognition. LGO has an indirect effect on leadership recognition through the joint mediation of felt safety and contextual role behavior. Our results offer insight on the link between LGO and leadership, with practical...
Thyvalikakath, Thankam P; Padman, Rema; Gupta, Sugandh
Mounting evidence suggests a potential association of periodontal disease with systemic diseases such as diabetes, cardiovascular disease, cancer and stroke. The objective of this study is to develop an integrated risk assessment tool that displays a patients' risk for periodontal disease in the context of their systemic disease, social habits and oral health. Such a tool will be used by not just dental professionals but also by care providers who participate in the team-based care for chronic disease management. Displaying relationships between risk factors and its influence on the patient's general health could be a powerful educational and disease management tool for patients and clinicians. It may also improve the coordination of care provided by the provider-members of a chronic care team.
Bjørnåli, Ekaterina S.
This dissertation addresses the under-studied area of the role of the top management team (TMT) and board of directors in the development of academic spin-off companies (ASOs) originating from public research institutes. ASO research receives growing attention internationally following the rise in commercialization activities in the vast majority of universities. The studies identify the barriers to and facilitators of ASO formation and growth, which are related to faculty attributes and ince...
David Strutton; William Carter
Cross-cultural top-management-teams (cc-TMTs) are typically comprised of rational individuals. Yet cc-TMTs featuring uniformly wise and experienced executives often make irrational decisions (i.e., choices incompatible with reason or logic). Even most executives acknowledge this is true. Behavioral economics suggests a primary reason why is that iterative combinations of cultural and cognitive biases invariably arise and interact in cc-TMT settings. As they arise, these biases often undermine...
Research in human error has provided useful tools for designing procedures, training, and intelligent interfaces that trap errors at an early stage. However, this "error prevention" policy may not be entirely successful because human errors will inevitably occur. This requires that the error management process (e.g., detection, diagnosis and correction) must also be supported. Research has focused almost exclusively on error detection; little is known about error recovery, especially in the context of safety critical systems. The aim of this paper is to develop a research framework that integrates error recovery strategies employed by experienced practitioners in handling their own errors. A control theoretic model of human performance was used to integrate error recovery strategies assembled from reviews of the literature, analyses of near misses from aviation and command & control domains, and observations of abnormal situations training at air traffic control facilities. The method of system dynamics has been used to analyze and compare error recovery strategies in terms of patterns of interaction, system affordances, and types of recovery plans. System dynamics offer a promising basis for studying the nature of error recovery management in the context of team interactions and system characteristics. The proposed taxonomy of error recovery strategies can help human factors and safety experts to develop resilient system designs and training solutions for managing human errors in unforeseen situations; it may also help incident investigators to explore why people's actions and assessments were not corrected at the time. Copyright © 2011 Elsevier Ltd. All rights reserved.
Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott
Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.
Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K
Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
"The stereotype of engineers is that they are not people oriented; the stereotype implies that engineers would not work well in teams---that their task emphasis is a solo venture and does not encourage social aspects of collaboration" (Miner & Beyerlein, 1999, p. 16). The problem is determining the best method of providing a motivating environment where design engineers may contribute within a team in order to achieve higher performance in the organization. Theoretically, self-directed work teams perform at higher levels. But, allowing a design engineer to contribute to the team while still maintaining his or her anonymity is the key to success. Therefore, a motivating environment must be established to encourage greater self-actualization in design engineers. The purpose of this study is to determine the favorable motivational environment for design engineers and describe the comparison between two aerospace design-engineering teams: one self-directed and the other manager directed. Following the comparison, this study identified whether self-direction or manager-direction provides the favorable motivational environment for operating as a team in pursuit of achieving higher performance. The methodology used in this research was the case study focusing on the team's levels of job satisfaction and potential for higher performance. The collection of data came from three sources, (a) surveys, (b) researcher observer journal and (c) collection of artifacts. The surveys provided information regarding personal behavior characteristics, potentiality for higher performance and motivational attributes. The researcher journal provided information regarding team dynamics, individual interaction, conflict and conflict resolution. The milestone for performance was based on the collection of artifacts from the two teams. The findings from this study illustrated that whether the team was manager-directed or self-directed does not appear to influence the needs and wants of the
Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.
Drawing from the organizational behaviour and services marketing literature, we develop a conceptual model of self-managing team (SMT) service climate, taking into account characteristics of the organizational context, the SMT, and the individual employee. In order to assess the impact of SMT
Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.
Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous
Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A
Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty
Morgeson, Frederick P
Relatively little empirical research has been conducted on external leaders of self-managing teams. The integration of functional leadership theory with research on team routines suggests that leaders can intervene in teams in several different ways, and the effectiveness of this intervention depends on the nature of the events the team encounters. External team leaders from 3 organizations first described a series of events (N=117), and leaders and team members then completed surveys to quantitatively describe the events. Results indicated that leader preparation and supportive coaching were positively related to team perceptions of leader effectiveness, with preparation becoming more strongly related to effectiveness as event novelty increased. More active leader intervention activities (active coaching and sense making) were negatively related to satisfaction with leadership yet were positively related to effectiveness as events became more disruptive.
Ni, Yun-Xia; Liu, Su-Zhen; Li, Ji-Ping; Diao, Yong-Shu; Dong, Ting; Tao, Lin
Managing increasing numbers of diabetic patients is placing increasing pressure on healthcare providers, especially general practitioners, who usually serve in multiple roles. This situation has caused generally poor results in terms of diabetes management. However, community nurses in some countries have successfully and effectively controlled chronic diseases among their patients. Therefore, the effects of nurse-led management is worth further exploration in order to better understand and promote this mode of care. To explore the effects of community-nurse-led team management on diabetes patients. An experimental research design was adopted. Patients with type 2 diabetes were recruited from two community health centers (the first for the intervention group, the second for the control group) in Wuhou District, Chengdu City, China. The intervention group received nurse-led team management care for 2 years, while the control group received standard care. The evaluations were conducted before the intervention and at 6, 12, and 24 months into the intervention. Outcomes included glycosylated hemoglobin (HbA1c) level, body mass index, waist circumference, visual acuity, ankle brachial index, kidney function index, urinary protein level, and electrocardiogram. The 179 participants included 88 in the intervention group and 91 in the control group. After the intervention, HbA1c level, ankle brachial index, and waist circumference were all significantly better in the intervention group than in the control group (F = 28.894, p team management is an effective mode of care in terms of controlling blood glucose control and preventing diabetes-related complications.
Fisher, Shelagh; Oulton, Tony
Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…
Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.
royalty -free government-purpose license to use, duplicate, or disclose the work, in whole or in part and in any manner, and to have or permit others to...Methodology of Incident Handling.” InfoSecurity 2001 Conference Program. Malaysian National Computer Confederation, 2001. 22 CMU/SEI-2004-TR-015
Schwartz, Mark D; Jensen, Ashley; Wang, Binhuan; Bennett, Katelyn; Dembitzer, Anne; Strauss, Shiela; Schoenthaler, Antoinette; Gillespie, Colleen; Sherman, Scott
Panel Management can expand prevention and chronic illness management beyond the office visit, but there is limited evidence for its effectiveness or guidance on how best to incorporate it into practice. We aimed to test the effectiveness of incorporating panel management into clinical practice by incorporating Panel Management Assistants (PMAs) into primary care teams with and without panel management education. We conducted an 8-month cluster-randomized controlled trial of panel management for improving hypertension and smoking cessation outcomes among veterans. Twenty primary care teams from the Veterans Affairs New York Harbor were randomized to control, panel management support, or panel management support plus education groups. Teams included 69 clinical staff serving 8,153 hypertensive and/or smoking veterans. Teams assigned to the intervention groups worked with non-clinical Panel Management Assistants (PMAs) who monitored care gaps and conducted proactive patient outreach, including referrals, mail reminders and motivational interviewing by telephone. Measurements included mean systolic and diastolic blood pressure, proportion of patients with controlled blood pressure, self-reported quit attempts, nicotine replacement therapy (NRT) prescriptions, and referrals to disease management services. Change in mean blood pressure, blood pressure control, and smoking quit rates were similar across study groups. Patients on intervention teams were more likely to receive NRT (OR = 1.4; 95% CI 1.2-1.6) and enroll in the disease management services MOVE! (OR = 1.2; 95% CI 1.1-1.6) and Telehealth (OR = 1.7, 95% CI 1.4-2.1) than patients on control teams. Panel Management support for primary care teams improved process, but not outcome variables among veterans with hypertension and smoking. Incorporating PMAs into teams was feasible and highly valued by the clinical staff, but clinical impact may require a longer intervention.
de Castro, S. M. M.; Busch, O. R. C.; van Gulik, T. M.; Obertop, H.; Gouma, D. J.
Background: Optimal management of severe pancreatic leakage after pancreatoduodenectomy can reduce morbidity and mortality. Completion pancreatectomy may be adequate but leads to endocrine insufficiency. This study evaluated an alternative management strategy for pancreatic leakage. Methods: Outcome
Fresco, A.; Subudhi, M.
Age-related degradation is managed through the maintenance program of a nuclear plant. From 1988 to 1991, the Nuclear Regulatory Commission (NRC) evaluated the maintenance program of every nuclear power plant in the United States. The authors reviewed 44 out of a total of 67 of the reports issued by the NRC on these in-depth team inspections. The reports were reviewed for insights into the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear plant structures, systems, and components. The authors' conclusions are presented. 6 refs
William R. Doucette; Cailin Lickteig; Stevie Veach; Barry Carter; Barcey Levy
Objectives: 1) Conduct team building activities for provider-community pharmacist teams in small communities and 2) Determine the impact of the team approach on practitioner-reported consequences and 3) Identify obstacles to the team approach and ways to overcome them. Methods: Eleven provider-pharmacist teams were recruited in rural/micropolitan communities in Iowa. The teams participated in team building sessions facilitated by the project leaders, to discuss the team approach. Decisio...
von Kodolitsch Y
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
Dunn, Edward J; Mills, Peter D; Neily, Julia; Crittenden, Michael D; Carmack, Amy L; Bagian, James P
Communication failure, a leading source of adverse events in health care, was involved in approximately 75% of more than 7,000 root cause analysis reports to the Department of Veterans Affairs (VA) National Center for Patient Safety (NCPS). The VA NCPS Medical Team Training (MTT) program, which is based on aviation principles of crew resource management (CRM), is intended to improve outcomes of patient care by enhancing communication between health care professionals. Unique features of MTT include a full-day interactive learning session (facilitated entirely by clinical peers in a health care context), administration of pre-and postintervention safety attitudes questionnaires, and follow-up semistructured interviews with reports of program activities and lessons learned. Examples of projects in these facilities include intensive care unit (ICU) teams' patient-centered multidisciplinary rounds, surgical teams' preoperative briefings and debriefings, an entire operating room (OR) unit's adoption of "Rules of Conduct" for expected staff behavior, and an ICU team's use of the model for daily administrative briefings. An MTT program based on applied CRM principles was successfully developed and implemented in 43 VA medical centers from September 2003 to May 2007.
Cheng, Cindy; Bartram, Timothy; Karimi, Leila; Leggat, Sandra G
This article examines the relationships among emotional labour, team climate, burnout, perceived quality of care and turnover intention among nurses in Australia, with the aim of addressing nurse retention and burnout. Emotional labour refers to the regulation of emotion during interpersonal transactions. It may involve faking unfelt emotions, hiding genuine emotions and deep acting whereby the individuals attempt to influence their inner feelings to induce the appropriate outward countenance. Currently, there is a dearth of literature that investigates the link between emotional labour and perceived quality of care and ultimately turnover intention. The contribution of team climate in the relationship between emotional labour and burnout is still uncertain. A cross-sectional quantitative study conducted with self-completed questionnaires. The study was conducted in 2011 with 201 registered nurses. Validated measures were used to measure the aforementioned constructs. Confirmatory factor analyses were used to examine the factor structure of the measured variables and hypotheses were tested using structural equation modelling. The final model demonstrates that faking has a significant negative influence on perceived quality of care. Hiding predicts burnout, leading to an increase in turnover intention. Team climate moderates the relationship between hiding and burnout, which may subsequently influence turnover intention. The establishment of a strong team climate may help nurses to manage the emotional demands of their role, promote their well-being and retention. © 2013 John Wiley & Sons Ltd.
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.
van Os, Annemiek; de Gilder, Dick; van Dyck, Cathy; Groenewegen, Peter
The purpose of this paper is to explore sensemaking of incidents by health care professionals through an analysis of the role of professional identity in narratives of incidents. Using insights from social identity theory, the authors argue that incidents may create a threat of professional identity, and that professionals make use of identity management strategies in response to this identity threat. The paper draws on a qualitative analysis of incident narratives in 14 semi-structured interviews with physicians, nurses, and residents at a Dutch specialist hospital. The authors used an existing framework of identity management strategies to categorize the narratives. The analysis yielded two main results. First, nurses and residents employed multiple types of identity management strategies simultaneously, which points to the possible benefit of combining different strategies. Second, physicians used the strategy of patronization of other professional groups, a specific form of downward comparison. The authors discuss the implications of the findings in terms of the impact of identity management strategies on the perpetuation of hierarchical differences in health care. The authors argue that efforts to manage incident handling may profit from considering social identity processes in sensemaking of incidents. This is the first study that systematically explores how health care professionals use identity management strategies to maintain a positive professional identity in the face of incidents. This study contributes to research on interdisciplinary cooperation in health care.
Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre
Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence. Pre-post treatment-non treatment group comparison. The program was administered by a trained psychologist on a once-a-week, 1-h session basis. Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group. Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview. Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η 2 p = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η 2 p = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p youth soccer sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches. Copyright © 2016 Elsevier Ltd. All rights reserved.
Effective and efficient caseload management requires extensive skills to ensure that patients receive the right care by the right person at the right time. District nursing caseloads are continually increasing in size and complexity, which requires specialist district nursing knowledge and skills. This article reviews the literature related to caseload management with the aim of identifying the most effective method for district nursing teams. The findings from this review are that there are different styles and methods of caseload management. The literature review was unable to identify a single validated tool or method, but identified themes for implementing effective caseload management, specifically caseload analysis; workload measurement; work allocation; service and practice development and workforce planning. This review also identified some areas for further research.
Full Text Available The research paper examines the moderating impact of Organizational Life Cycle on the relationship between Top Management Team Diversity and Company Performance. The study first elaborates and establishes the theoretical link between organization lifecycle and composition of management elites. Second, a quantitative empirical study is conducted to test the OLC stages moderating impact on the upper echelons diversity and firm performance of the top companies in the Czech Republic. A detailed procedure is developed to accurately classify organizations at different lifecycle stages, drawing extensively on existing literature and scales. Paper findings state that more mature the company becomes, more diversified the senior management is regardless the firm performance. Also, the industry dynamism impact has its own role in the relationship between the organization life cycle and senior management diversity which is expressed by the paper findings as well.
Mauro Enrique Carozzo-Todaro
Full Text Available This paper explores the effect of diversity and conflict management on the relationship between teamwork and organizational outcomes of small technology-based firms. To study the relationship between those variables, a quantitative research was conducted. The results of the survey involving 107 small Brazilian high-tech firms show that diversity and conflict management positively moderate the relationship between teamwork and organizational outcomes. So that, at higher levels of diversity and conflict management, best organizational outcomes. At the same time, it has been verified that conflict management is important regardless the level of diversity within teams. This research sheds new light on the factors that should be considered to become teamwork more effective in this specific context.
Buttigieg, Sandra C; Cassar, Vincent; Scully, Judy W
The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. The authors draw on solid theoretical frameworks--the complexity theory, team effectiveness model and the social identity theory--to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level.
Truijen, Karin; Sleegers, Peter; Meelissen, Martina; Nieuwenhuis, Loek
Purpose – At a time when secondary vocational education is implementing competence-based education (CBE) on a large scale, to adapt to the needs of students and of the labour market in a modern society, many vocational schools have recognised that interdisciplinary teacher teams are an important
Truijen, K.J.P.; Sleegers, P.J.C.; Meelissen, Martina R.M.; Nieuwenhuis, Loek
Purpose – At a time when secondary vocational education is implementing competence-based education (CBE) on a large scale, to adapt to the needs of students and of the labour market in a modern society, many vocational schools have recognised that interdisciplinary teacher teams are an important
Hamze Jamshidi Kohsari
Full Text Available Knowledge management is a process that has been recently generated as an activity which isvery important in the dynamic environment, and in the competitive scene. We believe that KM is aprocess which its organizational knowledge is created from the individual knowledge of themembers of the organization. The relevant studies have indicated that organizing based on workteams could be considered a way to create the appropriate context for KM. However, thisorganizing based on work teams is not enough; it only has the necessary characteristics of the workteams that favor KM. Moreover, based on studies done, we distinguish which characteristics ofwork teams favor the KM process in its different phases (i.e. creation, transfer and integration. Inthis study, we conducted multiple regression and analysis of variance.Complementary skills (H2 and a climate of trust (H3 in work teams were more importantfactors that favor the management of organizational knowledge.This research is based on the Zarraga and Perez studies in 2006.
Silva, Vitor V.A.; Santos, Andre A.C. dos; Cunha, Renan O.
The specification, configuration and management of a professional computer cluster are specialized tasks usually hold by well trained teams, often full-time hired computer scientists. However, in many situations and for widely different reasons, these very specific technical tasks must be carried on by no other than the user itself. This is the situation at Centro de Desenvolvimento da Tecnologia Nuclear - and in many nuclear research and educational centres in developing countries - where the scientists are the users of the cluster but also the technical team responsible to keep the system running. This paper presents the process of planning and installing the whole operating system and scientific software of a professional cluster aimed to be used in the nuclear engineering eld from the point of view of its users. The drawbacks of lack of expertise and technical skills to manage such type of technology are opposed to the advantages of freedom to chose the solutions which best t to the problems to be solved. The details of selected methods or technologies chosen for addressing a specific matter are presented together with other possible options, offering a broader view of the whole process of cluster's configuration. Specificities of dealing with closed, restricted and open software, common in the nuclear engineering eld, are also put in perspective. The ideas and solutions presented in this paper can be a valuable reference to other research teams found in a similar situation: being scientists and its own technical staff at the same time. (author)
Silva, Vitor V.A.; Santos, Andre A.C. dos; Cunha, Renan O., E-mail: firstname.lastname@example.org, E-mail: email@example.com, E-mail: firstname.lastname@example.org [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)
The specification, configuration and management of a professional computer cluster are specialized tasks usually hold by well trained teams, often full-time hired computer scientists. However, in many situations and for widely different reasons, these very specific technical tasks must be carried on by no other than the user itself. This is the situation at Centro de Desenvolvimento da Tecnologia Nuclear - and in many nuclear research and educational centres in developing countries - where the scientists are the users of the cluster but also the technical team responsible to keep the system running. This paper presents the process of planning and installing the whole operating system and scientific software of a professional cluster aimed to be used in the nuclear engineering eld from the point of view of its users. The drawbacks of lack of expertise and technical skills to manage such type of technology are opposed to the advantages of freedom to chose the solutions which best t to the problems to be solved. The details of selected methods or technologies chosen for addressing a specific matter are presented together with other possible options, offering a broader view of the whole process of cluster's configuration. Specificities of dealing with closed, restricted and open software, common in the nuclear engineering eld, are also put in perspective. The ideas and solutions presented in this paper can be a valuable reference to other research teams found in a similar situation: being scientists and its own technical staff at the same time. (author)
Brunton, Margaret Ann; Jeffrey, Lynn Maud
This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…
John Paul Stephens
Full Text Available Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team’s work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team’s work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams’ coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes.
Stewart, Greg L.; Courtright, Stephen H.; Barrick, Murray R.
The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how "peer-based rational control", which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and…
Raiman, Laura B.
Total quality management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The Assured Crew Return Vehicle (ACRV) Project Office was identified as an excellent project in which to demonstrate the applications and benefits of TQM processes. As the ACRV Program moves through its various stages of development, it is vital that effectiveness and efficiency be maintained in order to provide the Space Station Freedom (SSF) crew an affordable, on-time assured return to Earth. A critical factor for the success of the ACRV is attaining the maximum benefit from the resources applied to the program. Through a series of four tutorials on various quality improvement techniques, and numerous one-on-one sessions during the SSF's 10-week term in the project office, results were obtained which are aiding the ACRV Office in implementing a disciplined, ongoing process for generating fundamental decisions and actions that shape and guide the organization. Significant advances were made in improving the processes for two particular groups - the correspondence distribution team and the WATER Test team. Numerous people from across JSC were a part of the various team activities including engineering, man systems, and safety. The work also included significant interaction with the support contractor to the ACRV Project. The results of the improvement activities can be used as models for other organizations desiring to operate under a system of continuous improvement. In particular, they have advanced the ACRV Project Teams further down the path of continuous improvement, in support of a working philosophy of TQM.
"The intent of this primer is to inform and guide traffic incident management (TIM) professionals and transportation planners to initiate and develop collaborative relationships and advance TIM programs through the metropolitan planning process. The ...
Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.
The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...
Li Jing; Wang Dong; Zhang Ke
The welding quality of primary pipe directly affects the safe operation of nuclear power plants. Primary pipe automatic welding, first of its kind in China, is a complex systematic project involving many facets, such as design, manufacturing, material, and on-site construction. A R and D team was formed by China Guangdong Nuclear Power Engineering Co., Ltd. (CNPEC) together with other domestic nuclear power design institutes, and manufacturing and construction enterprises. According to the characteristics of nuclear power plant construction, and adopting team collaborative innovation management mode, through project co-ordination, resources allocation and building production, education and research collaborative innovation platform, CNPEC successfully developed the primary pipe automatic welding technique which has been widely applied to the construction of nuclear power plant, creating considerable economic benefits. (authors)
Bellam, Naveen; Kelkar, Anita A; Whellan, David J
The need for HF management is predicted to increase as the HF population ages. Balancing HF and the multiple cardiac comorbidities remains difficult for any single provider, but becomes Fig. 6. Five-year rates of death or urgent heart transplantation by deciles of total cholesterol in heart failure. (From Horwich TB, Fonarow GC, Hamilton MA, et al. Low serum total cholesterol is associated with marked increase in mortality in advanced heart failure. J Card Fail 2002;8(4):222; with permission.) easier with the involvement of a team. Collaboration between physicians, nurses, nurse practitioners, physician assistants, pharmacists, and other health care workers reduces the burden of care coordination and simultaneously improves delivery of care. Team-based approaches increase cost-effectiveness, reduce hospitalization rates, and equally important, give patients more resources and support, which research shows may ultimately improve compliance and outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.
Janie Canton-Tompson; Krista M. Gebert; Brooke Thompson; Greg Jones; David Calkin; Geoff. Donovan
Large wildland fires are complex, costly events influenced by a vast array of physical, climatic, and social factors. Changing climate, fuel buildup due to past suppression, and increasing populations in the wildland-urban interface have all been blamed for the extreme fire seasons and rising suppression expenditures of recent years. With each high-cost year comes a...
In designing an effective traffic management plan for non-recurrent congestion, it is critical for responsible highway agencies to have some vital information, such as estimated incident duration, resulting traffic queues, and the expected delays. Ov...
Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken
The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.
Perkins, R Serene; Lehner, Kathryn A; Armstrong, Randy; Gardiner, Stuart K; Karmy-Jones, Riyad C; Izenberg, Seth D; Long, William B; Wackym, P Ashley
Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment. Between December 2012 and December 2014, 22 surgical technicians and nurses participated in a curriculum complementary to the ATOM course, consisting of 8 individual 8-hour training sessions designed by and conducted at our institution. Didactic and practical sessions included educational content, hands-on instruction, and alternating role play during 5 system-specific injury scenarios in a simulated operating room environment. A pre- and postcourse examination was administered to participants to assess for improvements in team members' didactic knowledge. Course participants displayed a significant improvement in didactic knowledge after working in a team setting with trauma surgeons during the ATOM course, with a 9-point improvement on the postcourse examination (83%-92%, p = 0.0008). Most participants (90.5%) completing postcourse surveys reported being "highly satisfied" with course content and quality after working in our simulated team-training setting. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting. Improved communication, efficiency, appropriate equipment use, and staff awareness are the desired outcomes when shifting the paradigm from individual to surgical team training so that improved patient outcomes, decreased risk, and cost savings can be achieved. Determine whether a pilot curriculum for surgical technicians and nurses, based on the
Truijen, Karin; Sleegers, Peter; Meelissen, Martina; Nieuwenhuis, Loek
Purpose – At a time when secondary vocational education is implementing competence-based education (CBE) on a large scale, to adapt to the needs of students and of the labour market in a modern society, many vocational schools have recognised that interdisciplinary teacher teams are an important condition for this implementation. In order to provide students with the right competences for the labour market, different subject teachers should work and learn together and, by doing so, should be ...
In 2004, the Federal Highway Administration published updated rules governing work zone safety and mobility; all highway construction and maintenance projects using federal-aid highway funds are required to develop transportation management plans (TM...
Conversations with school and crisis personnel following large scale emergencies in and around schools, such as shootings, wildfires, and the attack on the World Trade Center on September 11, 2001, indicated a need for pre-incident training in managing student behavior during emergencies. This article outlines a training program of this kind and offers suggestions regarding both content and process of this training. The suggestions follow discussion of the unique context and needs of the school setting.
Gowing, Alice; Dickinson, Claire; Gorman, Tom; Robinson, Louise; Duncan, Rachel
To explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patients through care planning and regular reviews using primary, community, secondary and social care professionals. A qualitative study using semistructured interviews, which were digitally recorded, transcribed and subject to thematic analysis. Community patients receiving primary care in the county of Northumberland, England. 23 participants took part, of which 16 were patients enrolled on the NHRPP, and 7 carers. GP practices were selected purposively by size, deprivation and location, and patients identified and invited by General Practitioners to participate. 4 main themes emerged from the data: awareness and understanding of the NHRPP, confidence in the primary healthcare team, limitations of home care and the active role of being a patient. Despite having a low level of awareness of the details of the NHRPP, participants did think that its broad aim made sense. Participants discussed their high level of satisfaction with their care and access to team members. However, some limitations of alternatives to hospital care were identified, including the need to consider psychological as well as medical needs, the importance of overnight care and the needs of those without informal carers. Finally, participants discussed the active nature of being a patient under the NHRPP if they were to contribute fully to planning and managing their own care. This study has identified that a programme of MDT-led case management was generally very well received by patients and their families. However, a number of factors were identified that could improve the implementation of the programme and further research needs to be undertaken to address these. Published by the BMJ
Full Text Available This paper reviews research findings on entrepreneurial top management teams within the last 20 years. It concentrates on team-based management factors and their influence on a new venture’s growth and ability to raise capital. This paper integrates recent findings and provides an overview of the current state of research. Moreover, it contributes to the overall topic by proposing five clusters of major team-specific influences, derives determinants of success and failure, and reveals recommendations for further research.
A system for training of coordination and cooperation of decision makers in emergency management has been under construction for some time. A first prototype of the system was developed in the MUSTER system. The system is being developed modularly with one module for each of the suborganisations...... involved in the complete preparedness: fire brigade, police, medical team, civil defence, etc. All these modules will in the end be integrated on a common integration platform, either to a fully-fledged system covering all aspects of training for the complete preparedness, or for creating a dedicated...
Nandini V Kamat
This case report describes management of an adult patient with a traumatically repaired cleft. The maxilla was deficient in all three planes and the mandible appeared protrusive. The patient′s speech had nasalance and articulation problems. The patient was informed about the possibility of speech deterioration post-surgery and was explained about the options available. After appropriate presurgical orthodontics, maxilla was surgically expanded and was also advanced by 5 mm. After surgery, speech was more intelligible because of improved articulation. It was possible to get optimum esthetic and functional result due to coordinated team approach.
Mercedes Ramos Fresno
Full Text Available This article aims to establish some notes identifying the counseling process that has been developing for educational inspection services . We will focus on advising management teams, teachers and Educational coordination bodies, bearing in mind that this is a triadic counseling, whose ultimate aim is to achieve the maximum development in students from the premises of quality and equity. We will also have in mind the implications for the organizational and professional development of teachers from the principles of participation and autonomy, and how it promotes teacher professional improvement, commitment to teaching practice and the necessary self-criticism to constantly evaluate, generating educational proposals flexible, through self-reflection.
Kruger, Davida F; Lorenzi, Gayle M; Dokken, Betsy B; Sadler, Christopher E; Mann, Kelly; Valentine, Virginia
The importance of glycemic control has been well established. In response, the American Diabetes Association has established goals for glycemic control and other cardiovascular parameters, including blood pressure and low-density and high-density lipoprotein cholesterol. However, the National Health and Nutrition Examination Survey has shown that only about half (57%) of patients with diabetes meet a glycated hemoglobin A(1c) (HbA(1c)) goal of team care, coupled with appropriately chosen pharmacologic therapy and patient education that fosters the development of critical thinking skills and the ability to make self-management decisions, have been shown to improve glycemic control and cardiovascular outcomes.
Vader, Justin M; Rich, Michael W
HF is a condition in which the prognosis and treatment are often defined by comorbidities, many of which are noncardiac. Knowledge of the interactions between HF and specific comorbidities is essential, yet to date the clinical trial evidence base for managing comorbidity in patients with HF is limited; further investigations are clearly needed. Perhaps the most pressing need is a focus on the overall multimorbidity state and its relationship to HF-a need that should be addressed in forthcoming trials. Successful navigation between HF and common interacting comorbidities requires coordination of care and team-based approaches that continually evolve to meet patient needs. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents. Methods A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region. Results 16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination. Conclusion We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.
The primary purpose of this handbook is to provide guidance to the ISMS verification Team Leader and the verification team in conducting ISMS verifications. The handbook describes methods and approaches for the review of the ISMS documentation (Phase I) and ISMS implementation (Phase II) and provides information useful to the Team Leader in preparing the review plan, selecting and training the team, coordinating the conduct of the verification, and documenting the results. The process and techniques described are based on the results of several pilot ISMS verifications that have been conducted across the DOE complex. A secondary purpose of this handbook is to provide information useful in developing DOE personnel to conduct these reviews. Specifically, this handbook describes methods and approaches to: (1) Develop the scope of the Phase 1 and Phase 2 review processes to be consistent with the history, hazards, and complexity of the site, facility, or activity; (2) Develop procedures for the conduct of the Phase 1 review, validating that the ISMS documentation satisfies the DEAR clause as amplified in DOE Policies 450.4, 450.5, 450.6 and associated guidance and that DOE can effectively execute responsibilities as described in the Functions, Responsibilities, and Authorities Manual (FRAM); (3) Develop procedures for the conduct of the Phase 2 review, validating that the description approved by the Approval Authority, following or concurrent with the Phase 1 review, has been implemented; and (4) Describe a methodology by which the DOE ISMS verification teams will be advised, trained, and/or mentored to conduct subsequent ISMS verifications. The handbook provides proven methods and approaches for verifying that commitments related to the DEAR, the FRAM, and associated amplifying guidance are in place and implemented in nuclear and high risk facilities. This handbook also contains useful guidance to line managers when preparing for a review of ISMS for radiological
Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri
The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety. © 2017 John Wiley & Sons Ltd.
William R. Doucette
Full Text Available Objectives: 1 Conduct team building activities for provider-community pharmacist teams in small communities and 2 Determine the impact of the team approach on practitioner-reported consequences and 3 Identify obstacles to the team approach and ways to overcome them. Methods: Eleven provider-pharmacist teams were recruited in rural/micropolitan communities in Iowa. The teams participated in team building sessions facilitated by the project leaders, to discuss the team approach. Decisions included patient identification, practitioner roles, and communications. Most pharmacists conducted blood pressure (BP checks in the pharmacy and assessed the anti-hypertensive medications. If the BP was not at goal, the pharmacist worked with the patient and provider to make improvements. Teams followed their strategies for 3-5 months. Data were collected from pharmacy logs and on-line surveys of team members before and after the team period. Results: Using a multi-case approach, 4 cases were classified as Worked-Well, 5 as Limited-Success, and 2 as No-Team-Care. The Worked-Well teams provided an average of 26.5 BP visits per team, while the Limited-Success teams averaged 6.8 BP visits. The Worked-Well teams established and used a system to support the team approach. The Limited-Success teams either didn't fully establish their team system, or used it sparingly. The No-Team-Care cases did not provide any team care. Conclusions: Factors supporting success were: positive provider-pharmacist relations, established team system, commitment to team care, and patient willingness to participate. While this program had some success, potential improvements were identified: more follow-up after the team building session, additional patient materials, and guidance for practice changes. Type: Case Study
Lee, M.D.E. van der; Vugt, M. van der
The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of
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.
Ung, Kim Ann; Campbell, Belinda A; Duplan, Danny; Ball, David; David, Steven
Multidisciplinary team (MDT) meetings are increasingly regarded as a component of multidisciplinary cancer care. We aimed to prospectively measure the impact of MDT meetings on clinicians' management plans for lung oncology patients, and the implementation rate of the meeting recommendations. Consecutive patient cases presented at the weekly lung oncology MDT meetings were prospectively enrolled. Investigators compared the clinicians' management plans pre-meeting with the consensus plans post-meeting. The meeting was considered to have an impact on management plans if ≥1 of the following changes were detected: tumor stage, histology, treatment intent or treatment modality, or if additional investigations were recommended. Investigators reviewed hospital patient records at 4 months to determine if the meeting recommendations were implemented. Reasons for non-implementation were also recorded. Of the 55 eligible cases, the MDT meeting changed management plans in 58% (CI 45-71%; P management plans for lung oncology patients. The majority of MDT recommendations (72%) were implemented into patient care. These findings provide further evidence to support the role of MDT meetings as an essential part of the decision-making process for the optimal multidisciplinary management of patients with cancer. © 2014 Wiley Publishing Asia Pty Ltd.
Riyadh Mohamad Hasan
Full Text Available Background: Perianal fistula is among the most common anorectal diseases encountered in adults, men are more prone to be affected than women. There is a close relationship of abscess and fistula in etiology, anatomy, pathophysiology, therapy, complications and morbidity, it is appropriate to consider them as one entity. Aim of study: To determine the incidence of fistula formation and recurrent abscess in a sample of Iraqi patients in Baghdad and decide whether primary fistulotomy should be performed at the time of incision and drainage of perianal abscesses. Patients and methods: A retrospective study of 68 patients with perianal abscess operations conducted in Baghdad. They underwent incision and drainage under either local or general anesthesia at Al-Kindy Teaching Hospitals and private hospitals over a 15-year period from January 2000 to December 2015. Their ages ranged from 20 to 68 years (40.21 ± 1.34 males (63/68 (92.64% were more than females (5/68 (7.35%. Patients were treated with incision over the abscess under anesthesia and drainage of the abscess was done. The patients were followed up for an average 18 months (range 12–24 months after abscess drainage or until a fistula appeared and abscess recurrence. Results: The study group comprised of 68 (92.64% patients with perianal abscess with a median age 39 years (range 20–68 years. The mean follow-up period was identified to be 18 months (range 12–24 months. Males (63/68 (92.64% were more than females (5/68 (7.35%. The incidence of fistula formation after follow up, the patients with perianal abscess after incision and drainage was 31/68 (45.58% and males (30/31 (44.11% were more than females (1/31 (1.47%. The most common site was posterior then left lateral position. The percentage of patients with recurrent abscess n = 6 (8.82%were lower than fistula formation n = 31 (45.58%. The percentage of males n = 4/6 (5.88% were more than females 2/6 (2.94%. Conclusions: The
Steenbruggen, J.G.M.; Nijkamp, P.; Smits, J.M.; Mohabir, G.
Disaster Management and Traffic Incident Management involves the coordinated interactions of many public and private actors. On many levels, there is clearly a strong relation be-tween the road infrastructure and the effective handling of large scale disasters. To support these tasks in an effective
Glogowska, Margaret; Simmonds, Rosemary; McLachlan, Sarah; Cramer, Helen; Sanders, Tom; Johnson, Rachel; Kadam, Umesh T; Lasserson, Daniel S; Purdy, Sarah
The purpose of this study was to explore the perceptions and experiences of health care clinicians working in multidisciplinary teams that include specialist heart failure nurses when caring for the management of heart failure patients. We used a qualitative in-depth interview study nested in a broader ethnographic study of unplanned admissions in heart failure patients (HoldFAST). We interviewed 24 clinicians across primary, secondary, and community care in 3 locations in the Midlands, South Central, and South West of England. Within a framework of the role and contribution of the heart failure specialist nurse, our study identified 2 thematic areas that the clinicians agreed still represent particular challenges when working with heart failure patients. The first was communication with patients, in particular explaining the diagnosis and helping patients to understand the condition. The participants recognized that such communication was most effective when they had a long-term relationship with patients and families and that the specialist nurse played an important part in achieving this relationship. The second was communication within the team. Multidisciplinary input was especially needed because of the complexity of many patients and issues around medications, and the participants believed the specialist nurse may facilitate team communication. The study highlights the role of specialist heart failure nurses in delivering education tailored to patients and facilitating better liaison among all clinicians, particularly when dealing with the management of comorbidities and drug regimens. The way in which specialist nurses were able to be caseworkers for their patients was perceived as a method of ensuring coordination and continuity of care. © 2015 Annals of Family Medicine, Inc.
Talke, Katrin; Salomo, Søren; Kock, Alexander
A firm's strategic innovation orientation, which is aimed at discovering and satisfying emerging customer needs with novel technological solutions, has repeatedly been shown to be crucial for firm innovativeness and firm performance. Despite its apparent importance, relatively little research has...... addressed antecedents of a firm's strategic orientation that help explain heterogeneity in innovation strategies across firms. Especially the influence of top management teams (TMT) should be critical, since innovation strategies are shaped at the top management level. Building on the theory of upper...... market data for firm performance. Results indicate that TMT diversity, measured as heterogeneity in educational, functional, industry, and organizational background, has a strong positive effect on a firm's innovation orientation. A strong proactive focus on emerging customer needs and on novel...
Fresco, A.; Subudhi, M.
A plant's maintenance program is the principal vehicle through which age-related degradation is managed. From 1988 to 1991, the NRC evaluated the maintenance program of every nuclear power plant in the United States. Forty-four out of a total of sixty-seven of the reports issued on these in-depth team inspections have been reviewed for insights into the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear plant structures, systems, and components (SSCs). Relevant information has been extracted from these inspection reports sorted into several categories; including Specific Aging Insights, Preventive Maintenance, Predictive Maintenance and Condition Monitoring, Post Maintenance Testing, Failure Trending, Root Cause Analysis and Usage of Probabilistic Risk Assessment in the Maintenance Process. Specific examples of inspection and monitoring techniques successfully used by utilities to detect degradation due to aging have been identified
Peña-Viveros, Raúl; Hernández-Hernández, Dulce María; Vélez-Moreno, Ana María Luz; García-Sandoval, Martha Gabriela; Reyes-Tellez, María Araceli; Ureña-Bogarin, Enrique L
To identify the relationship between organizational climate of management teams and the performance of health services. A transversal and analytical study was designed. The Organizational Climate Scale (OCS) was utilized and performance was assessed by the achievement indicators through correlation analysis and multiple regression. Thirty four medical benefits services headquarters (JSPM) were measured of the Mexican Social Security Institute. Of 862 participating, 238 (27.6%) evaluated the climate of their organizations with a high level; the maximal score was 56%. Average performance value was 0.79 ± 0.07 (minimal: 0.65; maximal: 0.92). A positive correlation was demonstrated between organizational climate level and performance (r=0.4; p=0.008). The organizational climate of the health services managers (JSPM) is directly related with performance in health care.
Kakou-Guikahue, Maurice; N'Guetta, Roland; Anzouan-Kacou, Jean-Baptiste; Kramoh, Euloge; N'Dori, Raymond; Ba, Serigne Abdou; Diao, Maboury; Sarr, Moustapha; Kane, Abdoul; Kane, Adama; Damorou, Findide; Balde, Dadhi; Diarra, Mamadou Bocary; Djiddou, Mohamed; Kimbally-Kaki, Gisèle; Zabsonre, Patrice; Toure, Ibrahim Ali; Houénassi, Martin; Gamra, Habib; Chajai, Bachir; Gerardin, Benoit; Pillière, Rémy; Aubry, Pierre; Iliou, Marie-Christine; Isnard, Richard; Leprince, Pascal; Cottin, Yves; Bertrand, Edmond; Juillière, Yves; Monsuez, Jean-Jacques
Whereas the coronary artery disease death rate has declined in high-income countries, the incidence of acute coronary syndromes (ACS) is increasing in sub-Saharan Africa, where their management remains a challenge. To propose a consensus statement to optimize management of ACS in sub-Saharan Africa on the basis of realistic considerations. The AFRICARDIO-2 conference (Yamoussoukro, May 2015) reviewed the ongoing features of ACS in 10 sub-Saharan countries (Benin, Burkina-Faso, Congo-Brazzaville, Guinea, Ivory Coast, Mali, Mauritania, Niger, Senegal, Togo), and analysed whether improvements in strategies and policies may be expected using readily available healthcare facilities. The outcome of patients with ACS is affected by clearly identified factors, including: delay to reaching first medical contact, achieving effective hospital transportation, increased time from symptom onset to reperfusion therapy, limited primary emergency facilities (especially in rural areas) and emergency medical service (EMS) prehospital management, and hence limited numbers of patients eligible for myocardial reperfusion (thrombolytic therapy and/or percutaneous coronary intervention [PCI]). With only five catheterization laboratories in the 10 participating countries, PCI rates are very low. However, in recent years, catheterization laboratories have been built in referral cardiology departments in large African towns (Abidjan and Dakar). Improvements in patient care and outcomes should target limited but selected objectives: increasing awareness and recognition of ACS symptoms; education of rural-based healthcare professionals; and developing and managing a network between first-line healthcare facilities in rural areas or small cities, emergency rooms in larger towns, the EMS, hospital-based cardiology departments and catheterization laboratories. Faced with the increasing prevalence of ACS in sub-Saharan Africa, healthcare policies should be developed to overcome the multiple
Milton, John G.; Radunskaya, Ami E.; Lee, Arthur H.; de Pillis, Lisette G.; Bartlett, Diana F.
The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics…
Annosi, Maria Carmela; Foss, Nicolai Juul; Brunetta, Federica
-based firms. We argue that managerial and stakeholder interventions shape the self-construction of team identity as well as the team’s commitment to specific work objectives. We also suggest that team identity becomes isomorphic to organizational identity because of pressures related to: (1) the presence...... of a dense network of managers and stakeholders, which orients teams towards a focus on certain aspects of the higher-order identity; (2) the use of team routines and regular feedback loops, which force alignment with the organizational identity; and (3) the use of coordinating roles aimed at promoting......, ratifying and reinforcing the convergence of identity within the team. We analyse multiple cases from a major multinational corporation in the telecommunications industry, which we examine through the lens of a multi-level model of controls involving the micro, meso and macro organizational levels. We...
Hobson, Alexandra; Curtis, Alexa
Improving healthcare delivery for U.S. veterans is a national priority. The Veterans Health Administration (VHA) employs a variety of team-based, population health strategies to address critical issues in veterans' health including the effective management of chronic disease. Nurse practitioners (NPs) are integral members of the VHA patient care team with a substantial role to play in the organization and delivery of healthcare services for veterans. This report explores the contributions of NPs in team-based, population health strategies within the VHA. This review of the literature examines peer-reviewed articles published between 2006 and 2017 to explore the contributions of NPs in team-based, population health strategies within the VHA. Search words include veterans, VHA, NPs, population health, panel management, and chronic disease. NPs are vital members of the VHA primary care team; however, there is a dearth of available evidence reflecting the unique contribution of NPs within VHA team-based, population health management strategies. The VHA adoption of full practice authority for NP practice provides NPs with an expanded capacity to lead improvements in veterans' health. Future research is needed to fully understand the unique role of the NP in the delivery of population health management strategies for veterans. ©2017 American Association of Nurse Practitioners.
Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...
defined as emotional abuse cases (7%). Interventions recommended for these spouse abuse cases were marital therapy (61.4%), individual therapy (39.5...anger management training (50%), conflict containment classes (26.7%), group therapy (15.2%), family therapy (6.7%), and communication skills...discriminate against men who are victims" (p. 300). In contrast, feminist models have influenced many social work practitioners who have used them to
Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa
Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group
Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M
Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.
Behfar, Kristin J; Peterson, Randall S; Mannix, Elizabeth A; Trochim, William M K
This article explores the linkages between strategies for managing different types of conflict and group performance and satisfaction. Results from a qualitative study of 57 autonomous teams suggest that groups that improve or maintain top performance over time share 3 conflict resolution tendencies: (a) focusing on the content of interpersonal interactions rather than delivery style, (b) explicitly discussing reasons behind any decisions reached in accepting and distributing work assignments, and (c) assigning work to members who have the relevant task expertise rather than assigning by other common means such as volunteering, default, or convenience. The authors' results also suggest that teams that are successful over time are likely to be both proactive in anticipating the need for conflict resolution and pluralistic in developing conflict resolution strategies that apply to all group members. 2008 APA
Jiang Sen; Zhu Xiaohua; Sun Xiwen; You Zhengqian; Ma Jun; Yu Dong; Peng Gang; Jie Bing; Sun Chunyi
Objective: To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsibly NBSA for hemoptysis. Methods: The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectasis in 41 (1 case with post-lobectomy and 1 case with post-ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results: Seventy-three patients (52.5%) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 case with post-ligation of patent ductus arteriosus, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n=88), internal thoracic arteries (n=27), inferior phrenic arteries (n=21), proper esophageal arteries (n=20), lateral thoracic arteries (n=9), subscapular arteries (n=7), costocervical trunks (n=5) and thyrocervical trunks (n=4). Main responsible NBSA were posterior intercostal arteries (n=75) and branches of subclavian and axillary artery (n=44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n=16) and inferior phrenic arteries (n=17) in bronchiectasis. The clinical
Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela
Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.
Puvaneswaralingam, Shobitha; Ross, Daniella
Transferring patients from the ward of their specialty or consultant is described as boarding. 1 Boarding patients is becoming increasingly prevalent due to greater pressure on hospital capacity. This practice compromises patient safety through delayed investigations, prolonged hospital stays, and increased risk of hospital-acquired infections. 1 2 We evaluated how regularly boarded patients were reviewed, and how effectively information regarding their management was communicated from their primary specialty to ward staff. We aimed to improve the frequency of patient reviews by ensuring that each patient was reviewed every weekday and increase communication between primary specialty, and medical and nursing teams by 20% from baseline during the data collection period. The project was based in the Otolaryngology ward in Ninewells Hospital, Dundee, where there was a high prevalence of boarded patients. Baseline data showed a clear deficit in communication between the primary specialty and ward staff with only 31% of patient reviews being communicated to ward doctors. We designed and implemented a communication tool, in the form of a sticker, to be inserted into patients' medical notes for use by the primary specialty. Implementation of the sticker improved communication between teams as stickers were completed in 93% of instances. In 88% of patient reviews, the junior doctor was informed of the management plan, showing a large increase from baseline. Through PDSA cycles, we aimed to increase the sustainability and reliability of the sticker; however, we faced challenges with sustainability of sticker insertion. We aim to engage more stakeholders to raise awareness of the problem, brainstorm solutions together, and review the production and implementation of stickers with senior hospital management to discuss the potential use of this tool within practice. There is potentially a large scope for utilisation of this communication tool on a local level, which we hope
Choi, Eun Ha; Kim, Eun-Kyung; Kim, Pil Bong
EDUCATIONAL LEADERSHIP OF NURSING UNIT MANAGERS ON TEAM EFFECTIVENESS: Mediating Effects of Organizational Communication Satisfaction. This study identifies the effects of the educational leadership of nursing unit managers on team effectiveness and the mediating effects of organizational communication satisfaction; it highlights the importance of educational leadership and organizational communication and provides the data needed to enhance the education capacity of managers. The participants were 216 nursing unit managers of staff nurses at a tertiary hospital located in C Region, South Korea, and nurses who had worked for more than six months at the same hospital. This study was conducted using questionnaires on educational leadership, team effectiveness, and organizational communication satisfaction. Data analysis was performed with a t-test, ANOVA, Scheffé, Pearson's correlation coefficient, and simple and multiple regression analyses using SPSS version 23.0. Mediation analysis was tested using Baron and Kenny's regression analysis and a Sobel test. The mean score for the educational leadership of nursing unit managers was 3.74(±0.68); for organizational communication satisfaction, 3.14(±0.51); and for team effectiveness, 3.52(±0.49). Educational leadership was significantly positively correlated with team effectiveness and organizational communication satisfaction. Organizational communication satisfaction demonstrated a complete mediating effect on the relationship between educational leadership and team effectiveness (β=.61, pcommunication satisfaction among nurses; this supports the idea that educational leadership can contribute to team effectiveness. This suggests that the educational leadership and communication capacity of nursing unit managers must be improved to enhance the performance of nursing organizations. Copyright © 2018. Published by Elsevier B.V.
Dearbhaile C. Collins
Full Text Available Urachal carcinoma is an uncommon cancer whose rarity has precluded its study and evidence-based management strategies are lacking. This study assessed all urachal carcinomas in Ireland and clinical parameters in order to improve understanding. Urachal carcinomas diagnosed from 1994 to 2011 were identified from the National Cancer Registry in Ireland. Data obtained included patient age, gender, diagnostic year, pathology, tumor stage, patient treatment strategies and survival. Twenty-six urachal carcinomas were identified, the majority being adenocarcinoma. This comprised 0.3% of all invasive bladder tumors. Patients were predominantly male (62% and over 50 years of age (58%. Twenty-two patients (85% underwent surgery, with only six (23% undergoing chemotherapy. On average, median overall survival was 2.6 years (range 0-15.2 yrs. Survival was longer in women (5 vs. 1.9 yrs, patients under 50 years of age (3.6 vs. 1.9 yrs, those without confirmed metastasis (4.1 vs. 0.7 yrs and those who received chemotherapy (3.6 vs. 2.6 yrs. The overall survival of urachal carcinoma in Ireland is less than expected from published literature. This study highlights the need for centralization of rare tumors with international collaboration to identify the optimal treatment strategy and improve outcome.
Self-managing teams (SMTs) are receiving increasing attention from organizations striving for continuous improvement and searching for innovative ways to get their employees involved and empowered. More and more organizations are realizing the significant impact these teams have on quality, productivity, the social circles, worker esteem, and profitability. Consultants and researchers have also paid significant attention to the concept of SMTs, focusing on many aspects o...
Tânia Maria Fontenele Mourão
Full Text Available Este estudo teve como objetivo apreender a maneira como as equipes que têm uma mulher como gerente estão construindo representações sociais sobre este gerenciar. Participaram 74 mulheres e 72 homens de equipes que trabalham com sete mulheres que atingiram o topo de carreira, ocupando cargos administrativos nos níveis DAS 5 e DAS 6 da Administração Pública Federal. Utilizou-se a associação livre de palavras, sendo as respostas analisadas pelo software EVOC. Os resultados indicam que os participantes identificam algumas características que as equipes atribuem ao gerenciamento feminino. Apontam para uma forma de gestão voltada para as relações pessoais, respeito pela pessoa, preocupação com a qualidade do trabalho. Um gerenciamento cujo estilo interativo se caracterizaria pela capacidade de promover a inclusão, característico das formas de redes planas de gestão.The aim of this study was to apprehend the way teams that have a woman as amanager are building the social representation about this management. The participants were 74 women and 72 men whose teams work with seven women who have reached the top of their careers in administrative positions of DAS 5 and DAS 6 levels of the Public Federal Administration. A free association test was applied and analyzed through the EVOC software. The results showed that the participants identified some characteristics on women management that were considered a feminine form of leadership: interpersonal relationship, respect for individuality, concern with the quality of work. This kind of management carries an interactive style that is characterized by the capacity to promote inclusion, which is a characteristic of flat management nets.
Peterson, Eric D; Albert, Nancy M; Amin, Alpesh; Patterson, J Herbert; Fonarow, Gregg C
According to several medical registries, there is a need to improve the care of post-myocardial infarction (MI) patients, especially those with left ventricular dysfunction (LVD) and heart failure. This can potentially be achieved by implementing disease management programs, which include critical pathways, patient education, and multidisciplinary hospital teams. Currently, algorithms for critical pathways, including discharge processes, are lacking for post-MI LVD patients. Such schemes can increase the use of evidence-based medicines proved to reduce mortality. Educational programs are aimed at increasing patients' awareness of their condition, promoting medication compliance, and encouraging the adoption of healthy behaviors; such programs have been shown to be effective in improving outcomes of post-MI LVD patients. Reductions in all-cause hospitalizations and medical costs as well as improved survival rates have been observed when a multidisciplinary team (a nurse, a pharmacist, and a hospitalist) is engaged in patient care. In addition, the use of the "pay for performance" method, which can be advantageous for patients, physicians, and hospitals, may potentially improve the care of post-MI patients with LVD.
Stenner, Robert D.
The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.
Simons, T L; Peterson, R S
Task conflict is usually associated with effective decisions, and relationship conflict is associated with poor decisions. The 2 conflict types are typically correlated in ongoing groups, however, which creates a prescriptive dilemma. Three explanations might account for this relationship--misattribution of task conflict as relationship conflict, harsh task conflict tactics triggering relationship conflict, and misattribution of relationship conflict as task conflict. The authors found that intragroup trust moderates the relationship between task conflict and relationship conflict in 70 top management teams. This result supports the "misattribution of task conflict" explanation. The authors also found a weak effect that is consistent with the argument that tactical choices drive the association between the 2 conflict types. We infer that trust is a key to gaining the benefits of task conflict without suffering the costs of relationship conflict.
Peter R. Stinson
Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.
Saufl, Nancy M; Strzyzewski, Nancy
Because the availability of new, peripherally acting mu-opioid-receptor antagonists is expected soon, it is important for all members of the surgical team to familiarize themselves with new approaches and also re-evaluate older approaches to help improve patient outcomes. "Preop nurses" have numerous responsibilities, among which are mitigating some of the adverse outcomes of surgery such as postoperative ileus (POI), making these nursing personnel indispensable to the proper implementation of multimodal management protocols for POI. Establishing basic preoperative procedures is an important primary consideration. Preoperative evaluation of general health, medical history (including surgical history), and an assessment of gastrointestinal (GI) function and habits should all be part of careful up-front assessment for each patient, especially because POI and other GI adverse effects are so often encountered in the PACU. Hand-in-hand with how we as nurses interact with our surgical colleagues is patient education regarding hospitalization and postrecovery expectations. PACU nurses will be key players in maintaining proper implementation of multimodal regimens, essentially doing this in two "phases": Phase I interventions comprise the ongoing assessment and monitoring of patients, administering medications, and evaluating patient satisfaction and overall status; Phase II considerations encompass a further set of practice guidelines that center on optimizing discharge status, including pain management and education as well as other discharge needs. Where new agents may fit into multimodal regimens that optimally incorporate preoperative and postanesthesia protocols remains to be determined. What is clear is that as nurses and the entire surgical team strive to enhance patient satisfaction, nursing personnel must assume leadership roles in how new multimodal strategies are implemented and executed. Advanced clinical data for the new peripherally acting mu
Rayane Oliveira Cedraz
Full Text Available Abstract Objective: To evaluate the incidence and risk factors associated with falls and pressure injuries in a clinical unit. Methods: A quantitative, cross-sectional, descriptive-exploratory study was conducted at a university hospital in Rio de Janeiro using secondary data from patient records and information of registers of patients treated in 2015/2016. Data were analyzed using descriptive and inferential statistics. Results: Of the 157 treated patients, women, cardiovascular (43.9% and oncological diseases (35.0% predominated. The risk and incidences of falls and pressure injuries were higher in men. There were significant associations of gender with the risk of falling, the occurrence of falls and pressure injuries, and between the length of hospital stay and risk of falling. Conclusion: Risk management is essential to promote patient safety and improve quality of health care. Nurse staff plays a fundamental role in the process of guiding activities, updating the nursing team and evaluating interventions. The use of tools, such as protocols and indicators, allows the optimization of the work process and the achievement of these goals.
Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim
In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.
W. M. Wang
Full Text Available Conflict management is one of the most important issues in leveraging organizational competitiveness. However, traditional social scientists built theories or models in this area which were mostly expressed in words and diagrams are insufficient. Social science research based on computational modeling and simulation is beginning to augment traditional theory building. Simulation provides a method for people to try their actions out in a way that is cost effective, faster, appropriate, flexible, and ethical. In this paper, a computational simulation model for conflict management in team building is presented. The model is designed and used to explore the individual performances related to the combination of individuals who have a range of conflict handling styles, under various types of resources and policies. The model is developed based on agent-based modeling method. Each of the agents has one of the five conflict handling styles: accommodation, compromise, competition, contingency, and learning. There are three types of scenarios: normal, convex, and concave. There are two types of policies: no policy, and a reward and punishment policy. Results from running the model are also presented. The simulation has led us to derive two implications concerning conflict management. First, a concave type of resource promotes competition, while convex type of resource promotes compromise and collaboration. Second, the performance ranking of different styles can be influenced by introducing different policies. On the other hand, it is possible for us to promote certain style by introducing different policies.
Full Text Available Esme J Soan,1–3 Steven J Street,1,2 Sharon M Brownie,3,4 Andrew P Hills1–31Mater Mothers' Hospital, South Brisbane, 2Mater Research Institute – University of Queensland, South Brisbane, 3Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia; 4Green Templeton College, Oxford University, Oxford, UKAbstract: Noncommunicable diseases (NCDs, such as obesity and type 2 diabetes mellitus, are a growing public health challenge in Australia, accounting for a significant and increasing cost to the health care system. Management of these chronic conditions is aided by interprofessional practice, but models of care require updating to incorporate the latest evidence-based practice. Increasing research evidence reports the benefits of physical activity and exercise on health status and the risk of inactivity to chronic disease development, yet physical activity advice is often the least comprehensive component of care. An essential but as yet underutilized player in NCD prevention and management is the "accredited exercise physiologist," a specialist in the delivery of clinical exercise prescriptions for the prevention or management of chronic and complex conditions. In this article, the existing role of accredited exercise physiologists in interprofessional practice is examined, and an extension of their role proposed in primary health care settings.Keywords: interdisciplinary team, obesity, type 2 diabetes mellitus, exercise physiology, accredited exercise physiologist
Powell, Helen A; Baldwin, David R
Multidisciplinary team (MDT) management in thoracic oncology has been introduced over the past two decades with the aim of improving outcomes for patients. While MDT management has become the standard of care in some countries, not all healthcare systems have adopted this practice. In this article we review the history and implementation of MDT care in thoracic oncology and explore the evidence for, and challenges associated with, this system of working. There are many advantages of an MDT both to the patient, the clinicians and the wider population, but it is difficult to demonstrate a beneficial effect on outcomes such as treatment rates or survival given the substantial number of coexistent changes in the management of thoracic malignancies over the same time period. There are also some disadvantages associated with MDT working, particularly the costs of setting up the service and the time commitment from each of the healthcare professionals involved. Barriers to effective MDT working include poor attendance by some specialists, inadequate preparation and poor quality information about the patient. Variation in quality of MDTs has been reported so it is important that practice is monitored and areas for improvement identified. ©ERS 2014.
Fraas, M R; Coughlan, G F; Hart, E C; McCarthy, C
Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45-48%. Half of these injuries go unreported. Accurate knowledge of concussion signs and symptoms and appropriate management practices among coaches and medical staff is important to improve the welfare of players. Examine concussion knowledge among coaches, and management techniques among medical staff of professional Irish rugby teams. Surveys were administered to 11 coaches and 12 medical staff at the end of the 2010-2011 season. Coaches demonstrated an accurate knowledge of concussion with a good understanding of concussion-related symptoms. Medical staff reported using a variety of methods for assessing concussion and making return-to-play decisions. Reliance on subjective clinical methods was evident, with less reliance on objective postural stability performance. Overall, the coaches in this investigation have accurate knowledge of concussion and medical staff use effective techniques for managing this injury. On-going education is needed to assist coaches in identifying concussion signs and symptoms. It is recommended that medical staff increase their reliance on objective methods for assessment and return-to-play decision making.
Goicolea, Isabel; Vives-Cases, Carmen; San Sebastian, Miguel; Marchal, Bruno; Kegels, Guy; Hurtig, Anna-Karin
Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues-such as IPV management-get integrated into health systems, and that focuses on healthcare teams' learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning
Ferrete-Morales, C; Vázquez-Pérez, M A; Sánchez-Berna, M; Gilabert-Cerro, I; Corzo-Delgado, J E; Pineda-Vergara, J A; Vergara-López, S; Gómez-Mateos, J
To assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients. A total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined. The incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (phistory of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05-9.98, p=0.04). A catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.
Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.
Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.
DeFraia, Gary S
Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.
Buggy, A; Moore, Z
To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team. Data were extracted using a bespoke data extraction tool and quality appraisal of the studies was undertaken using the EBL Critical Appraisal checklist. Data analysis was undertaken using RevMan with results presented as odds ratio for dichotomous data, or mean difference for continuous data, all with the associated 95% confidence intervals. The search identified 19 eligible studies. Severity of amputation, death rates and length of hospital stay of clients receiving multidisciplinary team care were improved when compared with those who did not receive multidisciplinary team care. Ulcer healing and quality of life showed an improvement but not all studies explored these outcomes. Only 7 of the 19 articles appraised were found to be of acceptable quality, questioning the generalisability of the results. From the currently available evidence a positive impact of the multidisciplinary team on diabetic foot outcomes can be seen, but due to the lack of high-quality evidence and substantial heterogeneity in the studies, these results should be interpreted with caution.
Otter, den A.F.H.J.; Emitt, S.; Prins, M.
A Project Website (PWS) has been advocated as an important tool for design teams of construction projects, because the tool is supposed to greatly enhance team communication. This, finally, should result in improved team performance in terms of increase of efficiency and effectiveness. PWS vendors
Bartel-Radic, Anne; Moos, J. Chris; Long, Suzanna K.
This article presents an innovative pedagogy based on student participation in globally distributed project teams. The study questions the link between student learning of intercultural competence and the global teaming experience. Data was collected from 115 students participating in 22 virtual intercultural teams. Results revealed that students…
Tapp, Hazel; Phillips, Shay E; Waxman, Dael; Alexander, Matthew; Brown, Rhett; Hall, Mary
Since the care of patients with multiple chronic diseases such as diabetes and depression accounts for the majority of health care costs, effective team approaches to managing such complex care in primary care are needed, particularly since psychosocial and physical disorders coexist. Uncontrolled diabetes is a leading health risk for morbidity, disability and premature mortality with between 18-31% of patients also having undiagnosed or undertreated depression. Here we describe a team driven approach that initially focused on patients with poorly controlled diabetes (A1c > 9) that took place at a family medicare office. The team included: resident and faculty physicians, a pharmacist, social worker, nurses, behavioral medicine interns, office scheduler, and an information technologist. The team developed immediate integrative care for diabetic patients during routine office visits.
Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A
Smothering in poultry is an economic and welfare-related concern. This study presents the first results from a questionnaire addressing the incidence, location, timing and management of smothering of free-range farm managers from two commercial egg companies (representing 35 per cent of the UK free-range egg supply). Overall, nearly 60 per cent of farm mangers experienced smothering in their last flock, with an average of 25.5 birds lost per incidence, although per cent mortality due to smothering was low (x̄=1.6 per cent). The majority of farm managers also reported that over 50 per cent of all their flocks placed had been affected by smothering. The location and timing of smothering (excluding smothering in nest boxes) tended to be unpredictable and varied between farms. Blocking off corners/nest boxes and walking birds more frequently were identified as popular smothering reduction measures, although there was a wide variety of reduction measures reported overall. The motivation to implement reduction measures was related to a farm manager's previous experience of smothering. To our knowledge, this is the first study to provide a representative industry estimate on the incidence, location, timing and management of smothering. The results suggest that smothering is a common problem, unpredictable between flocks with no clear, effective reduction strategies. A follow-up study will investigate the correlations among smothering, disease and other welfare problems and may shed further light on management solutions. British Veterinary Association.
Powers, D A; Brown, R O; Cowan, G S; Luther, R W; Sutherland, D A; Drexler, P G
One hundred one patients receiving enteral nutritional support (ENS) by tube feeding during a 5-month period were prospectively studied. Fifty patients were managed by a nutritional support team (T) and 51 patients were managed by the nonteam approach (NT). Demographics, primary diagnosis, chronic diseases, medical service, calculated basal energy expenditure (BEE), duration of ENS, and final patient disposition were recorded. Enteral formula, formula modifications, results of laboratory tests and calories delivered were obtained daily. Results of nitrogen balance studies were obtained when available and each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. No significant difference was found between the team and nonteam managed groups in regard to total feeding days, mean feeding days per patient, total laboratory tests, laboratory tests per patient or laboratory tests per day. Significantly more team patients attained 1.2 times BEE (T = 47, NT = 38, p less than 0.05) for a significantly greater period of time (T = 398 days, NT = 281 days, p less than 0.05). Significantly more team patients achieved a measured positive nitrogen balance than nonteam patients (T = 42, NT = 1, p less than 0.05). Formula modifications to correct nutritional or metabolic aberrations were made in 15 (30%) team patients and five (9.8%) nonteam patients (p less than 0.05). The number of individual abnormalities (pulmonary, mechanical, gastrointestinal, and metabolic), as well as total abnormalities occurring in the team-managed group, was significantly lower than in the nonteam managed group (160 vs 695, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Shawqi Mohammed Hossain
Full Text Available Team formation is one of the essential elements in constructing effective teamwork of any team size that requires different skill sets. Diversity in team encourages students to challenge and compete with one another while searching for new ideas, which in turn can lead to a better team performance. In a well-functioning diverse teams, the students who performed poorly may gain benefit by observing how excellent students approach the assignments. They may also benefit by getting advice and assistance from the excellent students. Studies have shown that Malaysian university graduates lack of team skills. The purpose of this paper is to propose a framework for forming a diverse multidisciplinary team among engineering undergraduates based on selected criteria such as individual personality type, gender, and other relevant demographic information. The proposed framework can also be used to design an automated team-formation system based on the identified metrics. The purpose of the framework is to consolidate the existing team formation literature, and to develop and test interventions for maximizing individual member and team performance as a whole that makes an effective team. For this study, a multidisciplinary approach was used where first year engineering students from three different faculties, namely Faculty of Electrical Engineering (FKE, Faculty of Mechanical Engineering (FKM, and Faculty of Biosciences and Medical Engineering (FBME at Universiti Teknologi Malaysia (UTM worked on an innovation project using the Conceive, Design, Implement, and Operate (CDIO framework. Keirsey Temperament Sorter was used as an instrument to identify an individual's personality type.
Kinlaw, Dennis C.; Eads, Jeannette
It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.
Fresco, A.; Subudhi, M.; Gunther, W.; Grove, E.; Taylor, J. [Brookhaven National Lab., Upton, NY (United States)
A plant`s maintenance program is the principal vehicle through which age-related degradation is managed. From 1988 to 1991, the NRC evaluated the maintenance program of every nuclear power plant in the United States. Forty-four out of a total of 67 of the reports issued on these in-depth team inspections were reviewed for insights into the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear plant systems, structures, and components. Relevant information was extracted from these inspection reports and sorted into several categories, including Specific Aging Insights, Preventive Maintenance, Predictive Maintenance and Condition Monitoring, Post Maintenance Testing, Failure Trending, Root Cause Analysis and Usage of Probabilistic Risk Assessment in the Maintenance Process. Specific examples of inspection and monitoring techniques successfully used by utilities to detect degradation due to aging have been identified. The information also was sorted according to systems and components, including: Auxiliary Feedwater, Main Feedwater, High Pressure Injection for both BWRs and PWRs, Service Water, Instrument Air, and Emergency Diesel Generator Air Start Systems, and Emergency Diesel Generators Air Start Systems, emergency diesel generators, electrical components such as switchgear, breakers, relays, and motor control centers, motor operated valves and check valves. This information was compared to insights gained from the Nuclear Plant Aging Research (NPAR) Program. Attributes of plant maintenance programs where the NRC inspectors felt that improvement was needed to properly address the aging issue also are discussed.
Smulian, John C; Pascual, Ana-Liza; Hesham, Helai; Qureshey, Emma; Bijoy Thomas, M; Depuy, Amy M; Flicker, Amanda B; Scorza, William E
To determine the impact of a structured multi-disciplinary management strategy on clinical outcomes in women with invasive placental disease (IPD). This was a retrospective cohort study of consecutive women having peripartum hysterectomies with IPD over seven years. For the most recent three years, a structured multidisciplinary team (MDT) reviewed each suspected case, created a management plan, and implemented that plan. Outcomes were compared between cases delivered prior to and after the MDT process was started. There were 47 pregnancies with IPD, of which 31 (66.0%) were suspected antenatally and 40 (85.1%) had a prior uterine surgery. An MDT approach was performed in 19 (40.4%) cases. In the MDT group, there were longer operative times (260 min versus 181 min, p = 0.0001), less blood loss (1200 mL versus 2500 mL, p = 0.009), less administration of blood products (47.4% versus 85.7%, p = 0.005), and higher intraoperative lowest mean arterial pressures (MAPs) (57 mmHg versus 48 mmHg, p = 0.002, when compared to the No-MDT (n = 28) approach. No differences were found for other outcomes. Clinically meaningful improvements of less blood loss, fewer transfusions, and higher intraoperative MAPs suggest that MDT cases were more stable intraoperatively, which over a larger number of patients, should translate into improved outcomes.
Mercado, Joseph E; Rupp, Michael A; Chen, Jessie Y C; Barnes, Michael J; Barber, Daniel; Procci, Katelyn
We investigated the effects of level of agent transparency on operator performance, trust, and workload in a context of human-agent teaming for multirobot management. Participants played the role of a heterogeneous unmanned vehicle (UxV) operator and were instructed to complete various missions by giving orders to UxVs through a computer interface. An intelligent agent (IA) assisted the participant by recommending two plans-a top recommendation and a secondary recommendation-for every mission. A within-subjects design with three levels of agent transparency was employed in the present experiment. There were eight missions in each of three experimental blocks, grouped by level of transparency. During each experimental block, the IA was incorrect three out of eight times due to external information (e.g., commander's intent and intelligence). Operator performance, trust, workload, and usability data were collected. Results indicate that operator performance, trust, and perceived usability increased as a function of transparency level. Subjective and objective workload data indicate that participants' workload did not increase as a function of transparency. Furthermore, response time did not increase as a function of transparency. Unlike previous research, which showed that increased transparency resulted in increased performance and trust calibration at the cost of greater workload and longer response time, our results support the benefits of transparency for performance effectiveness without additional costs. The current results will facilitate the implementation of IAs in military settings and will provide useful data to the design of heterogeneous UxV teams. © 2016, Human Factors and Ergonomics Society.
Wholey, Douglas R; Disch, Joanne; White, Katie M; Powell, Adam; Rector, Thomas S; Sahay, Anju; Heidenreich, Paul A
Leadership by health care professionals is likely to vary because of differences in the social contexts within which they are situated, socialization processes and societal expectations, education and training, and the way their professions define and operationalize key concepts such as teamwork, collaboration, and partnership. This research examines the effect of the nurse and physician leaders on interdependence and encounter preparedness in chronic disease management practice groups. The aim of this study was to examine the effect of complementary leadership by nurses and physicians involved in jointly producing a health care service on care team functioning. The design is a retrospective observational study based on survey data. The unit of analysis is heart failure care groups in U.S. Veterans Health Administration medical centers. Survey and administrative data were collected in 2009 from 68 Veterans Health Administration medical centers. Key variables include nurse and physician leadership, interdependence, psychological safety, coordination, and encounter preparedness. Reliability and validity of survey measures were assessed with exploratory factor analysis and Cronbach alphas. Multivariate analyses tested hypotheses. Professional leadership by nurses and physicians is related to encounter preparedness by different paths. Nurse leadership is associated with greater team interdependence, and interdependence is positively associated with respect. Physician leadership is positively associated with greater psychological safety, respect, and shared goals but is not associated with interdependence. Respect is associated with involvement in learning activities, and shared goals are associated with coordination. Coordination and involvement in learning activities are positively associated with encounter preparedness. By focusing on increasing interdependence and a constructive climate, nurse and physician leaders have the opportunity to increase care coordination
Whaley, Alan; Gillis, William E
Hospitals throughout the United States establish leadership and management programs for their middle managers. Despite their pervasiveness and an increased emphasis on physician leadership, there is limited research regarding the development programs designed for clinical and nonclinical health care middle managers. Using two theoretical lenses, signaling and institutional theory, this exploratory study investigates mid-sized hospital development programs from the perspective of top management team (TMT) members. Our objective is to find out what types of programs hospitals have, how they are developed, and how they are evaluated. We conducted semistructured interviews with 13 TMT members in six purposefully selected hospitals and matched these interviews with program curricula. Careful coding of the data allowed us not only to show our data in a meaningful visual representation but also to show the progression of the data from raw form to aggregate themes in the qualitative research process. We identified four types of development programs used in the selected hospitals: (a) ongoing series, (b) curriculum-based, (c) management orientation, and (d) mentoring. Challenges existed in aligning the need for the program with program content. Communication occurred both through direct messaging regarding policies and procedures and through hidden signals. TMT members referenced other programs for guidance but were not always clear about what it is they wanted the programs to accomplish. Finally, there was limited program outcome measurement. Our small sample indicates that specific, structured, and comprehensive programs perform best. The better programs were always trying to improve but that most needed better accountability of tracking outcomes. In setting up a program, a collaborative approach among TMT members to establish what the needs are and how to measure outcomes worked well. Successful programs also tied in their leadership development with overall employee
Full Text Available This study examined the influence of transformational-transactional leadership behaviour on organisational citizenship behaviour in self-managed work teams and the augmenting effect of transformational-transactional leadership behaviour. This cross-sectional correlation study was conducted on 93 self-managed work teams in a multinational manufacturing company. Data were collected through group face-to-face administration by the researcher and statistically analysed through Pearson correlation, partial correlation and multiple regressions. Results showed that both transactional and transformational leadership behaviour have a positive influence on organisational citizenship behaviour among team members. Transformational leadership behaviour, however, has a greater influence on organisational citizenship behaviour compared to transactional leadership behaviour. The results also conf rmed the augmenting effect of transformational leadership behaviour on the relationship between transactional leadership behaviour and organisational citizenship behaviour.
Weidmann, Anita Elaine; MacLure, Katie; Marshall, Sarah; Gray, Gwen; Stewart, Derek
the need for a practice model which is systematically developed and suggested a scheme akin to the successful smoking cessation 12-week nicotine replacement therapy service already available in community pharmacies in Scotland. Pharmacists and MCAs interviewed in this study reported their perceptions of benefits to providing community pharmacy based weight management as part of a wider public health function. They described services as opportunistic and customer driven based on ease of access. There was a notable variation in pharmacist and MCA training, reflected in their levels of comfort and confidence. There is a clear need to systematically develop and provide evidence of effectiveness and cost effectiveness for a pharmacy based practice model with key roles and functions for the full pharmacy team.
Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.
Davari, Fereshteh; Zahed, Arash
Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.
Vaughan-Shaw, P G; Wheeler, J M D; Borley, N R
Local excision of early rectal cancer (ERCa) offers comparable survival and reduced operative morbidity compared with radical surgery, yet it risks an adverse oncological outcome if performed in the wrong setting. This retrospective review considers the impact of the introduction of a specialist early rectal cancer multidisciplinary team (ERCa MDT) on the investigation and management of ERCa. A retrospective comparative cohort study was undertaken. Patients with a final diagnosis of pT1 rectal cancer at our unit were identified for two 12-month periods before and after the introduction of the specialist ERCa MDT. Data on investigations and therapeutic interventions were compared. Nineteen patients from 2006 and 24 from 2011 were included. In 2006, 12 patients underwent MRI and four transrectal ultrasound (TRUS) examination, while in 2011, 18 and 20, respectively, received MRI and TRUS. In 2006 four patients underwent incidental ERCa polypectomy, with all having a positive resection margin leading to anterior resection. In 2011 only one case with a positive margin following extended endoscopic mucosal resection was identified. Definitive local excision without subsequent resection occurred in two patients in 2006 and in 16 in 2011. The study demonstrates an improvement in preoperative ERCa staging, a reduction in margin positivity and an increase in the use of local excision following the implementation of a specialist ERCa MDT. The increased detection of rectal neoplasms through screening and surveillance programmes requires further investigation and management. A specialist ERCa MDT will improve management and should be available to all practitioners involved with patients with ERCa. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.
Stokes, Jonathan; Kristensen, Søren Rud; Checkland, Kath; Bower, Peter
To evaluate a multidisciplinary team (MDT) case management intervention, at the individual (direct effects of intervention) and practice levels (potential spillover effects). Difference-in-differences design with multiple intervention start dates, analysing hospital admissions data. In secondary analyses, we stratified individual-level results by risk score. Single clinical commissioning group (CCG) in the UK's National Health Service (NHS). At the individual level, we matched 2049 intervention patients using propensity scoring one-to-one with control patients. At the practice level, 30 practices were compared using a natural experiment through staged implementation. Practice Integrated Care Teams (PICTs), using MDT case management of high-risk patients together with a summary record of care versus usual care. Primary measures of intervention effects were accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays; outpatient visits; and admissions for ambulatory care sensitive conditions. Secondary measures included inpatient length of stay; total cost of secondary care services; and patient satisfaction (at the practice level only). At the individual level, we found slight, clinically trivial increases in inpatient non-elective admissions (+0.01 admissions per patient per month; 95% CI 0.00 to 0.01. Effect size (ES): 0.02) and 30-day re-admissions (+0.00; 0.00 to 0.01. ES: 0.03). We found no indication that highest risk patients benefitted more from the intervention. At the practice level, we found a small decrease in inpatient non-elective admissions (-0.63 admissions per 1000 patients per month; -1.17 to -0.09. ES: -0.24). However, this result did not withstand a robustness check; the estimate may have absorbed some differences in underlying practice trends. The intervention does not meet its primary aim, and the clinical significance and cost-effectiveness of these small practice-level effects is debatable
Edmondson, Amy; Bohmer, Richard; Pisano, Gary
A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)
Field, B E; Devich, L E; Carlson, R W
We developed a supportive care team for hopelessly ill patients in an urban emergency/trauma hospital. The team includes a clinical nurse specialist and a faculty physician as well as a chaplain and social worker. The supportive care team provides an alternative to intensive care or conventional ward management of hopelessly ill patients and concentrates on the physical and psychosocial comfort needs of patients and their families. We describe our experience with 20 hopelessly ill patients with multiple organ failure vs a similar group treated before the development of the supportive care team. Although there was no difference in mortality (100 percent), the length of stay in the medical ICU for patients with multiple organ failure decreased by 12 days to 6 days. Additionally, there were 50 percent fewer therapeutic interventions provided by the supportive care team vs intensive care or conventional ward treatment of multiple organ failure patients. We describe the methods that the supportive care team uses in an attempt to meet the physical and psychosocial comfort needs of hopelessly ill multiple organ failure patients and their families. This multidisciplinary approach to the care of the hopelessly ill may have applications in other institutions facing the ethical, medical, and administrative challenges raised by these patients.
Sasou Kunihide; Ebisu, Mitsuhiro; Hirose, Ayako
Several studies have been done to evaluate or improve team performance in nuclear and aviation industries. Crew resource management is the typical example. In addition, team evaluation recently gathers interests in other teams of lawyers, medical staff, accountants, psychiatrics, executive, etc. However, the most evaluation methods focus on the results of team behavior that can be observed through training or actual business situations. What is expected team is not only resolving problems but also training younger members being destined to lead the next generation. Therefore, the authors set the final goal of this study establishing a series of methods to evaluate and improve teams inclusively such as decision making, motivation, staffing, etc. As the first step, this study develops team process model describing viewpoints for the evaluation. The team process is defined as some kinds of power that activate or inactivate competency of individuals that is the components of team's competency. To find the team process, the authors discussed the merits of team behavior with the experienced training instructors and shift supervisors of nuclear/thermal power plants. The discussion finds four team merits and many components to realize those team merits. Classifying those components into eight groups of team processes such as 'Orientation', 'Decision Making', 'Power and Responsibility', 'Workload Management', 'Professional Trust', 'Motivation', 'Training' and 'staffing', the authors propose Team Process Model with two to four sub processes in each team process. In the future, the authors will develop methods to evaluate some of the team processes for nuclear/thermal power plant operation teams. (author)
Kearney, Eric; Gebert, Diether
In a sample of 62 research and development (R&D) teams, the authors examined transformational leadership as a moderator of the relationship of age, nationality, and educational background diversity with team outcomes. When levels of transformational leadership were high, nationality and educational diversity were positively related to team leaders' longitudinal ratings of team performance. These relationships were nonsignificant when transformational leadership was low. Age diversity was not related to team performance when transformational leadership was high, and it was negatively related to team performance when transformational leadership was low. Two mediated moderation effects help explain these findings. Transformational leadership moderated the relationship of the 3 examined diversity dimensions with the elaboration of task-relevant information, which in turn was positively associated with team performance. Moreover, transformational leadership moderated the relationship of the 3 diversity types with collective team identification, which in turn was positively related to the elaboration of task-relevant information. The authors discuss the theoretical and practical implications of these results. Overall, this study suggests that transformational leadership can foster the utilization of the potential, but frequently untapped, benefits entailed by both demographic and informational/cognitive team diversity. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Lauring, Jakob; Jonassson, Charlotte
It has been argued that multinational teams create a number of competitive advantages when used strategically. However, multinational teams are not always successful, and a number of studies indicate that communication between team members may be the main obstacle. The purpose of this article...... is to investigate communication problems in organizations consisting of multinational teams. It is argued that researchers should not only look for differences in national culture when analyzing barriers to the communication flow. Challenges to communication may also develop in the locally constituted...... organizational culture. This is illustrated by an ethnographic field study in a multinational department of a Danish organization....
Willersrud, Anders; Imsland, Lars; Blanke, Mogens
Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...... and handling of symptoms of downhole drilling contingencies at an early stage are therefore crucial for the reliability and safety of MPD operations. In this paper we describe a method for early detection and localization of such incidents, based on a fit for purpose model of the downhole pressure hydraulics...... successfully been tested on experimental data from a medium-scale horizontal flow loop in Sta- vanger, Norway. The flow loop represents a 700 m borehole with emulation of the following downhole contingencies: drillstring washout, drill bit nozzle plugging, gas influx and fluid loss. In the tests...
Watts, Brook; Lawrence, Renée H; Drawz, Paul; Carter, Cameron; Shumaker, Amy Hirsch; Kern, Elizabeth F
Effective team-based models of care, such as the Patient-Centered Medical Home, require electronic tools to support proactive population management strategies that emphasize care coordination and quality improvement. Despite the spread of electronic health records (EHRs) and vendors marketing population health tools, clinical practices still may lack the ability to have: (1) local control over types of data collected/reports generated, (2) timely data (eg, up-to-date data, not several months old), and accordingly (3) the ability to efficiently monitor and improve patient outcomes. This article describes a quality improvement project at the hospital system level to develop and implement a flexible panel management (PM) tool to improve care of subpopulations of patients (eg, panels of patients with diabetes) by clinical teams. An in-depth case analysis approach is used to explore barriers and facilitators in building a PM registry tool for team-based management needs using standard data elements (eg, laboratory values, pharmacy records) found in EHRs. Also described are factors that may contribute to sustainability; to date the tool has been adapted to 6 disease-focused subpopulations encompassing more than 200,000 patients. Two key lessons emerged from this initiative: (1) though challenging, team-based clinical end users and information technology needed to work together consistently to refine the product, and (2) locally developed population management tools can provide efficient data tracking for frontline clinical teams and leadership. The preliminary work identified critical gaps that were successfully addressed by building local PM registry tools from EHR-derived data and offers lessons learned for others engaged in similar work. (Population Health Management 2016;19:232-239).
Loeb, Danielle F; Crane, Lori A; Leister, Erin; Bayliss, Elizabeth A; Ludman, Evette; Binswanger, Ingrid A; Kline, Danielle M; Smith, Meredith; deGruy, Frank V; Nease, Donald E; Dickinson, L Miriam
Develop and validate self-efficacy scales for primary care provider (PCP) mental illness management and team-based care participation. We developed three self-efficacy scales: team-based care (TBC), mental illness management (MIM), and chronic medical illness (CMI). We developed the scales using Bandura's Social Cognitive Theory as a guide. The survey instrument included items from previously validated scales on team-based care and mental illness management. We administered a mail survey to 900 randomly selected Colorado physicians. We conducted exploratory principal factor analysis with oblique rotation. We constructed self-efficacy scales and calculated standardized Cronbach's alpha coefficients to test internal consistency. We calculated correlation coefficients between the MIM and TBC scales and previously validated measures related to each scale to evaluate convergent validity. We tested correlations between the TBC and the measures expected to correlate with the MIM scale and vice versa to evaluate discriminant validity. PCPs (n=402, response rate=49%) from diverse practice settings completed surveys. Items grouped into factors as expected. Cronbach's alphas were 0.94, 0.88, and 0.83 for TBC, MIM, and CMI scales respectively. In convergent validity testing, the TBC scale was correlated as predicted with scales assessing communications strategies, attitudes toward teams, and other teamwork indicators (r=0.25 to 0.40, all statistically significant). Likewise, the MIM scale was significantly correlated with several items about knowledge and experience managing mental illness (r=0.24 to 41, all statistically significant). As expected in discriminant validity testing, the TBC scale had only very weak correlations with the mental illness knowledge and experience managing mental illness items (r=0.03 to 0.12). Likewise, the MIM scale was only weakly correlated with measures of team-based care (r=0.09 to.17). This validation study of MIM and TBC self-efficacy scales
Naugler, Willscott E; Alsina, Angel E; Frenette, Catherine T; Rossaro, Lorenzo; Sellers, Marty T
Optimal care of the patient with hepatocellular carcinoma (HCC) necessitates the involvement of multiple providers. Because the patient with HCC often carries 2 conditions with competing mortality risks (cancer and underlying cirrhosis), no single provider is equipped to deal with all of these patients' needs adequately. Multidisciplinary teams (MDTs) have evolved to facilitate care coordination, reassessments of clinical course, and nimble changes in treatment plans required for this complex group of patients. Providers or sites that elect to manage patients with HCC thus are increasingly aware of the need to build their own MDT or communicate with an established one. The availability of new communication technologies, such as teleconferencing or teleconsultation, offers the possibility of MDT expansion into underserved or rural areas, as well as areas such as correctional facilities. Although the availability of resources for HCC patient care varies from site to site, construction of an MDT is possible in a wide spectrum of clinical practices, and this article suggests a blueprint for assembly of such collaboration. Research strategies are needed to explain how MDTs improve clinical outcomes so that MDTs themselves can be improved. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
Long, Jenny; Luckraz, Heyman; Thekkudan, Joyce; Maher, Abdul; Norell, Michael
Recent ESC/EACTS revascularization guidelines advocate a 'Heart Team' (HT) approach in the decision-making process when managing patients with coronary disease. We prospectively assessed HT decision-making in 150 patients analysing personnel attendance, data presented, the 'actioning' of the HT decision and, if not completed, then the reasons why. Additionally, 50 patients were specifically re-discussed after 1 year in order to assess consistency in decision-making. We have two HT meetings each week. At least one surgeon, interventional cardiologist and non-interventional cardiologist were present at all meetings. Data presented included patient demographics, symptoms, co-morbidities, coronary angiography, left ventricular function and other relevant investigations, e.g. echocardiograms. HT decisions included continued medical treatment (22%), percutaneous coronary intervention (PCI; 22%), coronary-artery bypass grafting (CABG; 34%) or further investigations such as pressure wire studies, dobutamine stress echo or cardiac magnetic resonance imaging (22%). These decisions were fully undertaken in 86% of patients. Reasons for aberration in the remaining 21 patients included patient refusal (CABG 29%, PCI 10%) and further co-morbidities (28%). On re-discussion of the same patient data (n = 50) a year later, 24% of decisions differed from the original HT recommendations reflecting the fact that, for certain coronary artery disease pattern, either CABG or PCI could be appropriate.
Cecchetti, Alfred A; Parmanto, Bambang; Vecchio, Marcella L; Ahmad, Sjarif; Buch, Shama; Zgheib, Nathalie K; Groark, Stephen J; Vemuganti, Anupama; Romkes, Marjorie; Sciurba, Frank; Donahoe, Michael P; Branch, Robert A
Classical drug exposure: response studies in clinical pharmacology represent the quintessential prototype for Bench to Bedside-Clinical Translational Research. A fundamental premise of this approach is for a multidisciplinary team of researchers to design and execute complex, in-depth mechanistic studies conducted in relatively small groups of subjects. The infrastructure support for this genre of clinical research is not well-handled by scaling down of infrastructure used for large Phase III clinical trials. We describe a novel, integrated strategy, whose focus is to support and manage a study using an Information Hub, Communication Hub, and Data Hub design. This design is illustrated by an application to a series of varied projects sponsored by Special Clinical Centers of Research in chronic obstructive pulmonary disease at the University of Pittsburgh. In contrast to classical informatics support, it is readily scalable to large studies. Our experience suggests the culture consequences of research group self-empowerment is not only economically efficient but transformative to the research process.
Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.
NASA's Aviation Safety Reporting System (ASRS) incident reports are reviewed in two related areas: pilots' failures to appropriately manage tasks, and breakdowns in geographic orientation. Examination of 51 relevant reports on task management breakdowns revealed that altitude busts and inappropriate runway usee were the most frequently reported consequences. Task management breakdowns appeared to occur at all levels of expertise, and prominent causal factors were related to breakdowns in crew communications, over-involvement with the flight management system and, for small (general aviation) aircraft, preoccupation with weather. Analysis of the 83 cases of geographic disorientation suggested that these too occurred at all levels of pilot experience. With regard to causal factors, a majority was related to poor cockpit resource management, in which inattention led to a loss of geographic awareness. Other leading causes were related to poor weather and poor decision making. The potential of the ASRS database for contributing to research and design issues is addressed.
Ścieżki dywersyfikacji uprawiania gier sportowych jako wyznaczniki różnicowania kompetencji trenerów i team managerów – paradygmat a realia = Diversification of paths in sport games as a determinant of differentiating competences of trainers and team managers - the paradigm vs. reality
• explore the inadequacy of coaching and managing competences currently favoured in trainers and managers in Poland; finally, present a model of qualitatively diversified sets of competences, including: player's fitness coach, talented player's tutor, team coach and team manager. Keywords: sport games, development paths, competences of trainers and managers
Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.
Camfield, Carol S; Joseph, Marissa; Hurley, Teresa; Campbell, Karen; Sanderson, Susan; Camfield, Peter R
To compare phenylketonuria (PKU) management by a centralized, expert team in the Province of Nova Scotia (NS) with the decentralized approach in New Brunswick (NB). Retrospective chart review documented frequency of outpatient visits, phenylalanine (Phe) concentration, and medical formula use. Structured telephone interviews with the 8 regional NB dietitians (NB-D) documented their knowledge and support in PKU management. Patients with PKU (n=108; age, birth to 42 years) reside in NB (n=69) and NS (n=39). More were lost to contact in NB than in NS (9/69 vs 1/39) and more were completely off diet in NB than in NS (24/60 vs 1/38, P=.05). All 15 children 95% in NS. Mental handicap or borderline intelligence was common in both NB (44%) and NS (42%). All NB-D wished additional specialized medical, nursing, or social work assistance. PKU management appears to be more effective with an expert, coordinated team approach.
Cohen, I L; Bari, N; Strosberg, M A; Weinberg, P F; Wacksman, R M; Millstein, B H; Fein, I A
To test the hypothesis that a formal interdisciplinary team approach to managing ICU patients requiring mechanical ventilation enhances ICU efficiency. Retrospective review with cost-effectiveness analysis. A 20-bed medical-surgical ICU in a 450-bed community referral teaching hospital with a critical care fellowship training program. All patients requiring mechanical ventilation in the ICU were included, comparing patients admitted 1 yr before the inception of the ventilatory management team (group 1) with those patients admitted for 1 yr after the inception of the team (group 2). Group 1 included 198 patients with 206 episodes of mechanical ventilation and group 2 included 165 patients with 183 episodes of mechanical ventilation. A team consisting of an ICU attending physician, nurse, and respiratory therapist was formed to conduct rounds regularly and supervise the ventilatory management of ICU patients who were referred to the critical care service. The two study groups were demographically comparable. However, there were significant reductions in resource use in group 2. The number of days on mechanical ventilation decreased (3.9 days per episode of mechanical ventilation [95% confidence interval 0.3 to 7.5 days]), as did days in the ICU (3.3 days per episode of mechanical ventilation [90% confidence interval 0.3 to 6.3 days]), numbers of arterial blood gases (23.2 per episode of mechanical ventilation; p less than .001), and number of indwelling arterial catheters (1 per episode of mechanical ventilation; p less than .001). The estimated cost savings from these reductions was $1,303 per episode of mechanical ventilation. We conclude that a ventilatory management team, or some component thereof, can significantly and safely expedite the process of "weaning" patients from mechanical ventilatory support in the ICU.
Al-Alawi, Kamila; Johansson, Helene; Al Mandhari, Ahmed; Norberg, Margareta
AimThe aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches. The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines. A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FindingsThe study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.
Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.
Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy
We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating scale and an Advanced Trauma Life Support primary survey checklist. Eleven "trauma teams," consisting of physicians, nurses, and respiratory therapists, each completed 4 crisis simulations over 3 courses. Satisfaction remained high among participants with overall mean satisfaction being 4.39 on a 5-point Likert scale. As participants progressed through scenarios, improvements in global rating scale scores were seen between the 1st and 4th (29.8 vs 36.1 of 42, P = .022), 2nd and 3rd (28.2 vs 34.6, P = .017), and 2nd and 4th (28.2 vs 36.1, P = .003) scenarios. There were no differences in Advanced Trauma Life Support checklist with mean scores for each scenario ranging 11.3 to 13.2 of 17. The evolved Simulated Trauma and Resuscitative Team Training curriculum has maintained high participant satisfaction and is associated with improvement in team crisis resource management skills over the duration of the course. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Teamwork - a feature of modern leadership, lead to performance if the team members are sharing the samevision, understanding the objectives of the organization, communicating, cooperating and helping each other, livingand acting after the same principles, norms and values. Team gains more and more a decisive role for the success ofthe organization and even if the leader is strong and well-intentioned, its results are the effect of all those people thatmake up the community.Only by highlighting the skills, talents, inclinations and experience of staff, promoting the principle "all forone and one for all" and some healthy interpersonal relationships we create favorable conditions to obtaining superiorresults.The company presented in the case study fits very well in the elements mentioned above, the importance ofhuman resources in general and of the team in particular, represents some of the most important reasons of seniormanagement.This paper is based on theory of the assumed roles in the team and, as practical application I applied the testfor determining the Belbin team roles in the Betty Ice company's financial accounting department. Applying this testwas meant as a method for improvement of the effectiveness of teamwork within the organization and tried to see if theteam studied is well formed from the perspective of the theory of team roles. Results revealed that a close-knit team hasdifferent and complementary roles and its success is based precisely on the existence of as many roles proposed byMeredith Belbin.
Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann
This paper reports a study assessing the usefulness of a mantram repetition programme. Complementary/alternative therapies are becoming commonplace, but more research is needed to assess their benefits. A 5-week programme teaching a 'mind-body-spiritual' technique of silently repeating a mantram - a word or phrase with spiritual meaning - to manage stress was developed. A mantram was chosen by individuals, who were taught to repeat it silently throughout the day or night to interrupt unwanted thoughts and elicit the relaxation response. Participants who attended a 5-week course were invited to participate in the study. Of those who consented, a randomly selected subset (n = 66) was contacted approximately 3 months after the course for a telephone interview using the critical incident interviewing technique. Participants were asked whether the intervention was helpful or not, and if helpful, to identify situations where it was applied. Interviews were transcribed and incidents were identified and categorized to create a taxonomy of uses. The data were collected in 2001-2002. Participants included 30 veterans, mostly males (97%), and 36 hospital employees, mostly females (86%). Mean age was 56 years (sd = 12.94). Fifty-five participants (83.3%) practiced the technique and reported 147 incidents where the programme was helpful. Outcomes were organized into a taxonomy of incidents using four major categories that included managing: (a) emotions other than stress (51%); (b) stress (23.8%); (c) insomnia (12.9%); and (d) unwanted thoughts (12.3%). A group of raters reviewed the categories for inter-rater reliability. The majority of participants from two distinct samples reported that the mantram programme was helpful in a variety of situations. The critical incident interviewing method was found to be practical, efficient, and thorough in collecting and analyzing data. Such qualitative methods contribute to understanding the benefits of mind-body complementary therapies.
Kachko, Ludmyla; Ben Ami, Shiri; Lieberman, Alon; Shor, Rita; Tzeitlin, Elena; Efrat, Rachel
Chronic pain in children and adolescents is common, but proportion of neuropathic pain (NP), a heterogeneous group of diseases with major impact on health-related quality of life, significant economic burden, and limited treatment options, is unclear. Many studies have focused only on complex regional pain syndrome (CRPS). Our aim was to examine the incidence, clinical features, management, and outcome of non-CRPS NP in patients referred to a chronic pediatric pain clinic (CPPC) at a tertiary-care hospital. Retrospective analyses of the patient's files with non-CRPS NP from 2008 until 2012. Twenty patients (9.9-22.0 years; 10.7% of new referrals) were treated with non-CRPS NP (postoperative 8/20, trauma-related 5/20, disease-related 7/20). The number of consultations performed and the number of medications used before CPPC were significantly higher than in CPPC (Z = 0.75, P = 0.005; Z = 1.68, P = 0.003; respectively, Wilcoxon test). The number of diagnostic procedures was not statistically significant. Invasive treatments were used in 50% of patients. Full/partial recovery was accomplished in 95%. anova with repeated measures yielded a highly significant difference between the initial and final visual analog scale (VAS) scores (8.2 ± 1.3; 1.19 ± 2.01, respectively; P CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended. © 2014 John Wiley & Sons Ltd.
Snyderman, Carl H; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A
The management of sinonasal and ventral skull base malignancies is best performed by a team. Although the composition of the team may vary, it is important to have multidisciplinary representation. There are multiple obstacles, both individual and institutional, that must be overcome to develop a highly functioning team. Adequate training is an important part of team-building and can be fostered with surgical telementoring. A quality improvement program should be incorporated into the activities of a skull base team. Copyright © 2016 Elsevier Inc. All rights reserved.
Ogrin, Rajna; Houghton, Pamela E; Thompson, G William
A longitudinal observational study on a convenience sample was conducted between 4 January and 31 December of 2010 to evaluate clinical outcomes that occur when a new Interprofessional Diabetes Foot Ulcer Team (IPDFUT) helps in the management of diabetes-related foot ulcers (DFUs) in patients living in a small urban community in Ontario, Canada. Eighty-three patients presented to the IPDFUT with 114 DFUs of average duration of 19·5 ± 2·7 weeks. Patients were 58·4 ± 1·4 years of age and 90% had type 2 diabetes, HbA1c of 8·3 ± 2·0%, with an average diabetes duration of 22·3 ± 3·4 years; in 69% of patients, 78 DFUs healed in an average duration of 7·4 ± 0·7 weeks, requiring an average of 3·8 clinic visits. Amputation of a toe led to healing in three patients (4%) and one patient required a below-knee amputation. Six patients died and three withdrew. Adding a skilled IPDFUT that is trained to work together resulted in improved healing outcomes. The rate of healing, proportion of wounds closed and complication rate were similar if not better than the results published previously in Canada and around the world. The IPDFUT appears to be a successful model of care and could be used as a template to provide effective community care to the patients with DFU in Ontario, Canada. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Smith, Graham C; McDonald, Robbie A; Wilkinson, David
Bovine tuberculosis (bTB), caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles) is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2) and were evaluated over the whole of a 300 km(2) area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2) plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.
Graham C Smith
Full Text Available Bovine tuberculosis (bTB, caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2 and were evaluated over the whole of a 300 km(2 area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2 plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.
Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter
Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas. Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue. We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents. General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings. Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.