151
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Zozaya-Monohon M, Corona AR. Success of a Nurse Practitioner–led Interdisciplinary Team. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2019.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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152
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Viterbo LMF, Dinis MAP, Vidal DG, Costa AS. Implementation of an Interdisciplinary Approach to Promote Workers Global Health Status in the Oil Industry, Brazil (2006-2015). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2148. [PMID: 31213038 PMCID: PMC6617393 DOI: 10.3390/ijerph16122148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 12/23/2022]
Abstract
This study intends to analyse the behaviour of epidemiological variables of workers in anoilindustry of Bahia, Brazil, before and after implementation of interdisciplinary practices in occupational health assessments between 2006 and 2015. This is a retrospective longitudinal study carried out in two time periods. Data were collected from the workers electronic medical record and time trends were analysed before (2006-2010) and after (2011-2015) the implementation of the interdisciplinary practices focusing on health promotion. The data were complementarily compared to a control group from the same industry.A statistically significant reduction for data on the number of smokers, periodontal disease and of days away from work was obtained. A significant increase in the number of physically active subjects wasalso observed. Whilenot statistically significant, a reduction in the number of workers with obesity and overweight, with caries and altered glycemia, was identified. Coronary risk and high blood pressure indicators have shown aggravation. It can be concluded that an interdisciplinary health approach during the annual occupational assessments, with action directed to the population needs, can be associated with the improvement of the health indicators assessed, contributing to increased worker productivity in the oil industry.
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Affiliation(s)
- Lilian Monteiro Ferrari Viterbo
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa, 4249-004 Porto, Portugal.
- UniversidadeCorporativa, Bahia 41745-002, Brazil.
| | - Maria Alzira Pimenta Dinis
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa, 4249-004 Porto, Portugal.
| | - Diogo Guedes Vidal
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa, 4249-004 Porto, Portugal.
- CNPq Research Group "Dynamics of neuro-muscle-skeletal System", Bahiana School of Medicine and Public Health, Bahia 40290-000, Brazil.
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153
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Unmet need for interprofessional education in paediatric cancer: a scoping review. Support Care Cancer 2019; 27:3627-3637. [PMID: 31127437 PMCID: PMC6726701 DOI: 10.1007/s00520-019-04856-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/09/2019] [Indexed: 11/02/2022]
Abstract
PURPOSE Despite improved treatment and care, children and adolescents diagnosed with cancer continue to die, while many of those cured are burdened by treatment-related sequelae. The best clinical management of children and adolescents with cancer depends on healthcare professionals with various skills and expertise. Complex treatment, care and rehabilitation require collaboration between healthcare professionals. The purpose of this scoping review is to identify and evaluate existing interprofessional education in paediatric cancer. METHODS We utilised the scoping review methodology and searched PubMed, Scopus and Education Resources Information Center. Inclusion criteria were postgraduate studies targeting more than one profession and evaluation of the educational intervention. We applied Kirkpatrick's modified interprofessional education outcomes model to systematise outcomes. RESULTS Of 418 references, nine studies fulfilled the inclusion criteria. The design, strategy and content of all the studies were heterogeneous. None of the interprofessional educations systematically evaluated knowledge, skills, attitudes or the effects on patient outcomes or quality of care. CONCLUSION There is a lack of well-structured, interprofessional education in paediatric cancer that has undergone evaluation. Paediatric cancer may benefit from systematic education and evaluation frameworks since interprofessional education could potentially strengthen the treatment, care and rehabilitation for children and adolescents with cancer.
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154
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Clarkson P, Worsley PR, Schoonhoven L, Bader DL. An interprofessional approach to pressure ulcer prevention: a knowledge and attitudes evaluation. J Multidiscip Healthc 2019; 12:377-386. [PMID: 31213822 PMCID: PMC6536813 DOI: 10.2147/jmdh.s195366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/12/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Pressure ulcers (PUs) are a major burden to individuals, impacting their physical, mental and social wellbeing. While PU prevention is traditionally regarded as a nursing issue, an interprofessional approach has been promoted as best practice. However, little is known about current practice or the knowledge and attitudes of the wider interprofessional team (IPT). Purpose: Pre-designed questionnaires were used to explore knowledge and attitudes with healthcare staff in the community. Methods: Questionnaires were disseminated to all healthcare staff within a community healthcare Trust predominantly via an online tool. Data were analyzed using descriptive and inferential statistics. Results: The median values of all professional groups demonstrated satisfactory attitudes (>75%) and levels of knowledge (>60%) to PU prevention. However, there were differences within and between groups. Management staff demonstrated the most positive attitude to PU prevention (89%), followed by occupational therapists (OTs) and healthcare assistants (HCAs) (87%, IQR: 75%→89%). OTs demonstrated the highest scores for knowledge (69%, IQR: 62%→73%), while healthcare and rehabilitation assistants scored the lowest (58%, IQR: 58%-64%). Conclusion: This study has demonstrated that the majority of healthcare staff in a UK community setting have satisfactory levels of knowledge and attitudes in relation to PU prevention overall. Nevertheless, there were some differences between groups, albeit non-significant. There were also differences between sub-themes of the questionnaires, indicating a greater focus of pressure ulcer treatment over prevention. While PU prevention is widely regarded to be a nursing issue, these findings provide some indication of the potential for an interprofessional approach.
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Affiliation(s)
- Paul Clarkson
- School of Health Sciences, University of Southampton, Southampton, UK.,Southern Health NHS Foundation Trust, Calmore, UK
| | - Peter R Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Lisette Schoonhoven
- School of Health Sciences, University of Southampton, Southampton, UK.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Dan L Bader
- School of Health Sciences, University of Southampton, Southampton, UK
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155
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A critical reflection on improving effective team communication. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
This paper aims at critically reflecting on the author’s personal experience in the context of communication within a nursing team and exploring relevant existing constraints with a view to improving practice and achieving more effective outcomes in team communication.
Methods
Critical emancipatory reflection is used to evaluate and interpret the author’s practice. Smyth’s model serves as a framework to guide critical reflection step by step in this paper. Relevant theoretical perspectives help to make sense of the author’s performance in terms of team communication.
Results
It is identified via emancipatory reflection that the author endorses the ideas of equality, respect, trust, and collaboration, which were formed and established during the process of professional socialization. However, different constraints, such as sociocultural, historical, political, and personal factors, impede the author from performing more effectively in terms of team communication. Reconstruction provides the author opportunities to take actions to rectify constraints and avoid the reemergence of previous situations in the future.
Conclusions
Reflection is an effective way to gather knowledge and develop comprehensive understanding of practice. Alternative actions for effective team communication are recommended, including formulating ground rules for discussion, guiding nurses in the correct way, transforming conflicts within a team, being an active and reflective listener, and motivating nurses to actively create.
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156
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Abstract
Background: Investigating the interdisciplinary relationships between stakeholders engaged in arts and health practice in the UK and Denmark, specifically with regard to institutional logics theory. The identified stakeholders: health professionals, museum educators and mental health service users. Method: Semi-structured interviews were conducted with 30 participants: health professionals, museum educators and service users. Data were collected in Denmark and the UK. A thematic approach was used to analyse the data and theoretical lenses of sociological theories, and institutional logics explored the findings. Results: The interdisciplinary work in arts and health is complex, given the different disciplines and institutions involved. Findings illustrate that institutional logics play a vital and ambiguous part in arts and health practice and that this presents a challenge for interdisciplinary working in the field. Conclusions: Awareness of the complexity of multiple logics in the arts and health field; recognising the differences between disciplines and institutions could benefit from research and practice.
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Affiliation(s)
- Anita Jensen
- Centre for Culture and Health, Institute of Communication & Psychology, Aalborg University , Copenhagen , Denmark
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157
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Smith AE, Jnah A, Newberry D. Chromosome 16p13.11 Microdeletion Syndrome in a Newborn: A Case Study. Neonatal Netw 2019; 37:303-309. [PMID: 30567812 DOI: 10.1891/0730-0832.37.5.303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chromosome 16p13.11 microdeletion syndrome is a rare copy number variant that carries increased risks for complications in the neonatal period and throughout the life span. Clinical manifestations and associated defects known to present in the neonatal period include motor delay, facial dysmorphisms, microcephaly, gastroesophageal reflux disease (GERD), and congenital heart defects. Management in the neonatal period focuses on associated comorbidities, including motor delay with or without GERD, which commonly manifests as feeding difficulties. Life span implications of chromosome 16p13.11 microdeletion syndrome include developmental, speech, and language delay; psychiatric and behavioral problems; seizure disorders; and, less commonly, obesity. Nursing assessment is critical to the early identification of nonspecific abnormalities associated with de novo genetic disorders. Early identification and diagnosis of chromosome 16p13.11 microdeletion syndrome are critical to optimizing outcomes throughout infancy and across the life span. We present a case report of an infant diagnosed with chromosome 16p13.11 microdeletion. A discussion of genetic influences, associated clinical manifestations, diagnostics, management, and health promotion strategies are presented to establish core knowledge of chromosome 16p13.11 microdeletion.
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158
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D'Angelo M, Cervero R, Durning S, Varpio L. The Teamwork Model: Proposing a Model for Studying Interprofessional Healthcare Teams. MEDEDPUBLISH 2019; 8:81. [PMID: 38089299 PMCID: PMC10712620 DOI: 10.15694/mep.2019.000081.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Patient safety is a preeminent healthcare concern in modern medicine. In the years since To Err is Human, researchers have found that the number of preventable deaths far exceeds 98,000; more accurately, 400,000 patients die each year from preventable healthcare errors. To combat the evolving patient safety crisis, a variety of organizations from Institute of Medicine to World Health Organization have called for the development of interprofessional healthcare teams. Interprofessional healthcare teams and teamwork have been a topic of discussion for over 40 years. And while some Interprofessional healthcare teams have been shown to be beneficial in some settings the success of these teams is not universal nor achieved in all healthcare settings. In short, research has found that interprofessional healthcare teams both improve and impede patient care. Building on this contradictions of interprofessional healthcare teams and teamwork, we present a model for the conceptualization of teamwork that could be readily applied to clinical experiences. This model is informed by the interprofessional healthcare team literature and relevant theories, and we believe will enable us to examine authentic interprofessional healthcare team interactions and identify moments when team interactions were breaking down, and reasons why those breakdowns were happening.
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Affiliation(s)
| | | | | | - Lara Varpio
- Uniformed Services University of the Health Sciences
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159
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Strøm B, Pires Jorge JA, Meystre NR, Kukkes T, Metsälä E, Hafslund BN. Interprofessional work in early detection of breast cancer: An integrative review. Radiography (Lond) 2019; 25:170-177. [PMID: 30955691 DOI: 10.1016/j.radi.2018.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/30/2018] [Accepted: 11/20/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To identify the roles of health care staff in interprofessional work related to breast cancer detection and diagnosis. KEY FINDINGS A comprehensive search was performed using PICO to support inclusion and exclusion criteria. A shortened version of the STROBE checklist ensured evaluation of the studies. 21 included studies resulted in three main categories describing the role of health care professionals; (1) Communicating breast cancer awareness; (2) The Professional's tasks; (3) Efficacy of Interprofessional Teamwork relative to the profession and the individuals. CONCLUSIONS Health care professionals' roles in the breast cancer diagnostic process were described mostly from each professional's viewpoint. Support from leadership and management is needed in order to promote interprofessional work, which will benefit health care professions, professionals, and the patient.
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Affiliation(s)
- B Strøm
- Western Norway University of Applied Sciences (HVL), Norway.
| | - J A Pires Jorge
- Haute École de Santé Vaud/University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - N R Meystre
- Haute École de Santé Vaud/University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - T Kukkes
- Tartu Health Care Colleges (THCC), Estonia
| | - E Metsälä
- Helsinki Metropolia University of Applied Sciences (METROPOLIA), Finland
| | - B N Hafslund
- Western Norway University of Applied Sciences (HVL), Norway
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160
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Leveraging Interprofessional Team-Based Care Toward Case Management Excellence: Part 1, History, Fundamentals, Evidence. Prof Case Manag 2019; 24:130-141. [PMID: 30946250 DOI: 10.1097/ncm.0000000000000360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: Health care teams continue to be a constructive way to approach, assess, coordinate, plan, and facilitate the care of clients and populations. Independent of practice setting, some type of team is in place, engaging different professionals and specialists. There has been considerable evolution of these teams over the years, with a heritage of terms to frame each one, including "multidisciplinary," "interdisciplinary," and "transdisciplinary." However, these long-standing framings have been replaced by a timelier model that shifts both focus and aim of the team effort. Interprofessional team-based care (IPTBC) sets the tone for how students entering the industry are educated and empowers the workforce to a more intentional means to the care end. This is the first in a 2-part series focusing on the evolution and implementation of IPTBC across the industry. Part 1 focuses on the history and fundamental concepts of interprofessional models. Evidence and outcomes to promote the value proposition for IPTBC implementation are also provided. PURPOSE/OBJECTIVES This article: PRIMARY PRACTICE SETTING(S):: Applicable to all health and behavioral health settings where case management is practiced. FINDINGS/CONCLUSIONS Interprofessional team-based care models demonstrate a successful means to achieve client-driven, quality, and cost-effective care across disease states and practice settings. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE With case management so closely linked to the fiscal imperatives of organizations, engagement in IPTBC is a necessity for every practice setting. Poor team collaboration contributes to unsuccessful outcomes for clients, increased costs, and concerning quality and risk management issues for the organization. The latest generation of value-based care initiatives and complex population health needs (e.g., social determinants of health, co-occurring physical and behavioral health) translates to greater pressures on case managers to maximize financial risk and attain their share of financial incentives (e.g., bonuses, shared savings) by avoiding readmissions, preventable complications, and duplicate services.
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161
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Palocaren J, Puthuparampil RR, Thalappillil CM. Two monologues do not make a dialogue: the need for medical specialty–specific communication workshops: population-based study. BMJ LEADER 2019. [DOI: 10.1136/leader-2018-000083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AimIncreasing attacks on healthcare personnel in India have highlighted the need for improved communication between staff and patients. Currently, communication skill workshops target doctors and nurses, overlooking a key player relevant to patient satisfaction—allied health professionals (henceforth, AHPs). This study evaluates the impact of communication skills training for diagnostic laboratory and blood bank personnel on patient satisfaction scores.MethodThe impact of communication workshop for AHPs was tested through pre-workshop and post-workshop questionnaires to participants that tested how they handle communication with patients. Additionally, participants were also administered the questionnaire 4 months after the workshop to test knowledge retention. In parallel, the change in patient satisfaction towards AHPs was assessed by a pre-workshop and post-workshop patient survey.ResultsParticipants experienced a statistically significant improvement in communication skills, as measured by the pre-workshop and post-workshop questionnaires. This coincided with a significant increase in patient satisfaction scores after the workshop, as indicated by the patient satisfaction survey. The difference in communication skills scores between experienced and inexperienced personnel showed a marked decrease after the workshop, suggesting that such workshops can help inexperienced workers ‘catch up’ with more experienced workers. However, scores of all participants showed a statistically significant decrease after 4 months, suggesting that the use of such workshops can be enhanced through periodic refresher courses.ConclusionCommunication workshops for AHPs can play a crucial role in improving patient–hospital relations. These workshops can also help standardise services by bridging communication skill differences between experienced and inexperienced staff.
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162
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Batista REA, Peduzzi M. Interprofessional Practice in the Emergency Service: specific and shared assignments of nurses. Rev Bras Enferm 2019; 72:213-220. [DOI: 10.1590/0034-7167-2017-0797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 05/23/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To map and categorize, according to the Nursing Interventions Classification (NIC), the specific assignments of the nurses and to identify the assignments shared with doctors and physiotherapists in the Emergency Service. Method: Descriptive exploratory study, carried out in two phases: first, the analysis of dissertations /theses from the database of the Center for Studies and Research of the Brazilian Nursing Association; Second, the use of the Delphi Technique to reach the consensus about which assignments were specific to the nurse and which were shared with physiotherapists and doctors. Results: The results were 45.7% for specific to the nurses, 14.2% for shared with physiotherapists and/or doctors, and in 40% (n=42) there was no consensus about the sharing of assignments. Conclusion: The sharing of actions among professionals shows an increase in the scope of the practice of professions and the constitution of a common sphere of work, but the high number of assignments with no consensus among specialists can be a potential factor in conflicts due to the lack of definition of these assignments.
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163
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Dobrozsi S, Tomlinson K, Chan S, Belongia M, Herda C, Maloney K, Long C, Vertz L, Bingen K. Education Milestones for Newly Diagnosed Pediatric, Adolescent, and Young Adult Cancer Patients: A Quality Improvement Initiative. J Pediatr Oncol Nurs 2019; 36:103-118. [PMID: 30600752 DOI: 10.1177/1043454218820906] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The diagnosis of cancer in a child, adolescent, or young adult is an emotionally overwhelming time. To improve the quality of education and support provided to patients and caregivers with a new cancer diagnosis, we executed a quality improvement initiative to (a) define key education milestones for the delivery of essential education during the first 2 months following diagnosis and (b) to define role accountability within the multidisciplinary team for delivery of content and execution of tasks. To develop education milestones, we (a) identified educational content from review of the literature, (b) determined the sequence of content delivery through qualitative interviews with patients and caregivers, and (c) developed education milestones by evaluation of existing workflows. To develop task lists, we (a) determined which multidisciplinary team member was best suited to deliver specific content and (b) defined discrete tasks required to execute education milestones. Key content topics and preferred sequence are as follows: Emotional Adjustment to Diagnosis, When and How to Call the Doctor, Medication Management, Practical Needs, Line Care, and Access to Nontherapeutic Clinical Trials. Eight education milestones were defined across the initial 2 months following cancer diagnosis. The education milestones are paired with task lists. The education milestones and task lists guide the execution of complex education across a multidisciplinary service line in an emotionally challenging time. Early information focuses on essential content, role responsibility is clearly defined, and psychosocial support services are purposefully and iteratively integrated into care during the initial weeks following a cancer diagnosis.
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Affiliation(s)
| | | | | | | | - Carolyn Herda
- 2 Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | | | - Catherine Long
- 3 Prevea Health/St. Vincent's Hospital, Green Bay, WI, USA
| | - Lori Vertz
- 3 Prevea Health/St. Vincent's Hospital, Green Bay, WI, USA
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164
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Levine CB, Ansar M, Dimet A, Miller A, Moon J, Rice C, Schaeffer A, Andersson J, Ekpo-Out S, McGrath E, Sarraj H. Student Evaluation of Interprofessional Experiences between Medical and Graduate Biomedical Students. JOURNAL OF RESEARCH IN INTERPROFESSIONAL PRACTICE AND EDUCATION 2019; 9:10.22230/jripe.2019v9n1a274. [PMID: 31327981 PMCID: PMC6640866 DOI: 10.22230/jripe.2019v9n1a274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Interprofessional education (IPE) has fostered increased collaboration and appreciation for different disciplines among health professionals but has yet to be established in a translational research setting. Interprofessional experiences (IPEx) implemented early in student training could increase translational research productivity. METHODS AND FINDINGS Ten students involved in an IPE curriculum wrote autoethnographic accounts that were coded and emergent themes were grouped through constant comparative analysis. IPE led to improvements in communication, trust, appreciation, and an increased desire to seek IPE in future careers. Challenges included administrative barriers and interpersonal conflicts. CONCLUSIONS Participants found IPE beneficial to their careers and developed a respect for each other's discipline. To implement IPE, institutions should consider possible administrative challenges and inclusion of conflict management training.
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Affiliation(s)
- Corri B. Levine
- Institute for Translational Sciences, University of Texas Medical Branch
| | - Maria Ansar
- School of Medicine, University of Texas Medical Branch
- Department of Microbiology & Immunology, University of Texas Medical Branch
| | - Andrea Dimet
- Institute for Translational Sciences, University of Texas Medical Branch
| | - Austin Miller
- Institute for Translational Sciences, University of Texas Medical Branch
| | - Joon Moon
- School of Medicine, University of Texas Medical Branch
| | | | | | - Jourdan Andersson
- Institute for Translational Sciences, University of Texas Medical Branch
| | - Shaunte Ekpo-Out
- Institute for Translational Sciences, University of Texas Medical Branch
| | - Erica McGrath
- Institute for Translational Sciences, University of Texas Medical Branch
| | - Huda Sarraj
- College of Technology, University of Houston
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165
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Stern GR. One Component of Whole Health for Our Patients: Connection to Someone With Lived Experience. J Am Psychiatr Nurses Assoc 2019; 25:76-77. [PMID: 30793652 DOI: 10.1177/1078390318817721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gail R Stern
- 1 Gail R. Stern, RN, MSN, PMHCNS-BC, American Psychiatric Nurses Association, Falls Church, VA, USA
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166
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From a variety of ethics to the integrity and congruence of research on biodiversity conservation. Asian Bioeth Rev 2018; 10:313-332. [PMID: 33717295 DOI: 10.1007/s41649-018-0072-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/17/2018] [Accepted: 12/11/2018] [Indexed: 10/26/2022] Open
Abstract
This article aims to find the elements that are required for a common ethical approach that is suitable for the different perspectives adopted in integrative biodiversity conservation research. A general reflection on the integrity of research is a priority worldwide, with a common aim to promote good research practice. Beyond the relationship between researcher and research subject, the integrity of research is considered in a broader perspective which entails scientific integrity towards society. In research involving a variety of disciplines and a diversity of legal and ethical frameworks, there is a need of harmony between different sets of values. The notion of congruence (or more pragmatically, alignment) reflects the consistency of ethics in research within the biodiversity conservation's community of researchers. It also bears on the coherence of values shared between the scientific community and society. We examine the notion of research integrity in a broad sense. This examination is to be conducted in relation to the goal of protecting ecological integrity, which is at the core of biodiversity conservation. The notion of integrity constraints should be investigated further to develop a pragmatic response to the need for integrity and congruence in research for biodiversity conservation.
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167
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Tham TY, Tran TL, Prueksaritanond S, Isidro JS, Setia S, Welluppillai V. Integrated health care systems in Asia: an urgent necessity. Clin Interv Aging 2018; 13:2527-2538. [PMID: 30587945 PMCID: PMC6298881 DOI: 10.2147/cia.s185048] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A rapidly aging population along with the increasing burden of patients with chronic conditions in Asia requires efficient health systems with integrated care. Although some efforts to integrate primary care and hospital care in Asia are underway, overall care delivery remains fragmented and diverse, eg, in terms of medical electronic record sharing and availability, patient registries, and empowerment of primary health care providers to handle chronic illnesses. The primary care sector requires more robust and effective initiatives targeted at specific diseases, particularly chronic conditions such as diabetes, hypertension, depression, and dementia. This can be achieved through integrated care - a health care model of collaborative care provision. For successful implementation of integrated care policy, key stakeholders need a thorough understanding of the high-risk patient population and relevant resources to tackle the imminent population demographic shift due to the extremely rapid rate of increase in the aging population in Asia.
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Affiliation(s)
- Tat Yean Tham
- Clinical Affairs Department, Frontier Healthcare Group, Singapore
| | - Thuy Linh Tran
- Department of Pharmacy, National University of Singapore, Singapore
| | - Somjit Prueksaritanond
- Department of Community, Occupational and Family Medicine, Faculty of Medicine, Burapha University, Chonburi, Thailand
| | - Josefina S Isidro
- Department of Family and Community Medicine, University of the Philippines, Manila, Philippines
| | - Sajita Setia
- Transform Medical Communications, Wanganui, New Zealand
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168
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Ronald AH, Hooper LM, Head BA, Evans-Andris M, Estes EO. Insights and experiences of chaplain interns and social work interns on palliative care teams. DEATH STUDIES 2018; 44:141-151. [PMID: 30526429 DOI: 10.1080/07481187.2018.1527414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Interdisciplinary palliative care teams provide critical, comprehensive end-of-life care, although the accumulated literature points toward barriers that impede their effectiveness. The current phenomenological qualitative study presents perceptions of chaplaincy interns (N = 24) and social work interns (N = 23) after a semester-long end-of-life clinical training experience with interdisciplinary palliative care teams. Analysis of the end of semester reflections resulted in seven themes, which are fairly consistent with the literature base. The described experiential learning and reflections in the current study are powerful and can inform how to prepare practitioners for teamwork and compassionate end-of-life care.
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Affiliation(s)
- Ann H Ronald
- Department of Counseling and Human Development, The University of Louisville, Louisville, KY, USA
| | - Lisa M Hooper
- Department of Counseling and Human Development, The University of Louisville, Louisville, KY, USA
| | - Barbara A Head
- Department of Counseling and Human Development, The University of Louisville, Louisville, KY, USA
| | - Melissa Evans-Andris
- Department of Counseling and Human Development, The University of Louisville, Louisville, KY, USA
| | - Eileen O Estes
- Department of Counseling and Human Development, The University of Louisville, Louisville, KY, USA
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169
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Armstrong M, Champagne J, Mortimer DS. Department of Veterans Affairs Polytrauma Rehabilitation Centers: Inpatient Rehabilitation Management of Combat-Related Polytrauma. Phys Med Rehabil Clin N Am 2018; 30:13-27. [PMID: 30470417 DOI: 10.1016/j.pmr.2018.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Traumatic brain injury (TBI) is one of the signature injuries of Operation Iraqi Freedom and Operation Enduring Freedom. To ensure that rehabilitation care needs of veterans and active duty servicemembers with TBI and polytrauma injuries were met, the Department of Veterans Affairs (VA) established the Polytrauma System of Care (PSC) in 2005. The 5 VA Polytrauma Rehabilitation Centers provide tertiary, acute inpatient rehabilitation for the PSC. Interdisciplinary treatment teams of multiple rehabilitation disciplines provide the complex, patient-centered care to achieve maximum benefit. After discharge, veterans and servicemembers with TBI and polytrauma receive lifelong support and care through the PSC.
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Affiliation(s)
- Michael Armstrong
- Department of Physical Medicine and Rehabilitation, Minneapolis VA Health Care System, University of Minnesota, 1 Veterans Drive (117), Minneapolis, MN 55417, USA.
| | - Julie Champagne
- Polytrauma Transitional Rehabilitation, Minneapolis VA Health Care System, 1 Veterans Drive (117), Minneapolis, MN 55417, USA
| | - Diane Schretzman Mortimer
- Department of Physical Medicine and Rehabilitation, Polytrauma Network Site, Minneapolis VA Health Care System, 1 Veterans Drive (117), Minneapolis, MN 55417, USA
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170
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Franz S, Muser J, Thielhorn U, Wallesch CW, Behrens J. Inter-professional communication and interaction in the neurological rehabilitation team: a literature review. Disabil Rehabil 2018; 42:1607-1615. [PMID: 30457016 DOI: 10.1080/09638288.2018.1528634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Neurological early rehabilitation aims at regaining cooperativity and acquiring rehabilitation capability with brain-injured patients, most of whom are transferred from Intensive Care Units, most of whom still require intensive care and suffer from disorders of consciousness. In neurological early rehabilitation, therapeutic nursing is an integral part of the therapeutic team. Other than the specialized therapists, nurses are present on the ward 24/7, which gives them a closer perspective on the patient. The research question was how do nurses, physiotherapists, occupational therapists and speech therapists communicate and interact as teams in neurological rehabilitation wards. A literature review was conducted aiming at inter-professional communication and interaction with special regard to the role of these four professionals being the core team members in these settings.Methods: A literature search was conducted in the period from August to October 2016 within the following electronic Databases: Medline, CINAHL, PSYNDEX, SpeechBITE, PEDro und OTseeker. Further searches were undertaken in the reference lists of obtained studies to locate other relevant material. The aim was to gather and evaluate the evidence about inter-professional teamwork in neurological early rehabilitation. The main inclusion criterion was the presence of the following professionals as participants in the study: Nurses, physiotherapists, occupational therapists and speech therapists. Twenty-seven studies were found relevant, of which 17 (12 qualitative and five quantitative) bore empirical results that related to the research questions. These 17 studies were qualitatively analysed for the grade of evidence, methods and the relevance for the conditions and processes in rehabilitation units. Out of 17 studies, four were performed in neurological rehabilitation settings, five in stroke units, six in general rehabilitation, one in short-term care rehabilitation and one in geriatric rehabilitation. Due to the scarcity of material, all these studies were analysed under the perspective of relevance for neurological early rehabilitation.Results: The results of this exploratory literature review indicate that the efficiency and quality of cooperation in rehabilitation teams could be improved through a better patient-oriented inter-professional communication. This is achieved through cross-professional team organization, team supervision and by including team communication in vocational and on-the-job-training. Profession-specific terminologies and differences in understanding of roles could be barriers for collaboration in teams.Conclusions: According to this literature review, successful inter-professional patient-orientated care is promoted by being informed about the various functions of team members from different disciplines, about the role each member plays within the team and communication styles. Means of improving communication are being outlined.Implications for RehabilitationInter-professional communication is promoted by cross-professional team organization.Inter-professional communication should be included in vocational and on-the-job-training and supervision.Barriers for communication in teams are different terminologies and differences in role perception.
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Affiliation(s)
- Shiney Franz
- BDH - Federal Association of Rehabilitation, Bonn, Germany.,Medical Faculty, Institute for Health and Nursing Sciences, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | | | - Ulrike Thielhorn
- Management in Healthcare, Catholic University for Applied Sciences, Freiburg, Germany
| | | | - Johann Behrens
- Medical Faculty, Institute for Health and Nursing Sciences, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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171
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Ramaswamy V, Karimbux N, Dragan IF, Mehta NR, Danciu T. The Status of Interdisciplinary Education in Advanced Education Programs at U.S. Dental Schools. J Dent Educ 2018; 82:1213-1219. [PMID: 30385688 DOI: 10.21815/jde.018.126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/16/2018] [Indexed: 01/31/2023]
Abstract
Interdisciplinary education (IDE) during dental residencies can help produce dentists who work more efficiently to provide continuous and reliable patient care. The aim of this study was to assess the extent and type of interdisciplinary education in dental residency programs at U.S. dental schools. A 24-item survey addressing didactic courses and patient care was sent to academic and/or clinical deans at 65 U.S. dental schools in fall 2016; they were asked to forward the survey to the appropriate person in their school. The questions addressed IDE characteristics such as the academic home for IDE, focus areas, defined outcomes, program objectives, and perceived institutional barriers. Of the 65 schools invited to participate, 31 responded to the survey for an overall response rate of 48%. Of those schools, 23 (74%) reported having IDE for their advanced/postgraduate students. Among the schools with IDE, their IDE learning experiences primarily involved residents in different disciplines participating in clinical case group projects and small group workshops, and 77% of IDE faculty taught in department-specific clinical spaces as opposed to teaching together in a single clinic. The respondents identified barriers to implementing IDE such as a lack of clearly defined competencies, logistical challenges including academic calendars and scheduling, and faculty resistance. Also, 43% reported that their institutions did not have a program to support IDE faculty development. At the time of this survey, most of the respondents did not have a clearly defined IDE model consisting of competencies, defined assessments, and milestones.
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Affiliation(s)
- Vidya Ramaswamy
- Vidya Ramaswamy is Associate Director for Curriculum and Program Evaluation, University of Michigan School of Dentistry; Nadeem Karimbux is Academic Dean and Professor, Tufts University School of Dental Medicine; Irina F. Dragan is Assistant Professor, Tufts University School of Dental Medicine; Noshir R. Mehta is Professor of Public Health and Community Service, Tufts University School of Dental Medicine; and Theodora Danciu is Clinical Associate Professor, University of Michigan School of Dentistry
| | - Nadeem Karimbux
- Vidya Ramaswamy is Associate Director for Curriculum and Program Evaluation, University of Michigan School of Dentistry; Nadeem Karimbux is Academic Dean and Professor, Tufts University School of Dental Medicine; Irina F. Dragan is Assistant Professor, Tufts University School of Dental Medicine; Noshir R. Mehta is Professor of Public Health and Community Service, Tufts University School of Dental Medicine; and Theodora Danciu is Clinical Associate Professor, University of Michigan School of Dentistry
| | - Irina F Dragan
- Vidya Ramaswamy is Associate Director for Curriculum and Program Evaluation, University of Michigan School of Dentistry; Nadeem Karimbux is Academic Dean and Professor, Tufts University School of Dental Medicine; Irina F. Dragan is Assistant Professor, Tufts University School of Dental Medicine; Noshir R. Mehta is Professor of Public Health and Community Service, Tufts University School of Dental Medicine; and Theodora Danciu is Clinical Associate Professor, University of Michigan School of Dentistry.
| | - Noshir R Mehta
- Vidya Ramaswamy is Associate Director for Curriculum and Program Evaluation, University of Michigan School of Dentistry; Nadeem Karimbux is Academic Dean and Professor, Tufts University School of Dental Medicine; Irina F. Dragan is Assistant Professor, Tufts University School of Dental Medicine; Noshir R. Mehta is Professor of Public Health and Community Service, Tufts University School of Dental Medicine; and Theodora Danciu is Clinical Associate Professor, University of Michigan School of Dentistry
| | - Theodora Danciu
- Vidya Ramaswamy is Associate Director for Curriculum and Program Evaluation, University of Michigan School of Dentistry; Nadeem Karimbux is Academic Dean and Professor, Tufts University School of Dental Medicine; Irina F. Dragan is Assistant Professor, Tufts University School of Dental Medicine; Noshir R. Mehta is Professor of Public Health and Community Service, Tufts University School of Dental Medicine; and Theodora Danciu is Clinical Associate Professor, University of Michigan School of Dentistry
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172
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Predictive Analytics Approach to Improve and Sustain College Students’ Non-Cognitive Skills and Their Educational Outcome. SUSTAINABILITY 2018. [DOI: 10.3390/su10114012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The application of predictive analytics in higher education has increasingly gained acceptance and interest over the years. In this study, a predictive model is developed to map students’ non-cognitive skills against their class performance. Our predictive analytics model identified the non-cognitive skills that predicted new students’ class performance based on the dataset collected early in the semester. Based on the predictive analytics results, tailored teaching to improve students’ non-cognitive skills was offered in a required class designed for undergraduate business students. The improvement in the average final semester grade for students in the tailored-taught classes based on our predicted analytics approach was 9%, which was higher than that of the class grade taught without the approach. The study finding also demonstrates a long-term, sustainable positive effect to the students with the predictive analytics approach.
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173
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Munar W, Wahid SS, Mookherji S, Innocenti C, Curry L. Team- and individual-level motivation in complex primary care system change: A realist evaluation of the Salud Mesoamerica Initiative in El Salvador. Gates Open Res 2018. [DOI: 10.12688/gatesopenres.12878.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background:We study the role of individual and team-level motivation in explaining large-scale primary care performance improvements in El Salvador, one of the top-performing countries in the Salud Mesoamerica Initiative.Methods:Case study with outlier sampling of high-performing, community health teams in El Salvador. Design includes scoping review of literature, document review, non-participant observation, and qualitative analysis of in-depth interviews following a realist case study protocol.Results:The interplay between program interventions and organizational, community and policy contexts trigger multi-level motivational mechanisms that operate in complex, dynamic fashion. Interventions like performance measurement and team-based, in-kind incentives foster motivation among individual members of high-performing teams, which may be moderated by working conditions, supervision practices, and by the stress exerted by the interventions themselves. Individuals report a strong sense of public service motivation and an overarching sense of commitment to the community they serve. At the interpersonal level, the linkage between performance measurement and in-kind incentives triggers a sense of collective efficacy and increases team motivation and improvement behaviors. The convening of learning forums and performance dialogue increases the stakes for high-performing teams, helps them make sense of performance data, and leads to performance information utilization for healthcare improvements. Closeness to communities creates strong emotional linkages among team members that further increases collective efficacy and social identity. Such changes in individuals, team, and organizational behaviors can contribute to improved delivery of primary care services and explain the gains in performance demonstrated by the program.Conclusions:This case suggests that primary care systems that rely on multi-disciplinary teams for the provision of care can benefit from performance measurement and management interventions that leverage individual and team-level motivation. Realist evaluation can help prioritize policy-relevant research and enhance the design and evaluation of large-scale performance reforms in primary care systems in low- and middle-income settings.
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174
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Stratil JM, Rieger MA, Voelter-Mahlknecht S. Image and perception of physicians as barriers to inter-disciplinary cooperation? - the example of German occupational health physicians in the rehabilitation process: a qualitative study. BMC Health Serv Res 2018; 18:769. [PMID: 30305099 PMCID: PMC6180505 DOI: 10.1186/s12913-018-3564-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the German rehabilitation system, primary care physicians (PCPs), occupational health physicians (OPs), and rehabilitation physicians (RPs) fulfill different distinct functions and roles. While effective cooperation can improve outcomes of rehabilitation, the cooperation between these groups of stakeholders has been criticized as lacking or insufficient. This article proposes an approach to understand the low levels of cooperation by examining the role of group perception and group identity in intra-professional cooperation as a barrier to cooperation between physicians in different roles. Group perception was evaluated in terms of (1) negative views about another group of medical specialists and (2) differences between the perception of members and non-members of a medical specialty group. To examine this issue, we focused on the role of OPs in the German rehabilitation process. METHODS We implemented a qualitative study design with eight focus group discussions with PCPs, OPs, RPs, and patients (two focus group discussions per stakeholder group; 4-10 participants) and qualitative content analysis. We used the Social Identity Approach by Tajfel and Turner as a theoretical underpinning. RESULTS While all protagonists reported a positive perception of their own professional group, we found numerous negative perceptions about other groups, especially regarding OPs. Negative perceptions of OPs included 1) apparent conflict of interest between employer and employee, 2) lack of commitment to patient outcomes, 3) lack of useful specialized knowledge which could have a bearing on rehabilitation outcomes, and 4) distrust on the part of their patients. We also found divergent perceptions regarding roles, responsibilities, and capabilities among the specialist groups. Both negative and conflicting perceptions about roles were characterized as barriers to cooperation by study participants. CONCLUSION This example of cooperation between RPs, OPs, and PCPs suggests that negative and diverging perceptions about an out-group could create barriers in intra-professional and inter-disciplinary cooperation between physicians. These perspectives might also be useful in explaining problems at intersections between different specialties. We suggest examining the inter-group dimension of perception-based barriers to cooperation in future interventions to overcome problems caused by intra-professional and inter-disciplinary conflicts in addition to other barriers (i.e. organizational hurdles).
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Affiliation(s)
- Jan M Stratil
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstrasse 27, 72074, Tuebingen, Germany.
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstrasse 27, 72074, Tuebingen, Germany
| | - Susanne Voelter-Mahlknecht
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstrasse 27, 72074, Tuebingen, Germany
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175
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Shung-King M, Gilson L, Mbachu C, Molyneux S, Muraya KW, Uguru N, Govender V. Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study. Int J Equity Health 2018; 17:148. [PMID: 30227872 PMCID: PMC6145101 DOI: 10.1186/s12939-018-0859-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The importance of strong and transformative leadership is recognised as essential to the building of resilient and responsive health systems. In this regard, Sustainable Development Goals (SDG) 5 prioritises a current gap, by calling for women's full and effective participation and equal opportunities for leadership, including in the health system. In South Africa, pre-democracy repressive race-based policies, coupled with strong patriarchy, led to women and especially black women, being 'left behind' in terms of career development and progression into senior health leadership positions. METHODS Given limited prior inquiry into this subject, we conducted a qualitative exploratory study employing case study design, with the individual managers as the cases, to examine the influence of gender on career progression and leadership perceptions and experiences of senior managers in South Africa in five geographical districts, located in two provinces. We explored this through in-depth interviews, including life histories, career pathway mapping and critical incident analysis. The study sample selection was purposive and included 14 female and 5 male senior-managers in district and provincial health departments. RESULTS Our findings suggest that women considerably lag behind their male counterparts in advancing into management- and senior positions. We also found that race strongly intersected with gender in the lived experiences and career pathways of black female managers and in part for some black male managers. Professional hierarchy further compounded the influence of gender and race for black women managers, as doctors, who were frequently male, advanced more rapidly into management and senior management positions, than their female counterparts. Although not widespread, other minority groups, such as male managers in predominantly female departments, also experienced prejudice and marginalisation. Affirmative employment policies, introduced in the new democratic dispensation, addressed this discriminatory legacy and contributed to a number of women being the 'first' to occupy senior management positions. In one of the provinces, these pioneering female managers assumed role-modelling and mentoring roles and built strong networks of support for emerging managers. This was aided by an enabling, value-based, organisational culture. CONCLUSION This study has implications for institutionalising personal and organisational development that recognise and appropriately advances women managers, paying attention to the intersections of gender, race and professional hierarchy. It is important in the context of national and global goals, in particular SDG 5, that women and in particular black women, are prioritised for training and capacity development and ensuring that transformative health system policies and practices recognise and adapt, supporting the multiple social and work roles that managers, in particular women, play.
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Affiliation(s)
- Maylene Shung-King
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Lucy Gilson
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Chinyere Mbachu
- College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | | | | | - Nkoli Uguru
- College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Veloshnee Govender
- Alliance for Health Policy and Systems, World Health Organization, Geneva, Switzerland
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176
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Cutler S, Morecroft C, Carey P, Kennedy T. Are interprofessional healthcare teams meeting patient expectations? An exploration of the perceptions of patients and informal caregivers. J Interprof Care 2018; 33:66-75. [DOI: 10.1080/13561820.2018.1514373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Suzanne Cutler
- School of Pharmacy and Bimolecular Sciences, Liverpool, UK
| | | | - Phil Carey
- School of Nursing and Alled Health, Liverpool, UK
| | - Tom Kennedy
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
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177
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Barton G, Bruce A, Schreiber R. Teaching nurses teamwork: Integrative review of competency-based team training in nursing education. Nurse Educ Pract 2018; 32:129-137. [DOI: 10.1016/j.nepr.2017.11.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 11/29/2017] [Indexed: 12/29/2022]
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178
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Gao W, Huque S, Morgan M, Higginson IJ. A Population-Based Conceptual Framework for Evaluating the Role of Healthcare Services in Place of Death. Healthcare (Basel) 2018; 6:E107. [PMID: 30200247 PMCID: PMC6164352 DOI: 10.3390/healthcare6030107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/24/2018] [Accepted: 08/28/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND There is a significant geographical disparity in place of death. Socio-demographic and disease-related variables only explain less than a quarter of the variation. Healthcare service factors may account for some (or much) of the remaining variation but their effects have never been systematically evaluated, partly due to the lack of a conceptual framework. This study aims to propose a population-based framework to guide the evaluation of the role of the healthcare service factors in place of death. METHODS Review and synthesis of health service models that include the impact of a service component on either place of death/end of life care outcomes or service access/utilization. RESULTS The framework conceptualizes the impact of healthcare services on the place of death as starting from the end of life care policies that in turn influence service commissioning and shape healthcare service characteristics, including service type, service capacity-facilities, service location, and workforce, through which service utilization and ultimately place of death are affected. Patient socio-demographics, disease-related variables, family and community support and social care also influence place of death, but they are not the focus of this framework and therefore are grouped as needs and other environmental factors. Information on service utilization, together with the place of death, creates loop feedback to inform policy and service commission. CONCLUSIONS The framework provides guidance for analysis aiming to understand the role of healthcare services in place of death. It aids the interpretation of results in the light of existing knowledge and potentially identifies service factors that can be addressed to improve end of life care.
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Affiliation(s)
- Wei Gao
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, Denmark Hill, London SE5 9PJ, UK.
| | - Sumaya Huque
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, Denmark Hill, London SE5 9PJ, UK.
| | - Myfanwy Morgan
- Institute of Pharmaceutical Science, King's College London, London SE1 9NH, UK.
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, Denmark Hill, London SE5 9PJ, UK.
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179
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Klemenc-Ketis Z, Makivić I, Poplas Susic A. The development and validation of a new interprofessional team approach evaluation scale. PLoS One 2018; 13:e0201385. [PMID: 30092005 PMCID: PMC6084891 DOI: 10.1371/journal.pone.0201385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/13/2018] [Indexed: 11/18/2022] Open
Abstract
A team approach in health care involves an interprofessional approach to patient care. We wanted to develop and validate a tool that would evaluate the interprofessional team approach to patients of a family medicine team. We performed a descriptive study in three consecutive phases: a literature review, consensus development panels, and a cross-sectional validation study. Three rounds of consensus development panels were carried out in order to evaluate and adapt the initial scale. The cross-sectional study was carried out in all Slovenian family medicine practices, each invited 10 consecutive patients. In the quantitative study, 3,292 patients participated (a 50.7% response rate), of which 1,810 (55.0%) were women. The mean age of the sample was 53.1 ± 1.2 years. The final Cronbach’s alpha was 0.901. A factor analysis of the 9-item scale put forward two factors (Team Approach and Person-Centred approach) which explained 68.6% of the variance. This study provided a new scale for the evaluation of patient satisfaction with the interprofessional family medicine team from the patients’ point of view. It opened the question of family medicine team competencies and pointed towards the need to develop a family medicine interprofessional team competency framework and a comprehensive tool for its assessment.
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Affiliation(s)
- Zalika Klemenc-Ketis
- Community Health Centre Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- * E-mail:
| | - Irena Makivić
- Community Health Centre Ljubljana, Ljubljana, Slovenia
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Al-Arifi MN, Al-Omar HA. Impact of a multidisciplinary intensive education program on type 2 diabetes mellitus patients' glycemic control and cardiovascular risk factors. Saudi Med J 2018; 39:705-710. [PMID: 29968894 PMCID: PMC6146253 DOI: 10.15537/smj.2018.7.22194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the impact of a multidisciplinary intensive education program (MIEP) on type 2 diabetes mellitus (T2DM) patients' outcomes. METHODS A retrospective study was used to evaluate the impact of MIEP on T2DM patients' outcomes for between May 2016 and May 2017. Data were collected from the diabetes education clinic in King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia where patients were referred from diabetes outpatient clinics to the diabetes education clinic to receive MIEP. In terms of measuring the clinical outcomes of the T2DM patients, glycemic control, blood pressure, weight, and lipid profiles were assessed before MIEP at 3, 6, and 12 months. Results: A total of 174 patients with T2DM fulfilled study inclusion criteria. The results indicate improved glycemic control where patients' HbA1c and blood sugar levels were significantly reduced 3, 6, and 12 months after MIEP compared to the baseline (p less than 0.005). Moreover, blood pressure improved after education; a significant improvement was observed in the mean systolic blood pressure (SBP) from baseline to 12 months (p=0.036), and in the mean diastolic blood pressure (DBP) after 12 months (p=0.016). Additionally, the study found significant differences in total cholesterol and low-density lipoprotein (LDL) cholesterol 6 months after the intervention (p=0.014, p=0.02, respectively). Conclusion: Implementing an MIEP for T2DM patients can improve their clinical outcomes, which consequently may delay the disease's long-term complications.
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Affiliation(s)
- Mohamed N Al-Arifi
- College of Pharmacy, Clinical Pharmacy Department, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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King O, Borthwick A, Nancarrow S, Grace S. Sociology of the professions: what it means for podiatry. J Foot Ankle Res 2018; 11:30. [PMID: 29942353 PMCID: PMC6000928 DOI: 10.1186/s13047-018-0275-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/07/2018] [Indexed: 12/02/2022] Open
Abstract
Background The health professions have progressed and evolved considerably over the last few decades in response to demographic, technological, societal and political changes. They continue to do so as the volume and complexity of population health needs steadily increase. Role boundary expansion is among the key changes to the health professions, including podiatry to meet demand. Nonetheless podiatry’s role boundary expansion has not been achieved swiftly or without resistance from neighbouring and dominant professions. This paper seeks to explain the nature of this resistance with respect to the sociology of the professions literature and to shed light on some of the factors and processes at play when role boundary changes arise in health care. Discussion Six of the most contemporaneously relevant sociology of the professions theories are summarised: Taxonomic, Marxian, Bourdieusian, Foucauldian, Boundary Work and Neo-Weberian paradigms. Conclusion This review highlights that some paradigms are more relevant than others in the current socio-political landscape. It also illustrates that there is a common theme underlying each approach to defining the professions and their boundaries: competition. This may help health professionals, including podiatrists, to understand and manage the challenges and resistance experienced when professions attempt to expand role boundaries to meet increasing and changing population health needs.
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Affiliation(s)
- Olivia King
- 1Monash Centre for Scholarship in Health Education, Monash University, Clayton, 3800 Australia
| | - Alan Borthwick
- 2University of Southampton, Highfield, Southampton, SO17 1BJ UK
| | - Susan Nancarrow
- 3Southern Cross University, Military Drive, Lismore, 2480 Australia
| | - Sandra Grace
- 3Southern Cross University, Military Drive, Lismore, 2480 Australia
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Marsilio M, Torbica A, Villa S. Health care multidisciplinary teams: The sociotechnical approach for an integrated system-wide perspective. Health Care Manage Rev 2018; 42:303-314. [PMID: 27351480 DOI: 10.1097/hmr.0000000000000115] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current literature on the enabling conditions of multidisciplinary teams focuses on the singular dimensions of the organizations (i.e., human resources, clinical pathways, objects) without shedding light on to the way in which these organizational factors interact and mutually influence one another. PURPOSE Drawing on a system perspective of organizations, the authors analyze the organizational patterns that promote and support multidisciplinary teams and how they interrelate and interact to enforce the organization work system. METHODOLOGY/APPROACH The authors develop a modified sociotechnical system (STS) model to understand how the two dimensions of technical (devices/tools, layout/organization of space, core process standardization) and social (organizational structure, management of human resources and operations) can facilitate the implementation of multidisciplinary teams in health care. The study conducts an empirical analysis based on a sample of hospital adopters of transcatheter aortic valve implantation using the revised STS model. FINDINGS The modified STS model applied to the case studies improves our understanding of the critical implementation factors of a multidisciplinary approach and the importance of coordinating radical changes in the technical and the social subsystems of health care organizations. The analysis informs that the multidisciplinary effort is not a sequential process and that the interplay between the two subsystems needs to be managed efficaciously as an integrated organizational whole to deliver the goals set. PRACTICE IMPLICATIONS Hospital managers must place equal focus on the closely interrelated technical and social dimensions by investing in (a) shared layouts and spaces that cross the boundaries of the specialized health care units, (b) standardization of the core processes through the implementation of local clinical pathways,
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Affiliation(s)
- Marta Marsilio
- Marta Marsilio, PhD, is Assistant Professor, University of Milan, Italy, and Centre for Research in Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy. Aleksandra Torbica, PhD, is Assistant Professor, Centre for Research in Health and Social Care Management (CERGAS), Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy. E-mail: . Stefano Villa, PhD, is Associate Professor, Department of Management, Catholic University, Rome, Italy, and Coordinator of field research projects at CERISMAS (Research Centre in Health Care Management), Catholic University of Milano, Italy. This material is based on research supported by the European Health Technology Institute for Socio Economic Research (EHTI) through an unrestricted grant awarded to the Centre for Research in Health and Social Care Management (CERGAS). During the project execution, all authors were affiliated with CERGAS, Bocconi University
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183
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Woody CA, Baxter AJ, Harris MG, Siskind DJ, Whiteford HA. Identifying characteristics and practices of multidisciplinary team reviews for patients with severe mental illness: a systematic review. Australas Psychiatry 2018; 26:267-275. [PMID: 29417829 DOI: 10.1177/1039856217751783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Multidisciplinary teams in mental health receive limited guidance, leading to inconsistent practices. We undertook a systematic review of the characteristics and practices of multidisciplinary team reviews for patients with severe mental illness or in relevant mental health service settings. METHODS Sources published since 2000 were located via academic database and web searches. Results were synthesised narratively. RESULTS A total of 14 sources were analysed. Important characteristics and practices identified included routine monitoring and evaluation, good communication, equality between team members, and clear documentation practices. Success factors included defined leadership and clear team goals. Four sources described considerations for patients with complex clinical needs, including allocating sufficient time for discussion, maintaining connections with community providers, and ensuring culturally sensitive practices. CONCLUSIONS No single best practice model was found, due to variations in team caseload, casemix, and resourcing levels. However, key ingredients for success were proposed. Sources were mostly descriptive; there remains a lack of evidence-based guidance regarding multidisciplinary team review characteristics and practices.
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Affiliation(s)
- Charlotte A Woody
- Research Officer, Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, and; School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Amanda J Baxter
- Research Fellow, Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, and; School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Meredith G Harris
- Associate Professor, School of Public Health, University of Queensland, Herston, QLD, and; Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Dan J Siskind
- Clinical Academic Psychiatrist, Metro South Addiction and Mental Health Services, Brisbane, QLD, and; Associate Professor, School of Medicine, University of Queensland, Brisbane, QLD, and; Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Harvey A Whiteford
- Professor of Population Mental Health, School of Public Health, University of Queensland, Herston, QLD, and; Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, and; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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184
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Russell E, Kosny A. Communication and collaboration among return-to-work stakeholders. Disabil Rehabil 2018; 41:2630-2639. [DOI: 10.1080/09638288.2018.1472815] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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185
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"They Are Talking About Me, but Not with Me": A Focus Group Study to Explore the Patient Perspective on Interprofessional Team Meetings in Primary Care. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 10:429-438. [PMID: 28110379 PMCID: PMC5534197 DOI: 10.1007/s40271-017-0214-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The number of people with multiple chronic conditions receiving primary care services is growing. To deal with their increasingly complex health care demands, professionals from different disciplines need to collaborate. Interprofessional team (IPT) meetings are becoming more popular. Several studies describe important factors related to conducting IPT meetings, mostly from a professional perspective. However, in the light of patient-centeredness, it is valuable to also explore the patients’ perspective. Objective The aim was to explore the patients’ perspectives regarding IPT meetings in primary care. Methods A qualitative study with a focus group design was conducted in the Netherlands. Two focus group meetings took place, for which the same patients were invited. The participants, chronically ill patients with experience on interprofessional collaboration, were recruited through the regional patient association. Participants discussed viewpoints, expectations, and concerns regarding IPT meetings in two rounds, using a focus group protocol and selected video-taped vignettes of team meetings. The first meeting focused on conceptualization and identification of themes related to IPT meetings that are important to patients. The second meeting aimed to gain more in-depth knowledge and understanding of the priorities. Discussions were audio-taped and transcribed verbatim, and analyzed by means of content analysis. Results The focus group meetings included seven patients. Findings were divided into six key categories, capturing the factors that patients found important regarding IPT meetings: (1) putting the patient at the center, (2) opportunities for patients to participate, (3) appropriate team composition, (4) structured approach, (5) respectful communication, and (6) informing the patient about meeting outcomes. Conclusions Patients identified different elements regarding IPT meetings that are important from their perspective. They emphasized the right of patients or their representatives to take part in IPT meetings. Results of this study can be used to develop tools and programs to improve interprofessional collaboration. Electronic supplementary material The online version of this article (doi:10.1007/s40271-017-0214-3) contains supplementary material, which is available to authorized users.
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Communication and Relational Ties in Inter-Professional Teams in Norwegian Specialized Health Care: A Multicentre Study of Relational Coordination. Int J Integr Care 2018; 18:9. [PMID: 30127693 PMCID: PMC6095090 DOI: 10.5334/ijic.3432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: The delivery of integrated care depends on the quality of communication and relationships among health-care professionals in inter-professional teams. The main aim of this study was to investigate individual and team communication and relational ties of teams in specific care processes within specialized health care. Methods: This cross-sectional multi-centre study used data from six somatic hospitals and six psychiatric units (N = 263 [response rate, 52%], 23 care processes) using a Norwegian version of the Relational Coordination Survey. We employed linear mixed-effect regression models and one-way analyses of variance. Results: The mean (standard deviation) relational coordination total score ranged from 4.5 (0.33) to 2.7 (0.50). The communication and relationship sub-scale scores were significantly higher within similar functional groups than between contrasting functional groups (P < .05). Written clinical procedures were significantly associated with higher communication scores (P < .05). The proportion of women in a team was associated with higher communication and relationship scores (P < .05). Conclusion: The Relational Coordination Survey shows a marked variation in team functions within inter-professional teams in specialized health-care settings. Further research is needed to determine the reasons for these variations.
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187
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Rosell L, Alexandersson N, Hagberg O, Nilbert M. Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care. BMC Health Serv Res 2018; 18:249. [PMID: 29622020 PMCID: PMC5887214 DOI: 10.1186/s12913-018-2990-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/14/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants' views on the meeting function, including perceived benefits and barriers. METHODS In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation. RESULTS The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports. CONCLUSIONS Health professionals' report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented.
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Affiliation(s)
- Linn Rosell
- Institute of Clinical Sciences, Division of Oncology and Pathology, Lund University, Scheelev. 2, 223 63, Lund, Sweden.,Regional Cancer Centre South, Region Skåne, Sweden
| | | | | | - Mef Nilbert
- Institute of Clinical Sciences, Division of Oncology and Pathology, Lund University, Scheelev. 2, 223 63, Lund, Sweden. .,Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark. .,Danish Cancer Society Research Center, Copenhagen, Denmark.
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Rosell L, Alexandersson N, Hagberg O, Nilbert M. Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care. BMC Health Serv Res 2018. [PMID: 29622020 DOI: 10.1186/s12913-018-2990-4.pmid:29622020;pmcid:pmc5887214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants' views on the meeting function, including perceived benefits and barriers. METHODS In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation. RESULTS The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports. CONCLUSIONS Health professionals' report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented.
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Affiliation(s)
- Linn Rosell
- Institute of Clinical Sciences, Division of Oncology and Pathology, Lund University, Scheelev. 2, 223 63, Lund, Sweden.,Regional Cancer Centre South, Region Skåne, Sweden
| | | | | | - Mef Nilbert
- Institute of Clinical Sciences, Division of Oncology and Pathology, Lund University, Scheelev. 2, 223 63, Lund, Sweden. .,Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark. .,Danish Cancer Society Research Center, Copenhagen, Denmark.
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189
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Marshall DC, Finlayson MP. Identifying the nontechnical skills required of nurses in general surgical wards. J Clin Nurs 2018; 27:1475-1487. [DOI: 10.1111/jocn.14290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 02/04/2023]
Affiliation(s)
| | - Mary P Finlayson
- College of Nursing and Midwifery; Charles Darwin University; Darwin Australia
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Hanin MCE, Queenan K, Savic S, Karimuribo E, Rüegg SR, Häsler B. A One Health Evaluation of the Southern African Centre for Infectious Disease Surveillance. Front Vet Sci 2018; 5:33. [PMID: 29616227 PMCID: PMC5864892 DOI: 10.3389/fvets.2018.00033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/16/2018] [Indexed: 11/13/2022] Open
Abstract
Rooted in the recognition that emerging infectious diseases occur at the interface of human, animal, and ecosystem health, the Southern African Centre for Infectious Disease Surveillance (SACIDS) initiative aims to promote a trans-sectoral approach to address better infectious disease risk management in five countries of the Southern African Development Community. Nine years after SACIDS’ inception, this study aimed to evaluate the program by applying a One Health (OH) evaluation framework developed by the Network for Evaluation of One Health (NEOH). The evaluation included a description of the context and the initiative, illustration of the theory of change, identification of outputs and outcomes, and assessment of the One Healthness. The latter is the sum of characteristics that defines an integrated approach and includes OH thinking, OH planning, OH working, sharing infrastructure, learning infrastructure, and systemic organization. The protocols made available by NEOH were used to develop data collection protocols and identify the study design. The framework relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative evaluation (scoring). Data for the analysis were gathered during a document review, in group and individual interviews and in an online survey. Operational aspects (i.e., OH thinking, planning, and working) were found to be balanced overall with the highest score in the planning dimension, whereas the infrastructure (learning infrastructure, systemic organization, and sharing infrastructure) was high for the first two dimensions, but low for sharing. The OH index calculated was 0.359, and the OH ratio calculated was 1.495. The program was praised for its great innovative energy in a difficult landscape dominated by poor infrastructure and its ability to create awareness for OH and enthuse people for the concept; training of people and networking. Shortcomings were identified regarding the balance of contributions, funds and activities across member countries in the South, lack of data sharing, unequal allocation of resources, top-down management structures, and limited horizontal collaboration. Despite these challenges, SACIDS is perceived to be an effective agent in tackling infectious diseases in an integrated manner.
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Affiliation(s)
- Marie C E Hanin
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology Economics and Public Health Group, Royal Veterinary College, London, United Kingdom
| | - Kevin Queenan
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology Economics and Public Health Group, Royal Veterinary College, London, United Kingdom
| | - Sara Savic
- Scientific Veterinary Institute Novi Sad, Novi Sad, Serbia
| | | | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology Economics and Public Health Group, Royal Veterinary College, London, United Kingdom
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191
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Smith T, Fowler-Davis S, Nancarrow S, Ariss SMB, Enderby P. Leadership in interprofessional health and social care teams: a literature review. Leadersh Health Serv (Bradf Engl) 2018; 31:452-467. [PMID: 30234446 DOI: 10.1108/lhs-06-2016-0026] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this study is to review evidence on the nature of effective leadership in interprofessional health and social care teams. Design/methodology/approach A critical review and thematic synthesis of research literature conducted using systematic methods to identify and construct a framework to explain the available evidence about leadership in interprofessional health and social care teams. Findings Twenty-eight papers were reviewed and contributed to the framework for interprofessional leadership. Twelve themes emerged from the literature, the themes were: facilitate shared leadership; transformation and change; personal qualities; goal alignment; creativity and innovation; communication; team-building; leadership clarity; direction setting; external liaison; skill mix and diversity; clinical and contextual expertise. The discussion includes some comparative analysis with theories and themes in team management and team leadership. Originality/value This research identifies some of the characteristics of effective leadership of interprofessional health and social care teams. By capturing and synthesising the literature, it is clear that effective interprofessional health and social care team leadership requires a unique blend of knowledge and skills that support innovation and improvement. Further research is required to deepen the understanding of the degree to which team leadership results in better outcomes for both patients and teams.
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Affiliation(s)
- Tony Smith
- Centre for Leadership in Health and Social Care, Faculty of Health and Wellbeing, Sheffield Hallam University , Sheffield, UK
| | - Sally Fowler-Davis
- Centre for Health and Social Care Research, Sheffield Hallam University , Sheffield, UK
| | | | | | - Pam Enderby
- School of Health and Related Research, University of Sheffield , Sheffield, UK
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Rüegg SR, Nielsen LR, Buttigieg SC, Santa M, Aragrande M, Canali M, Ehlinger T, Chantziaras I, Boriani E, Radeski M, Bruce M, Queenan K, Häsler B. A Systems Approach to Evaluate One Health Initiatives. Front Vet Sci 2018; 5:23. [PMID: 29594154 PMCID: PMC5854661 DOI: 10.3389/fvets.2018.00023] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/05/2018] [Indexed: 11/13/2022] Open
Abstract
Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans, animals, and ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. As a result of the EU COST Action (TD 1404) "Network for Evaluation of One Health" (NEOH), we propose an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regard them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the initiative and its context, (2) the description of the theory of change with an assessment of expected and unexpected outcomes, (3) the process evaluation of operational and supporting infrastructures (the "OH-ness"), and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of "OH-ness" (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision-analysis. Here, we focus on the methodology for Elements (1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of the "OH-ness". We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps researchers, practitioners, and evaluators to conceptualise and conduct evaluations of integrated approaches to health and facilitates comparison and learning across different OH activities thereby facilitating decisions on resource allocation. The application of the framework has been described in eight case studies in the same Frontiers research topic and provides first data on OH-index and OH-ratio, which is an important step towards their validation and the creation of a dataset for future benchmarking, and to demonstrate under which circumstances OH initiatives provide added value compared to disciplinary or conventional health initiatives.
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Affiliation(s)
- Simon R. Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | - Mijalche Santa
- Faculty of Economics—Skopje, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia
| | - Maurizio Aragrande
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Massimo Canali
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Timothy Ehlinger
- Center for Global Health Equity, University of Wisconsin Milwaukee, Milwaukee, WI, United States
| | | | - Elena Boriani
- Global Decision Support Initiative (GDSI), Technical University of Denmark, Kongens Lyngby, Denmark
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Miroslav Radeski
- Faculty of Veterinary Medicine, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia
| | - Mieghan Bruce
- School of Veterinary and Life Science, Murdoch University, Perth, WA, Australia
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Holden RJ, Binkheder S, Patel J, Viernes SHP. Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams. Appl Clin Inform 2018; 9:141-148. [PMID: 29490407 DOI: 10.1055/s-0038-1626724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Broussard CS, Shapiro-Mendoza CK, Peacock G, Rasmussen SA, Mai CT, Petersen EE, Galang RR, Newsome K, Reynolds MR, Gilboa SM, Boyle CA, Moore CA. Public Health Approach to Addressing the Needs of Children Affected by Congenital Zika Syndrome. Pediatrics 2018; 141:S146-S153. [PMID: 29437047 PMCID: PMC5841754 DOI: 10.1542/peds.2017-2038c] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
We have learned much about the short-term sequelae of congenital Zika virus (ZIKV) infection since the Centers for Disease Control and Prevention activated its ZIKV emergency response in January 2016. Nevertheless, gaps remain in our understanding of the full spectrum of adverse health outcomes related to congenital ZIKV infection and how to optimize health in those who are affected. To address the remaining knowledge gaps, support affected children so they can reach their full potential, and make the best use of available resources, a carefully planned public health approach in partnership with pediatric health care providers is needed. An essential step is to use population-based data captured through surveillance systems to describe congenital Zika syndrome. Another key step is using collected data to investigate why some children exhibit certain sequelae during infancy and beyond, whereas others do not, and to describe the clustering of anomalies and the timing of when these anomalies occur, among other research questions. The final critical step in the public health framework for congenital Zika syndrome is an intervention strategy with evidence-based best practices for longer-term monitoring and care. Adherence to recommended evaluation and management procedures for infants with possible congenital ZIKV infection, including for those with less obvious developmental and medical needs at birth, is essential. It will take many years to fully understand the effects of ZIKV on those who are congenitally infected; however, the lifetime medical and educational costs as well as the emotional impact on affected children and families are likely to be substantial.
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Affiliation(s)
| | | | | | - Sonja A Rasmussen
- Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cara T Mai
- National Center on Birth Defects and Developmental Disabilities
| | - Emily E Petersen
- National Center for Chronic Disease Prevention and Health Promotion, and
| | - Romeo R Galang
- National Center on Birth Defects and Developmental Disabilities
| | | | | | | | - Coleen A Boyle
- National Center on Birth Defects and Developmental Disabilities
| | - Cynthia A Moore
- National Center on Birth Defects and Developmental Disabilities
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Rowan BH, Robinson J, Granato A, Bla CK, Kouyaté S, Djety GV, Abo K, Koné A, Gloyd S. Workforce patterns in the prevention of mother to child transmission of HIV in Côte d'Ivoire: a qualitative model. HUMAN RESOURCES FOR HEALTH 2018; 16:4. [PMID: 29325561 PMCID: PMC5765713 DOI: 10.1186/s12960-018-0268-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 01/03/2018] [Indexed: 06/07/2023]
Abstract
BACKGROUND Côte d'Ivoire continues to struggle with one of the highest rates of mother-to-child HIV transmission in West Africa, previously thought to be in part due to suboptimal workforce patterns. This study aimed to understand the process through which workforce patterns impact prevention of mother-to child transmission of HIV (PMTCT) program success, from the perspective of healthcare workers in Côte d'Ivoire. METHODS A total of 142 semi-structured interviews were conducted with physicians, midwives, nurses, community counselors, social workers, pharmacists, management personnel and health aides from a nationally representative sample of 48 PMTCT sites across Côte d'Ivoire. RESULTS Healthcare workers described three categories of workforce patterns that they perceived to be affecting PMTCT success: workforce inputs, healthcare roles and responsibilities, and facilitators of task performance. According to their descriptions, PMTCT success depends on the presence of an adequate and trained PMTCT workforce, with an interdisciplinary team of healthcare workers with flexible roles and expanded task responsibilities, and whose tasks are translated into patient care through collaboration, ongoing trainings, and appropriate motivators. CONCLUSIONS This study provides a model for understanding the impact of workforce patterns on PMTCT success in Côte d'Ivoire and provides insight into workforce-related facilitators and barriers of program performance that should be targeted in future research and interventions. It highlights the importance of workforce integration and collaboration between healthcare workers.
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Affiliation(s)
- Brianne H. Rowan
- University of Washington Department of Global Health, Box 359931, Seattle, WA 98104 United States of America
| | - Julia Robinson
- University of Washington Department of Global Health, Box 359931, Seattle, WA 98104 United States of America
- University of Washington School of Social Work, Box 354900, Seattle, WA 98195-4900 United States of America
- Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA 98105 United States of America
| | - Adam Granato
- University of Washington Department of Global Health, Box 359931, Seattle, WA 98104 United States of America
- Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA 98105 United States of America
| | - Claire Konan Bla
- Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA 98105 United States of America
| | - Seydou Kouyaté
- Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA 98105 United States of America
| | - Guy Vincent Djety
- Côte d’Ivoire Ministry of Health and Public Hygiene. Ministère de la Santé et de l’Hygiene Publique, 16 ème Etage-Tour C, Administrative Abidjan-Plateau, Ivory Coast
| | - Kouamé Abo
- Côte d’Ivoire Ministry of Health and Public Hygiene. Ministère de la Santé et de l’Hygiene Publique, 16 ème Etage-Tour C, Administrative Abidjan-Plateau, Ivory Coast
| | - Ahoua Koné
- University of Washington Department of Global Health, Box 359931, Seattle, WA 98104 United States of America
- Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA 98105 United States of America
| | - Stephen Gloyd
- University of Washington Department of Global Health, Box 359931, Seattle, WA 98104 United States of America
- Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA 98105 United States of America
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Griffiths B. Preparing Tomorrow's Nurses for Collaborative Quality Care Through Simulation. TEACHING AND LEARNING IN NURSING 2018. [DOI: 10.1016/j.teln.2017.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ely LI, Toassi RFC. Integração entre currículos na educação de profissionais da Saúde: a potência para educação interprofissional na graduação. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/1807-57622017.0658] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Este artigo apresenta os resultados de pesquisa de abordagem qualitativa (estudo de caso) que se propôs a compreender os significados da vivência multiprofissional na atividade de ensino integradora de uma universidade pública do sul do Brasil, que acontece em serviços da Atenção Primária à Saúde, analisando seu potencial para a educação interprofissional (EIP). A produção de dados foi constituída por entrevistas individuais semiestruturadas com egressos, estudantes e gestor universitário, grupo focal com professores e observação participante com registros em diário de campo. Os dados foram interpretados pela análise temática de conteúdo. A inte(g)ração entre estudantes, professores e profissionais da Saúde promoveu aprendizagens relacionadas às competências colaborativas, características da EIP. Desafios institucionais, físicos e pedagógicos para o compartilhamento das vivências entre profissões foram destacados, havendo necessidade da ampliação de iniciativas de EIP nos currículos da graduação em Saúde.
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Loeb DF, Leister E, Ludman E, Binswanger IA, Crane L, Dickinson M, Kline DM, deGruy FV, Nease D, Bayliss EA. Factors associated with physician self-efficacy in mental illness management and team-based care. Gen Hosp Psychiatry 2018; 50:111-118. [PMID: 29156252 PMCID: PMC5842160 DOI: 10.1016/j.genhosppsych.2017.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Danielle F. Loeb
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, USA;
| | - Erin Leister
- Department of Biostatistics & Informatics, Colorado School of Public Health, The Adult and Child Center for Outcomes Research and Delivery Science, Aurora, USA.
| | | | - Ingrid A. Binswanger
- Institute for Health Research, Kaiser Permanente Colorado, Denver, USA; Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, USA
| | - Lori Crane
- The Adult and Child Center for Outcomes Research and Delivery Science, Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, USA.
| | - Miriam Dickinson
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, USA; Department of Family Medicine, University of Colorado, Aurora, USA.
| | - Danielle M. Kline
- Division of General Internal Medicine, Department of Internal Medicine, University of Colorado School of Medicine, Aurora, USA;
| | | | - Donald Nease
- Department of Family Medicine, University of Colorado, Aurora, USA.
| | - Elizabeth A. Bayliss
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; Department of Family Medicine, University of Colorado, Aurora, CO, USA;
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Vestergaard E, Nørgaard B. Interprofessional collaboration: An exploration of possible prerequisites for successful implementation. J Interprof Care 2017; 32:185-195. [PMID: 29144793 DOI: 10.1080/13561820.2017.1363725] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Poor collaboration among professional groups may be a major cause of incoherent patient pathways in hospital settings. For over a decade, interprofessional collaboration (IPC) have been stressed as an effective method to enhance the delivery of patient care. This article presents a theory-based stakeholder evaluation of the implementation of an intervention aiming to implement the concept of IPC in a Danish regional hospital from 2012 to 2015. Involving five departments and eight professions, the intervention aimed at developing coherent practices across health professions by optimising patient pathways with the establishment of interprofessional teams as a core element. The evaluation assessed the professionals' views of the intervention. Data were collected through focus group interviews and document analysis. We found that a strengthened focus on patient pathways, well-trained instructors, and an evidence-based strategy for implementation facilitates the success of interventions with a focus on IPC in hospital settings. We furthermore found that cultural and organisational factors are barriers to the implementation of IPC practices, that interruptions of uni-professional work may hamper coordination across professions, and that the interprofessional teams may form new isolated organisational structures.
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Affiliation(s)
- Erik Vestergaard
- a Department of Orthopaedic and Surgery and Traumatology , Kolding Hospital, Lillebaelt Hospital , Kolding , Denmark
| | - Birgitte Nørgaard
- b Department of Public Health , University of Southern Denmark , Odense , Denmark
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Klemenc-Ketis Z, Deilkås ET, Hofoss D, Bondevik GT. Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care. J Multidiscip Healthc 2017; 10:417-423. [PMID: 29184416 PMCID: PMC5687361 DOI: 10.2147/jmdh.s149011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV). Results The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9±15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4±0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8±0.9). Conclusion Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided.
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Affiliation(s)
- Zalika Klemenc-Ketis
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor.,Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana.,Community Health Centre Ljubljana, Ljubljana, Slovenia
| | | | - Dag Hofoss
- Institute of Health and Society, University of Oslo, Oslo
| | - Gunnar Tschudi Bondevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen.,National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway
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