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Keller S, Jelsma JGM, Tschan F, Sevdalis N, Löllgen RM, Creutzfeldt J, Kennedy-Metz LR, Eppich W, Semmer NK, Van Herzeele I, Härenstam KP, de Bruijne MC. Behavioral sciences applied to acute care teams: a research agenda for the years ahead by a European research network. BMC Health Serv Res 2024; 24:71. [PMID: 38218788 PMCID: PMC10788034 DOI: 10.1186/s12913-024-10555-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Multi-disciplinary behavioral research on acute care teams has focused on understanding how teams work and on identifying behaviors characteristic of efficient and effective team performance. We aimed to define important knowledge gaps and establish a research agenda for the years ahead of prioritized research questions in this field of applied health research. METHODS In the first step, high-priority research questions were generated by a small highly specialized group of 29 experts in the field, recruited from the multinational and multidisciplinary "Behavioral Sciences applied to Acute care teams and Surgery (BSAS)" research network - a cross-European, interdisciplinary network of researchers from social sciences as well as from the medical field committed to understanding the role of behavioral sciences in the context of acute care teams. A consolidated list of 59 research questions was established. In the second step, 19 experts attending the 2020 BSAS annual conference quantitatively rated the importance of each research question based on four criteria - usefulness, answerability, effectiveness, and translation into practice. In the third step, during half a day of the BSAS conference, the same group of 19 experts discussed the prioritization of the research questions in three online focus group meetings and established recommendations. RESULTS Research priorities identified were categorized into six topics: (1) interventions to improve team process; (2) dealing with and implementing new technologies; (3) understanding and measuring team processes; (4) organizational aspects impacting teamwork; (5) training and health professions education; and (6) organizational and patient safety culture in the healthcare domain. Experts rated the first three topics as particularly relevant in terms of research priorities; the focus groups identified specific research needs within each topic. CONCLUSIONS Based on research priorities within the BSAS community and the broader field of applied health sciences identified through this work, we advocate for the prioritization for funding in these areas.
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Affiliation(s)
- Sandra Keller
- Department of Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland.
- Department for BioMedical Research (DBMR), Bern University, Bern, Switzerland.
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Franziska Tschan
- Institute for Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, KCL, London, UK
| | - Ruth M Löllgen
- Pediatric Emergency Department, Astrid Lindgrens Children's Hospital; Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Johan Creutzfeldt
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Center for Advanced Medical Simulation and Training, (CAMST), Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Lauren R Kennedy-Metz
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Division of Cardiac Surgery, VA Boston Healthcare System, Boston, MA, USA
- Psychology Department, Roanoke College, Salem, VA, USA
| | - Walter Eppich
- Department of Medical Education & Collaborative Practice Centre, University of Melbourne, Melbourne, Australia
| | - Norbert K Semmer
- Department of Work Psychology, University of Bern, Bern, Switzerland
| | - Isabelle Van Herzeele
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Karin Pukk Härenstam
- Pediatric Emergency Department, Astrid Lindgrens Children's Hospital; Karolinska University Hospital, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Martine C de Bruijne
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Lin RH, kofi kujabi B. Addressing Challenges in the Development of Health Information Systems in The Gambia. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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3
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Hulen E, Edwards ST, Poppe AP, Singh MK, Shunk R, Tuepker A. Creating change, challenging structure: graduate and faculty perspectives on the implementation of an interprofessional education program in veterans affairs primary care. J Interprof Care 2019; 34:756-762. [DOI: 10.1080/13561820.2019.1676706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Elizabeth Hulen
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
| | - Samuel T. Edwards
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Section of General Internal Medicine, VA Portland Health Care System, Portland, OR, USA
- Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR, USA
| | - Anne P. Poppe
- Center of Excellence in Primary Care Education, VA Puget Sound Health Care System, Seattle, WA, USA
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Mamta K. Singh
- Center of Excellence in Primary Care Education, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rebecca Shunk
- Center of Excellence in Primary Care Education, San Francisco VA Medical Center, San Francisco, CA, USA
- Department of Medicine, University of California - San Francisco, San Francisco, CA, USA
| | - Anais Tuepker
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR, USA
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Runtu TM, Novieastari E, Handayani H. How does organizational culture influence care coordination in hospitals? A systematic review. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Piras EM, Cabitza F, Lewkowicz M, Bannon L. Personal Health Records and Patient-Oriented Infrastructures: Building Technology, Shaping (New) Patients, and Healthcare Practitioners. Comput Support Coop Work 2019. [DOI: 10.1007/s10606-019-09364-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hashemi MS, Irajpour A, Abazari P. Improving Quality of Care in Hemodialysis: a Content Analysis. J Caring Sci 2018; 7:149-155. [PMID: 30283760 PMCID: PMC6163156 DOI: 10.15171/jcs.2018.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 06/25/2018] [Indexed: 11/09/2022] Open
Abstract
Introduction: Hemodialysis is currently the most common alternative treatment in patients with renal failure in the world. Today, despite the support provided by healthcare providers for these patients, they still express dissatisfaction with the quality of care and find it inadequate. However, there have been few studies investigating the needs of in-patients receiving hemodialysis care in Iran. Thus this research was undertaken to study the needs and demands of such patients. Methods: This qualitative research was conducted from June to November 2016 to investigate the view points of the patients, their families and health care providers about improving quality of care in dialysis unit. At first, the sampling was based on a purposeful sampling method. A total of 35 participants (patients, their families and health care providers) were interviewed. The interviews were analyzed via Graneheim & Lundman qualitative content analysis. Results: Data analyses led to the production of 700 primary codes, 54 subcategories and 27 secondary categories out which 4 main categories of modification of physical stressors, requirement of support and the requirement of improved quality of Health Care service and improved facilities and equipment requirement. Conclusion: Planning for modification of physical stressors, improved support of patients, enhancing the quality of care services provided by the treatment team, upgrading the facilities and equipment and the adoption of an interdisciplinary approach are all believed to improve the care services among in-patients receiving hemodialysis treatment.
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Affiliation(s)
- Maryam Sadat Hashemi
- Department of Critical Care, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Ira
| | - Alireza Irajpour
- Department of Critical Care, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvaneh Abazari
- Department of Medical-Surgical, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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8
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DiazGranados D, Dow AW, Appelbaum N, Mazmanian PE, Retchin SM. Interprofessional practice in different patient care settings: A qualitative exploration. J Interprof Care 2018; 32:151-159. [PMID: 29083254 PMCID: PMC6361112 DOI: 10.1080/13561820.2017.1383886] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 09/20/2017] [Indexed: 10/18/2022]
Abstract
Increasing interprofessional practice is seen as a path to improved quality, decreased cost, and enhanced patient experience. However, little is known about how context shapes interprofessional work and how interventions should be crafted to account for a specific setting of interprofessional practice. To better understand, how the work of interprofessional practice differs across patient care settings we sought to understand the social processes found in varying work contexts to better understand how care is provided. A case study design was used in this study to yield a picture of patient care across three different settings. Qualitative analysis of teams from three healthcare settings (rehabilitation, acute care, and code team) was conducted, through the use of ten in-depth semi-structured interviews. Interview data from each participant were analyzed via an inductive content analysis approach based upon theories of work and teams from organisational science, a framework for interprofessional practice, and competencies for interprofessional education. The work processes of interprofessional practice varied across settings. Information exchange was more physician-centric and decision-making was more physician dominant in the non-rehabilitation settings. Work was described as concurrent only for the code team. Goal setting varied by setting and interpersonal relationships were only mentioned as important in the rehabilitation setting. The differences observed across settings identify some insights into how context shapes the process of interprofessional collaboration and some research questions that need further study.
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Affiliation(s)
| | - Alan W Dow
- Virginia Commonwealth University, Richmond, United States
| | - Nital Appelbaum
- Virginia Commonwealth University, School of Medicine, Richmond, United States
| | - Paul E Mazmanian
- Virginia Commonwealth University, School of Medicine, Richmond, United States
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Bardach SH, Real K, Bardach DR. Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records. J Interprof Care 2017; 31:300-306. [PMID: 28151026 PMCID: PMC5896008 DOI: 10.1080/13561820.2016.1269312] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 10/26/2016] [Accepted: 12/04/2016] [Indexed: 10/20/2022]
Abstract
Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.
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Affiliation(s)
- Shoshana H Bardach
- a Graduate Center for Gerontology and Sanders-Brown Center on Aging , University of Kentucky , Lexington , Kentucky , USA
| | - Kevin Real
- b College of Communication and Information , University of Kentucky , Lexington , Kentucky , USA
| | - David R Bardach
- c National Committee for Quality Assurance , Washington , DC , USA
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The impact of electronic health records on collaborative work routines: A narrative network analysis. Int J Med Inform 2016; 94:100-11. [DOI: 10.1016/j.ijmedinf.2016.06.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 11/20/2022]
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White Delaney C, Kuziemsky C, Brandt BF. Integrating informatics and interprofessional education and practice to drive healthcare transformation. J Interprof Care 2015; 29:527-9. [PMID: 26652627 DOI: 10.3109/13561820.2015.1108735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Craig Kuziemsky
- b Telfer School of Management, University of Ottawa , Ottawa , ON , Canada , and
| | - Barbara F Brandt
- c National Center for Interprofessional Practice and Education, University of Minnesota , Minneapolis , MN , USA
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Using Semantic Components to Represent Dynamics of an Interdisciplinary Healthcare Team in a Multi-Agent Decision Support System. J Med Syst 2015; 40:42. [DOI: 10.1007/s10916-015-0375-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
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Ledford CJW, Canzona MR, Cafferty LA, Kalish VB. Negotiating the equivocality of palliative care: a grounded theory of team communicative processes in inpatient medicine. HEALTH COMMUNICATION 2015; 31:536-543. [PMID: 26431077 DOI: 10.1080/10410236.2014.974134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In the majority of U.S. hospitals, inpatient medicine teams make palliative care decisions in the absence of a formalized palliative system. Using a grounded theory approach, interviews with inpatient team members were systematically analyzed to uncover how participants conceptualize palliative care and how they regard the communicative structures that underlie its delivery. During analysis, Weick's model of organizing emerged as a framework that fit the data. The 39 participant inpatient team members discussed palliative care as primarily a communicative process. Themes describing the meaning of palliative care emerged around the concepts of receiver of care, timeline of care, and location of care. The emerging model included four stages in the communicative processes of inpatient palliative care: (a) interpret the need, (b) initiate the conversation, (c) integrate the processes, and (d) identify what works. In contrast to stable, focused palliative care teams or hospice care teams, which have prescribed patient populations and processes, the inpatient medicine team faces the equivocality of providing palliative care within a broader practice. This research offers a four-phase model to show how these inpatient teams communicate within this context. Implications for the provision of palliative care are discussed.
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Affiliation(s)
- Christy J W Ledford
- a Department of Family Medicine , Uniformed Services University of the Health Sciences
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Eikey EV, Reddy MC, Kuziemsky CE. Examining the role of collaboration in studies of health information technologies in biomedical informatics: A systematic review of 25 years of research. J Biomed Inform 2015; 57:263-77. [DOI: 10.1016/j.jbi.2015.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 07/31/2015] [Accepted: 08/05/2015] [Indexed: 10/23/2022]
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15
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Kuziemsky CE. Review of Social and Organizational Issues in Health Information Technology. Healthc Inform Res 2015; 21:152-60. [PMID: 26279951 PMCID: PMC4532839 DOI: 10.4258/hir.2015.21.3.152] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 06/28/2015] [Accepted: 06/29/2015] [Indexed: 01/10/2023] Open
Abstract
Objectives This paper reviews organizational and social issues (OSIs) in health information technology (HIT). Methods A review and synthesis of the literature on OSIs in HIT was conducted. Results Five overarching themes with respect to OSIs in HIT were identified and discussed: scope and frameworks for defining OSIs in HIT, context matters, process immaturity and complexity, trade-offs will happen and need to be discussed openly, and means of studying OSIs in HIT. Conclusions There is a wide body of literature that provides insight into OSIs in HIT, even if many of the studies are not explicitly labelled as such. The two biggest research needs are more explicit and theoretical studies of OSI in HITs and more research on integrating micro and macro perspectives of HIT use in organizations.
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Klemets J, Evjemo TE. Technology-mediated awareness: Facilitating the handling of (un)wanted interruptions in a hospital setting. Int J Med Inform 2014; 83:670-82. [DOI: 10.1016/j.ijmedinf.2014.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 04/04/2014] [Accepted: 06/06/2014] [Indexed: 11/16/2022]
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Flemming D, Hübner U. How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review. Int J Med Inform 2013; 82:580-92. [DOI: 10.1016/j.ijmedinf.2013.03.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 03/17/2013] [Accepted: 03/24/2013] [Indexed: 10/26/2022]
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Poulymenopoulou M, Malamateniou F, Vassilacopoulos G. Specifying process requirements for holistic care. Inform Health Soc Care 2013; 38:302-12. [PMID: 23514044 DOI: 10.3109/17538157.2013.764308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Holistic (health and social) care aims at providing comprehensive care to the community, especially to elderly people and people with multiple illnesses. In turn, this requires using health and social care resources more efficiently through enhanced collaboration and coordination among the corresponding organizations and delivering care closer to patient needs and preferences. This paper takes a patient-centered, process view of holistic care delivery and focuses on requirements elicitation for supporting holistic care processes and enabling authorized users to access integrated patient information at the point of care when needed. To this end, an approach to holistic care process-support requirements elicitation is presented which is based on business process modeling and places particular emphasis on empowering collaboration, coordination and information sharing among health and social care organizations by actively involving users and by providing insights for alternative process designs. The approach provides a means for integrating diverse legacy applications in a process-oriented environment using a service-oriented architecture as an appropriate solution for supporting and automating holistic care processes. The approach is applied in the context of emergency medical care aiming at streamlining and providing support technology to cross-organizational health and social care processes to address global patient needs.
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Affiliation(s)
- M Poulymenopoulou
- Department of Digital Systems, University of Piraeus, Piraeus, Greece.
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