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Tan HSK, Ponnamperuma G, de Nooijer J, Stalmeijer RE. Measuring interprofessional collaboration in fluid healthcare teams through the lens of teamness. J Interprof Care 2024:1-8. [PMID: 38989965 DOI: 10.1080/13561820.2024.2375638] [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: 07/21/2023] [Accepted: 04/09/2024] [Indexed: 07/12/2024]
Abstract
Health professionals often need to work together to provide team-based care. With increasing healthcare complexities and manpower shortages, more health professionals are working in multiple, fluid teams instead of one stable team, to provide care to patients. However, there is currently no validated instrument to measure the quality of interprofessional collaboration in fluid teams. One approach is to assess team members' perceived level of teamness (qualities that make clinical teams effective). This study aimed to examine the validity evidence of using the Assessment for Collaborative Environment (ACE-15) in fluid teams and investigate if teamness varies among health professions and clinical settings. Content and response process validity were gathered through consulting experts and cognitive interviews, resulting in revisions to 11 of 15 items in ACE-15. Through exploratory factor analysis of 194 responses on the revised ACE-15, a 13-item instrument, ACE-13F, with strong validity evidence for use in fluid teams was developed. A two-factor fixed effect ANOVA model revealed that the clinical setting that health professionals work in has a significant impact on the level of teamness (F[3,170] = 6.15, p < .001, η2 = 0.09). ACE-13F can be used as a rapid instrument to measure interprofessional collaboration in fluid healthcare teams.
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Affiliation(s)
- Heidi Siew Khoon Tan
- Department of Occupational Therapy, Tan Tock Seng Hospital, Singapore
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | | | - Jascha de Nooijer
- Department of Health Promotion, School of Health Professions Education, Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Renée E Stalmeijer
- Department of Educational Development and Research, School of Health Professions Education, Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Davidson AR, Morgan M, Ball L, Reidlinger DP. Patients' experiences of and roles in interprofessional collaborative practice in primary care: a constructivist grounded theory study. Prim Health Care Res Dev 2024; 25:e24. [PMID: 38721698 DOI: 10.1017/s1463423624000148] [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] [Indexed: 05/16/2024] Open
Abstract
AIM This constructivist grounded theory study aimed to (1) explore patients' experiences of and roles in interprofessional collaborative practice for chronic conditions in primary care and (2) consider the relevance and alignment of an existing theoretical framework on patients' roles and based on the experiences of patient advocates. BACKGROUND High-quality management of chronic conditions requires an interprofessional collaborative practice model of care considering an individual's mental, physical, and social health situation. Patients' experiences of this model in the primary care setting are relatively unknown. METHODS A constructivist grounded theory approach was taken. Interview data were collected from primary care patients with chronic conditions across Australia in August 2020 - February 2022. Interviews were recorded, transcribed verbatim, and thematically analysed by (1) initial line-by-line coding, (2) focused coding, (3) memo writing, (4) categorisation, and (5) theme and sub-theme development. Themes and sub-themes were mapped against an existing theoretical framework to expand and confirm the results from a previous study with a similar research aim. FINDINGS Twenty adults with chronic conditions spanning physical disability, diabetes, heart disease, cancer, autoimmune, and mental health conditions participated. Two themes were developed: (1) Adapting to Change with two sub-themes describing how patients adapt to interprofessional team care and (2) Shifting across the spectrum of roles, with five sub-themes outlining the roles patients enact while receiving care. The findings suggest that patients' roles are highly variable and fluid in interprofessional collaborative practice, and further work is recommended to develop a resource to support greater patient engagement in interprofessional collaborative practice.
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Affiliation(s)
- Alexandra R Davidson
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Mark Morgan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, The University of Queensland, Brisbane, Queensland, Australia
| | - Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Chou YF, Hsieh SI, Tseng YP, Yeh SL, Chiang MC, Hsiao CC, Lin CT, Hu ST, Chen SH, Liao MN. Development and Validation of the Interprofessional Collaboration Practice Competency Scale (IPCPCS) for Clinical Nurses. Healthcare (Basel) 2024; 12:806. [PMID: 38610228 PMCID: PMC11012165 DOI: 10.3390/healthcare12070806] [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: 10/27/2023] [Revised: 03/12/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Interprofessional collaborative practice is a core competency and is the key to strengthening health practice systems in order to deliver safe and high-quality nursing practice. However, there is no Interprofessional Collaboration Practice Competency Scale (IPCPCS) for clinical nurses in Taiwan. Therefore, the purposes of this study were to develop an IPCPCS and to verify its reliability and validity. This was a psychometric study with a cross-sectional survey using convenience sampling to recruit nurses from the seven hospitals of a medical foundation. A self-designed structured IPCPCS was rolled out via a Google survey. The data were analyzed using descriptive statistics, principal-axis factoring (PAF) with Promax rotation, Pearson correlation, reliability analysis, and one-way ANOVA. PAF analysis found that three factors could explain 77.76% of cumulative variance. These were collaborative leadership and interprofessional conflict resolution, interprofessional communication and team functioning, and role clarification and client-centered care. The internal consistency of the three factors (Cronbach's α) was between 0.970 to 0.978, and the Pearson correlation coefficients were between 0.814 to 0.883. Significant differences were presented in the IPCPCS score by age, education level, total years of work experience, position on the nursing clinical ladder, and participation in interprofessional education. In conclusion, the three factors used in the IPCPCS have good reliability and construct validity. This scale can be used as an evaluation tool of in-service interprofessional education courses for clinical nurses.
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Affiliation(s)
- Yen-Fang Chou
- Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (Y.-F.C.); (C.-C.H.)
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City 11031, Taiwan
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan
| | - Suh-Ing Hsieh
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan
| | - Yi-Ping Tseng
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan City 33378, Taiwan;
- School of Nursing, College of Medicine, National Taiwan University, Taipei City 10617, Taiwan
| | - Shu-Ling Yeh
- Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung City 20401, Taiwan; (S.-L.Y.); (S.-T.H.)
| | - Ming-Chu Chiang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 83301, Taiwan;
| | - Chia-Chi Hsiao
- Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (Y.-F.C.); (C.-C.H.)
| | - Chiu-Tzu Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan;
| | - Shui-Tao Hu
- Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung City 20401, Taiwan; (S.-L.Y.); (S.-T.H.)
| | - Sue-Hsien Chen
- Administration Center, Chang Gung Medical Foundation, Taoyuan City 33305, Taiwan; (S.-H.C.); (M.-N.L.)
- Department of Nursing, Chang Gung University, Taoyuan City 33375, Taiwan
| | - Mei-Nan Liao
- Administration Center, Chang Gung Medical Foundation, Taoyuan City 33305, Taiwan; (S.-H.C.); (M.-N.L.)
- Department of Nursing, Chang Gung University, Taoyuan City 33375, Taiwan
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4
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Ängeby K, VanGompel EW, Johansson K, Edqvist M. Labor unit culture and attitudes toward supporting vaginal birth-The Swedish version of the labor culture survey (S-LCS)-Psychometric properties. Birth 2024; 51:163-175. [PMID: 37803969 DOI: 10.1111/birt.12777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 06/27/2023] [Accepted: 09/12/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND In order to evaluate interventions aimed at reducing cesarean births, care practitioners' attitudes are important to measure. The Labor Culture Survey (LCS) is a scale that measures individual and unit attitudes towards supporting vaginal birth. As no equivalent scale exists in Sweden, the aim was to translate, adapt, and validate the LCS and to investigate whether there were differences in attitudes toward supporting vaginal birth between maternity care practitioners. METHODS A cross-sectional study including midwives, physicians, and nurse assistants working with intrapartum care in five labor wards in Sweden. The original LCS was translated into Swedish, and six context-specific items were developed for the Swedish setting (SLCS). The translation was tested for face validity. Psychometric analysis was conducted using exploratory factor analysis with principal component analysis, parallel analysis, and principal axis factoring. Reliability was estimated using Cronbach's alpha. One-way ANOVA and Tukey HSD were calculated to analyze differences in attitudes between professions on the subscales of the S-LCS. RESULTS A total of 539 midwives, physicians, and nurse assistants participated. The final S-LCS showed a five-factor solution with the following subscales: Best Practices to reduce cesarean overuse, Unpredictability of vaginal birth, Unit Microculture, Maternal Agency, and Organizational Oversight. Chronbach alpha values varied from 0.60 to 0.83. Midwives were more supportive towards vaginal birth and less fearful of potential consequences of vaginal birth compared with physicians. CONCLUSIONS The S-LCS demonstrated satisfactory psychometric properties for use in Swedish maternity care. Further work to improve the scale should include additional items reflecting the subscale Maternal Agency.
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Affiliation(s)
- Karin Ängeby
- Centre for Clinical Research and Education, Region Värmland, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Emily White VanGompel
- Departments of Family Medicine and Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois, USA
- The University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA
| | - Kari Johansson
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Edqvist
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
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Rogers L, Hughes Spence S, Aivalli P, De Brún A, McAuliffe E. A systematic review critically appraising quantitative survey measures assessing power dynamics among multidisciplinary teams in acute care settings. J Interprof Care 2024; 38:156-171. [PMID: 36708308 DOI: 10.1080/13561820.2023.2168632] [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: 07/22/2022] [Accepted: 01/07/2023] [Indexed: 01/29/2023]
Abstract
By valuing the knowledge of each discipline holistic patient-centered care can be achieved as decisions arise from expertise rather than established hierarchies. While healthcare has historically operated as a hierarchical power structure (i.e., some voices have more influence), these dynamics are rarely discussed. This review addresses this issue by appraising extant quantitative measures that assess multidisciplinary team (MDT) power dynamics. By identifying psychometrically sound measures, change agents can uncover the collective thought processes informing power structures in practice and develop strategies to mitigate power disparities. Several databases were searched. English language articles were included if they reported on quantitative measures assessing power dynamics among MDTs in acute/hospital settings. Results were synthesized using a narrative approach. In total, 6,202 search records were obtained of which 62 met the eligibility criteria. The review reveals some promising measures to assess power dynamics (e.g., Interprofessional Collaboration Scale). However, the findings also confirm several gaps in the current evidence base: 1) need for further psychometric and pragmatic testing of measures; 2) inclusion of more representative MDT samples; 3) further evaluation of unmatured power dimensions. Addressing these gaps will support the development of future interventions aimed at mitigating power imbalances and ultimately improve collaborative working within MDTs.
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Affiliation(s)
- Lisa Rogers
- University College Dublin Centre for Interdisciplinary Research, Education, and Innovation (UCD IRIS), UCD School of Nursing, Midwifery and Health Systems, Dublin 4, Ireland
| | - Shannon Hughes Spence
- University College Dublin Centre for Interdisciplinary Research, Education, and Innovation (UCD IRIS), UCD School of Nursing, Midwifery and Health Systems, Dublin 4, Ireland
| | - Praveenkumar Aivalli
- University College Dublin Centre for Interdisciplinary Research, Education, and Innovation (UCD IRIS), UCD School of Nursing, Midwifery and Health Systems, Dublin 4, Ireland
| | - Aoife De Brún
- University College Dublin Centre for Interdisciplinary Research, Education, and Innovation (UCD IRIS), UCD School of Nursing, Midwifery and Health Systems, Dublin 4, Ireland
| | - Eilish McAuliffe
- University College Dublin Centre for Interdisciplinary Research, Education, and Innovation (UCD IRIS), UCD School of Nursing, Midwifery and Health Systems, Dublin 4, Ireland
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Osborne ML, Tilden VP, Eckstrom E. Training Health Professions preceptors in rural practices: A challenge for Interprofessional practice and education. J Interprof Care 2023; 37:S102-S104. [PMID: 29648901 DOI: 10.1080/13561820.2018.1458707] [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: 06/27/2017] [Revised: 01/30/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
The ever-increasing mandate for interprofessional practice and education (IPE) faces challenges in rural settings. Oregon Health & Science University (OHSU) launched a preceptor development program as part of its commitment to training interprofessional student groups in rural settings. The objectives of the program were to (1) encourage preceptors to exemplify team behaviors; (2) characterize contemporary learners and learning styles of trainees; (3) encourage interprofessional precepting skills, and (4) apply practical teaching tools in the clinical setting. This was a qualitative observational project performed at OHSU rural faculty primary care clinics. Subjects were a convenience sample of rural interprofessional preceptors who volunteered to participate. Each educational session was based on a prior interview identifying their specific training needs. Data analysis was based on results from an evaluation survey and comments from providers at these sites. Key factors such as dedicated time for preceptor development, good communication between the rural practices and the academic health center, and concerns about billing revenue were discovered to be critical to the success of the program.
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Affiliation(s)
- Molly L Osborne
- Oregon Health & Science University, VA Portland Health Care System, Portland, OR, USA
| | - Virginia P Tilden
- School of Nursing, Oregon Health & Science University, Portland, OR, USA, Portland, OR
| | - Elizabeth Eckstrom
- Division of General Internal Medicine & Geriatrics, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
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7
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Sick B, Radosevich DM, Pittenger AL, Brandt B. Development and validation of a tool to assess the readiness of a clinical teaching site for interprofessional education (InSITE). J Interprof Care 2023; 37:S105-S115. [PMID: 30739518 DOI: 10.1080/13561820.2019.1569600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 12/02/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
Interprofessional education within clinical teaching sites is a key part of training for pre-professional students. However, the necessary characteristics of these interprofessional clinical teaching sites is unclear. We developed a tool, the Interprofessional Education Site Readiness, or InSITE, tool, for individuals at a site to use as a self-assessment of the site's current readiness for providing interprofessional education. The tool progressed through six stages of development, collecting evidence for validity and reliability, resulting in a final tool with 23 questions distributed across five domains. Data from 94 respondents from a variety of national sites were used for the item analysis showing acceptable item-to-total correlations. Internal reliability testing gave a Cronbach's coefficient alpha of more than 0.70 for each group level comparison. Known groups validity testing provides strong evidence for its responsiveness in detecting differences in sites where IPE is implemented. The results of the testing lead us to conclude that the InSITE tool has acceptable psychometric properties. Additionally, we discovered that the process in which the InSITE tool was used demonstrated that it can facilitate learning in practice for the health professionals and can help make implicit, informal workplace learning and the hidden curriculum explicit.
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Affiliation(s)
- Brian Sick
- Internal Medicine, University of Minnesota, Minneapolis, USA
| | - David M Radosevich
- Epidemiology and Biostatistics, University of Minnesota, Minneapolis, USA
| | - Amy L Pittenger
- Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, USA
| | - Barbara Brandt
- National Center for Interprofessional Practice and Education, University of Minnesota, Minneapolis, USA
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Brandt BF, Stumpf Kertz J, Arenson C. National Center for Interprofessional Practice and Education 2023: reflecting back, looking forward. J Interprof Care 2023; 37:S4-S14. [PMID: 37073117 DOI: 10.1080/13561820.2023.2197939] [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: 08/11/2022] [Revised: 02/21/2023] [Accepted: 03/14/2023] [Indexed: 04/20/2023]
Abstract
The United States (US) National Center for Interprofessional Practice and Education was funded at the University of Minnesota to serve as the National Coordinating Center for Interprofessional Education and Collaborative Practice (IPECP) in the US In 2012, the funders had specific expectations for operationalizing their vision that included scholarship, programs and leadership as an unbiased, neutral convener to align education with health system redesign. While US specific, the National Center benefited from and contributed to the international maturity of the field over the past decade. Through its various services and technology platforms, the National Center has a wide reach nationally and internationally. This perspective provides a unique view of the field in the US with observations and implications for the future.
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Affiliation(s)
- Barbara F Brandt
- National Center for Interprofessional Practice & Education; Professor, Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jennifer Stumpf Kertz
- National Center for Interprofessional Practice & Education, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine Arenson
- National Center for Interprofessional Practice & Education; Professor in the Department of Family Medicine and Community Health, School of Medicine University of Minnesota, Minneapolis, Minnesota, USA
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Brandt BF, Dieter C, Arenson C. From the Nexus vision to the NexusIPE™ learning model. J Interprof Care 2023; 37:S15-S27. [PMID: 37161725 DOI: 10.1080/13561820.2023.2202223] [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: 08/11/2022] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023]
Abstract
The Nexus vision of simultaneously transforming health professions education and healthcare delivery to achieve Triple (now Quadruple) Aim outcomes was first articulated in the 2012 proposal and funding of the National Center for Interprofessional Practice and Education (National Center). Over the past decade, the National Center has worked with over 70 sites implementing large scale and practice-based interprofessional practice and education (IPE) programs. Because what is needed to implement the Nexus to achieve Quadruple Aim outcomes was not well understood in 2012, the National Center took a social innovations and developmental evaluation approach. This iterative method led to the development of the National Center NexusIPE™ Learning Model that adapts the 3-P high-level stages (Presage, Process, and Product), proposed as a framework for IPE by Barr and colleagues. National Center collaborators' lessons learned about the Nexus vision are highlighted in this issue and provide real-world examples of elements of the NexusIPETM Learning Model. Reflecting on ten years of experience, the National Center leaders recognize the need for Nexus transformation and the relevance of the NexusIPETM Learning Model today as education and health systems grapple with mounting workforce challenges. The model provides opportunities to address growing workforce shortages, provide equitable care that leads to health, and support the well-being of practice teams in the face of challenges such as the COVID-19 pandemic.
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Affiliation(s)
- Barbara F Brandt
- National Center for Interprofessional Practice & Education; Professor, Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Carla Dieter
- NexusIPE™ Programs, National Center for Interprofessional Practice & Education, University of Minnesota, Minneapolis, USA
| | - Christine Arenson
- National Center for Interprofessional Practice & Education; Professor in the Department of Family Medicine and Community Health, School of Medicine University of Minnesota, Minneapolis, USA
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Delaney CW, AbuSalah A, Yeazel M, Stumpf Kertz J, Pejsa L, Brandt BF. National Center for Interprofessional Practice and Education IPE core data set and information exchange for knowledge generation. J Interprof Care 2023; 37:S28-S40. [PMID: 32811224 DOI: 10.1080/13561820.2020.1798897] [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: 07/19/2019] [Revised: 07/13/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
Since 2012, the National Center for Interprofessional Practice and Education has worked with over 70 sites implementing over 100 interprofessional education and collaborative practice (IPECP) programs in the United States (U.S.). Program leaders have contributed data and information to the National Center to inform an approach to advancing the science of interprofessional practice and education (IPE), called IPE Knowledge Generation. This paper describes how the evolution of IPE Knowledge Generation blends traditional research and evaluation approaches with the burgeoning field of health informatics and big data science. The goal of IPE Knowledge Generation is to promote collaboration and knowledge discovery among IPE program leaders who collect comparable, sharable data in an information exchange. This data collection then supports analysis and knowledge generation. To enable the approach, the National Center uses a structured process for guiding IPE program design and implementation in practice settings focused on learning and the Quadruple Aim outcomes while collecting the IPE core data set and the contribution of contemporary big data science.
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Affiliation(s)
- Connie White Delaney
- Knowledge Generation Lead, National Center for Interprofessional Practice and Education, Professor and Dean, School of Nursing, University of Minnesota, Minneapolis, USA
| | - Ahmad AbuSalah
- Former Informatics Lead, National Center for Interprofessional Practice and Education, Director of Clinical Informatics Services, Clinical and Translational Science Institute, Director of Clinical Informatics Services, Masonic Cancer Center, Core Health Informatics Professor, Institute for Health Informatics, University of Minnesota, Minneapolis, USA
| | - Mark Yeazel
- Scientific Review Team Lead, National Center for Interprofessional Practice and Education, Professor, Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, USA
| | - Jennifer Stumpf Kertz
- Deputy Director, National Center for Interprofessional Practice and Education, University of Minnesota, Minneapolis, USA
| | - Laura Pejsa
- Director of Evaluation and Organizational Learning., National Center for Interprofessional Practice and Education, University of Minnesota, Minneapolis, USA
| | - Barbara F Brandt
- Director National Center for Interprofessional Practice and Education, Professor, Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, USA
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Johnson K, Elvander C, Johansson K, Saltvedt S, Edqvist M. The effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork-a cross-sectional study. Acta Obstet Gynecol Scand 2023; 102:355-369. [PMID: 36629126 PMCID: PMC9951341 DOI: 10.1111/aogs.14502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/05/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork in Swedish maternity care. MATERIAL AND METHODS The study used a cross-sectional design, with a web-based survey sent to midwives, physicians and nurse assistants at five labor wards in Sweden. The survey consisted of two validated scales: the Swedish version of the Labor Culture Survey (S-LCS), measuring attitudes toward supporting vaginal birth, and the Assessment of Collaborative Environments (ACE-15), measuring attitudes toward interprofessional teamwork. Two-way ANOVA was conducted to assess the main effect of and interaction effect between organizational belonging and profession for the different subscales of the S-LCS and the ACE-15, together with Tukey's honest significant difference post-hoc analysis and partial eta squared to determine effect size. The relation between the subscales was assessed using the Pearson's correlation analysis. RESULTS A total of 539 midwives, physicians and nurse assistants completed the survey. Organizational belonging significantly influenced attitudes toward supporting vaginal birth and interprofessional teamwork, with the largest effect for Positive team culture (F = 38.88, effect size = 0.25, p < 0.001). The effect of profession was strongest for the subscale Best practices (F = 59.43, effect size = 0.20, p < 0.001), with midwives being more supportive of strategies proposed to support vaginal birth than physicians and nurse assistants. A significant interaction effect was found for four of the subscales of the S-LCS, with the strongest effect for items reflecting the Unpredictability of vaginal birth (F = 4.49, effect size = 0.07, p < 0.001). Labor ward culture (unit microculture) specifically related to supporting vaginal birth was strongly correlated to interprofessional teamwork (r = 0.598, p < 0.001). CONCLUSIONS In the current study, both organizational belonging and profession influenced attitudes toward supporting vaginal birth and interprofessional teamwork. Positive team culture was positively correlated to an organizational culture supportive of vaginal birth. Interventions to support vaginal births should include efforts to strengthen teamwork between professions, as well as considering women's values, preferences and informed choices.
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Affiliation(s)
- Karin Johnson
- Clinical Epidemiology Division, Department of Medicine SolnaKarolinska InstitutetSolnaSweden,Department of Women's Health and Health professionsKarolinska University HospitalStockholmSweden
| | - Charlotte Elvander
- Clinical Epidemiology Division, Department of Medicine SolnaKarolinska InstitutetSolnaSweden
| | - Kari Johansson
- Clinical Epidemiology Division, Department of Medicine SolnaKarolinska InstitutetSolnaSweden,Department of Women's Health and Health professionsKarolinska University HospitalStockholmSweden
| | - Sissel Saltvedt
- Department of Women's Health and Health professionsKarolinska University HospitalStockholmSweden,Department of Women's and Children's Health, Department of Medicine SolnaKarolinska InstitutetSolnaSweden
| | - Malin Edqvist
- Clinical Epidemiology Division, Department of Medicine SolnaKarolinska InstitutetSolnaSweden,Department of Women's Health and Health professionsKarolinska University HospitalStockholmSweden
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12
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Al Sabei SD, Labrague LJ, Al-Rawajfah O, AbuAlRub R, Burney IA, Jayapal SK. Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout. Nurs Forum 2022; 57:568-576. [PMID: 35152423 DOI: 10.1111/nuf.12706] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/20/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship. AIM To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout. METHODS A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout. RESULTS Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout. CONCLUSION Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.
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Affiliation(s)
- Sulaiman D Al Sabei
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al-Rawajfah
- Department of Adult and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
- Department of Adult, College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram A Burney
- Medical Oncology, Women's Health Program, The Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman
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Ianni L, Camden C, Anaby D. How can we evaluate collaborative practices in inclusive schools? Challenges and proposed solutions. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2022. [DOI: 10.1080/19411243.2022.2054486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Lina Ianni
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Chantal Camden
- École de réadapation, Université de Sherbrooke Sherbrooke, Quebec, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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14
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Labrague LJ, Al Sabei S, Al Rawajfah O, AbuAlRub R, Burney I. Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses. J Nurs Manag 2021; 30:268-278. [PMID: 34601772 DOI: 10.1111/jonm.13491] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored. AIM This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction. METHODS This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman. RESULTS Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations. CONCLUSION Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes. IMPLICATIONS FOR NURSING MANAGEMENT Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.
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Affiliation(s)
- Leodoro J Labrague
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.,Adjunct Faculty, Graduate School, St. Paul University Philippines, Tuguegarao, Philippines
| | - Sulaiman Al Sabei
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al Rawajfah
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.,College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Community and Mental Health Department, College of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram Burney
- Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Young J, Daulton B, Griffith C. The effectiveness of an educational intervention to enhance undergraduate nursing students' competence with interprofessional collaboration. Nurs Forum 2021; 57:69-77. [PMID: 34597424 DOI: 10.1111/nuf.12655] [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: 06/10/2021] [Revised: 08/13/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Interprofessional collaboration and teamwork have been identified as priorities for delivering quality client care. Improved teamwork, communication, and collaboration among healthcare professionals improve client outcomes. Nurse professionals are challenged to be equally engaged with other healthcare professionals to develop a culturally competent client-centered plan of care. PURPOSE The purpose of the current project was to examine the effectiveness of a multifaceted educational intervention on prelicensure nursing students' development of interprofessional competencies with teams and teamwork, communication, roles and responsibility, values, and ethics. METHODS Metrics used included the Interprofessional Collaboration Competency Attainment (ICCAS) and the Assessment of Collaborative Environments (ACE-15) surveys. RESULTS The results support practical and statistical significance in the students' self-reported collaborative competence across all items of the ICCAS at p < 0.000 level, and across each individual item. CONCLUSIONS The multifaceted educational strategy effectively engaged prelicensure nursing students with other healthcare disciplines to develop a client-centered plan of care and achieve interprofessional competencies.
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Affiliation(s)
- Judith Young
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Brittany Daulton
- Curriculum Development and Research, Interprofessional Practice and Education Center, Indiana University, Indianapolis, Indiana, USA
| | - Cheryl Griffith
- Indiana University Health Office of Clinical Education, Indianapolis, Indiana, USA
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16
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Lim L, Zimring CM, DuBose JR, Lee J, Stroebel RJ, Matthews MR. Designing for Effective and Safe Multidisciplinary Primary Care Teamwork: Using the Time of COVID-19 as a Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168758. [PMID: 34444522 PMCID: PMC8394340 DOI: 10.3390/ijerph18168758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
Effective medical teamwork can improve the effectiveness and experience of care for staff and patients, including safety. Healthcare organizations, and especially primary care clinics, have sought to improve medical teamwork through improved layout and design, moving staff into shared multidisciplinary team rooms. While co-locating staff has been shown to increase communication, successful designs balance four teamwork needs: face-to-face communications; situational awareness; heads-down work; perception of teamness. However, precautions for COVID-19 make it more difficult to conduct face-to-face communications. In this paper we describe a model for understanding how layout affects these four teamwork needs and describe how the perception of teamwork by staff changed after COVID-19 precautions were put in place. Observations, interviews and two standard surveys were conducted in two primary care clinics before COVID-19 and again in 2021 after a year of precautions. In general, staff felt more isolated and found it more difficult to conduct brief consults, though these perceptions varied by role. RNs, who spent more time on the phone, found it convenient to work part time-from home, while medical assistants found it more difficult to find providers in the distanced clinics. These cases suggest some important considerations for future clinic designs, including greater physical transparency that also allow for physical separation and more spaces for informal communication that are distanced from workstations.
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Affiliation(s)
- Lisa Lim
- College of Architecture, Texas Tech University, Lubbock, TX 79409, USA;
| | - Craig M. Zimring
- College of Design, Georgia Institute of Technology, Atlanta, GA 30332, USA;
- Correspondence:
| | - Jennifer R. DuBose
- College of Design, Georgia Institute of Technology, Atlanta, GA 30332, USA;
| | - Jaehoon Lee
- College of Education, Texas Tech University, Lubbock, TX 79409, USA;
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17
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Al Sabei SD, AbuAlRub R, Labrague LJ, Ali Burney I, Al-Rawajfah O. The impact of perceived nurses' work environment, teamness, and staffing levels on nurse-reported adverse patient events in Oman. Nurs Forum 2021; 56:897-904. [PMID: 34350619 DOI: 10.1111/nuf.12639] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fostering a healthy work environment becomes a necessity in health care institutions that value quality care and patient safety. However, limited studies investigated the impact of work environment characteristics including staffing and teamness among healthcare teams on adverse patient events in Oman. AIMS To examine the (1) impact of work environment, interprofessional teamness, staffing levels on adverse patient events and (2) predicting factors of perceptions of work environment among nurses in the Sultanate of Oman. METHOD A cross-sectional descriptive design was utilized to collect data from 2113 nurses. Participants completed a self-report questionnaire that included a set of instruments. RESULTS The results showed a strong positive relationship between work environment and teamness (r = 0.59, p < 0.001). Nurses working in a favorable environment that has positive teamwork reported a reduction in adverse events including patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medication errors (p < 0.001). There was a nonsignificant correlation between staffing and adverse patient events. CONCLUSION Fostering a healthy and supportive work environment continue to be crucial for ensuring patient safety. Nurse administrators should strive to improve work environment through creating a culture that values interprofessional teamwork and collaborative relationships.
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Affiliation(s)
- Sulaiman Dawood Al Sabei
- Department of Fundamentals and Nursing Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Raeda AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing/Jordan University of Science and Technology, Jordan
| | - Leodoro J Labrague
- Fundamentals and Nursing Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Ikram Ali Burney
- Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Omar Al-Rawajfah
- Department of Adult and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.,Department of Adult Health Nursing, College of Nursing, Al al-Bayt University, Mafraq, Jordan
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18
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Glover PD, Gray H, Shanmugam S, McFadyen AK. Evaluating collaborative practice within community-based integrated health and social care teams: a systematic review of outcome measurement instruments. J Interprof Care 2021; 36:458-472. [PMID: 34219603 DOI: 10.1080/13561820.2021.1902292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Collaborative practice is a workforce priority for integrated health and social care systems internationally, requiring robust outcome measurement instruments (OMIs) to enable team development and good quality research. In this systematic review, we appraised self-administered OMIs that could be used to measure team-based collaborative practice within integrated health and social care teams in community settings. The most important measurement properties when selecting between OMIs are content and structural validity and internal consistency. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) systematic review method was modified to evaluate each OMI. For each measurement property, the methodological quality of individual studies and quality of each parameter were rated, and the level of evidence graded. A search strategy applied to 19 bibliographic databases identified 7 instruments that met eligibility criteria. A total of 6 development studies, 6 content validity studies, 8 studies for structural validity, and 10 for internal consistency were included. Only the shortened version of the Assessment of Interprofessional Team Collaboration Scale (ATICS-II) was rated as Sufficient for each measurement property with Very Low or Moderate quality evidence. Further validation of each OMI for use by community integrated teams is needed; studies evaluating relevance, comprehensibility and comprehensiveness are a priority.
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Affiliation(s)
| | - Heather Gray
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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19
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Rotz ME, Calligaro IL, Kaplan LI, Lu X, Sinnott MC, Spadone S, Vernon R, Zhao H, Idahosa CN. Design and evaluation of an interprofessional education workshop series for preclinical and prelicensure health professional students. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:885-894. [PMID: 34074523 DOI: 10.1016/j.cptl.2021.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/14/2020] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There are a variety of designs and implementation strategies reported for interprofessional education (IPE); however, most of these descriptions lack robust evaluations of interprofessional (IP) outcomes. INTERPROFESSIONAL EDUCATION ACTIVITY An IPE Workshop Series was implemented for preclinical and prelicensure students in eight health professions, consisting of four sessions: health professionals' roles and responsibilities (1A); introduction to patient safety (1B); IP diabetes management (2A); and IP pain management in the opioid epidemic (2B). For Workshops 2A and 2B, student perceptions of IPE were measured using the validated Students Perceptions of Interprofessional Clinical Education Revised Version 2 and IP team care plans were assessed with a rubric. Five hundred twenty-seven students attended all four workshops and completed all surveys. Student perceptions of IPE and collaboration were significantly increased after completing the IPE Workshop Series. Most teams met or exceeded expectations on the diabetes team care plans for collaboration, addressing patient concerns, and gaps in care; however, most teams needed improvement on addressing additional workup and management. The pain management team care plans were below expectations for most teams. DISCUSSION Student perceptions of IP collaboration increased and were maintained longitudinally indicating a positive impact on this IPE outcome; however, performance on team care plans did not meet faculty expectations suggesting areas for improvement in the design and evaluation for this outcome. IMPLICATIONS These findings reinforce the importance of evaluation to ensure IPE curricula are achieving IP outcomes, notably, utilizing validated instruments and incorporating faculty assessments that are appropriately leveled for learners.
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Affiliation(s)
- Melissa E Rotz
- Department of Pharmacy Practice, Temple University School of Pharmacy, 3307 North Broad Street, Office 150A, Philadelphia, PA 19140, United States.
| | - Ina Lee Calligaro
- Temple University School of Pharmacy, 3307 N. Broad Street, Philadelphia, PA 19140, United States
| | - Lawrence I Kaplan
- Section of General Internal Medicine, Lewis Katz School of Medicine at Temple University Office of Medical Education, 3500 North Broad Street, Suite 325, Philadelphia, PA 19140, United States
| | - Xiaoning Lu
- Department of Clinical Sciences, Temple University Kresge 223A, 3440 N Broad St, Philadelphia, PA 19140, United States.
| | - Mary C Sinnott
- Temple University, College of Public Health, Department of Health and Rehabilitation Sciences, Program in Physical Therapy, 1301 Cecil B. Moore Avenue, Ritter Annex Rm 625, Philadelphia, PA 19122, United States.
| | - Samuel Spadone
- School of Podiatric Medicine, Temple University, 8th at Race Street, Philadelphia, PA 19107, United States.
| | - Rebecca Vernon
- Temple University, Department of Health and Rehabilitation Sciences, College of Public Health, 1301 Cecil B. Moore Avenue, Ritter Annex, Room 630, Philadelphia, PA 19122, United States.
| | - Huaqing Zhao
- Department of Clinical Sciences, Kresge East Room 218, 3440 N. Broad Street, Philadelphia, PA 19140, United States.
| | - Chizobam N Idahosa
- Oral Medicine, Dept. of Oral and Maxillofacial Pathology, Medicine and Surgery, Temple University Kornberg School of Dentistry, 3223 North Broad St., Philadelphia, PA 19140, United States.
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20
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Akehurst J, Stronge P, Giles K, Ling J. Making a difference: workforce skills and capacity for integrated care. JOURNAL OF INTEGRATED CARE 2021. [DOI: 10.1108/jica-05-2020-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The aim of this action research was to explore, from a workforce and a patient/carer perspective, the skills and the capacity required to deliver integrated care and to inform future workforce development and planning in a new integrated care system in England.
Design/methodology/approach
Semi-structured interviews and focus groups with primary, community, acute care, social care and voluntary care, frontline and managerial staff and with patients and carers receiving these services were undertaken. Data were explored using framework analysis.
Findings
Analysis revealed three overarching themes: achieving teamwork and integration, managing demands on capacity and capability and delivering holistic and user-centred care. An organisational development (OD) process was developed as part of the action research process to facilitate the large-scale workforce changes taking place.
Research limitations/implications
This study did not consider workforce development and planning challenges for nursing and care staff in residential, nursing care homes or domiciliary services. This part of the workforce is integral to the care pathways for many patients, and in line with the current emerging national focus on this sector, these groups require further examination. Further, data explore service users' and carers' perspectives on workforce skills. It proved challenging to recruit patient and carer respondents for the research due to the nature of their illnesses.
Practical implications
Many of the required skills already existed within the workforce. The OD process facilitated collaborative learning to enhance skills; however, workforce planning across a whole system has challenges in relation to data gathering and management. Ensuring a focus on workforce development and planning is an important part of integrated care development.
Social implications
This study has implications for social and voluntary sector organisations in respect of inter-agency working practices, as well as the identification of workforce development needs and potential for informing subsequent cross-sector workforce planning arrangements and communication.
Originality/value
This paper helps to identify the issues and benefits of implementing person-centred, integrated teamworking and the implications for workforce planning and OD approaches.
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21
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Cavanaugh KJ, Logan JM, Zajac SA, Holladay CL. Core conditions of team effectiveness: Development of a survey measuring Hackman's framework. J Interprof Care 2021; 35:914-919. [PMID: 33587006 DOI: 10.1080/13561820.2020.1871327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Leaders and team development practitioners working toward increasing interprofessional team effectiveness frequently need to quickly and accurately determine the extent to which a team possesses the most essential and foundational components required for effective teamwork. While there is no shortage of team theories, there are few freely available, practical, short, and well-developed surveys to measure team functioning across a variety of team types. We developed a 9-item team assessment to fill this gap in the literature, measuring the most fundamental criteria for optimising team functioning, based on Hackman's widely used framework of the foundational conditions for team effectiveness. Reliability and validity of the assessment were investigated through multiple methods, including confirmatory factor analysis and bivariate correlations. Initial psychometric work would appear to support the use of this assessment to measure the three core conditions of team effectiveness. This assessment can be completed by interprofessional team members and their responses can be used to help leaders and team development practitioners focus resources on the most relevant conditions to increase the likelihood of team effectiveness.
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Affiliation(s)
- Katelyn J Cavanaugh
- Leadership Institute, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jessica M Logan
- Organizational Development, Houston Methodist Hospital, Houston, TX, USA
| | - Stephanie A Zajac
- Leadership Institute, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Courtney L Holladay
- Leadership Institute, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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22
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Byerly LK, Floren LC, Yukawa M. Fostering Interprofessional Geriatric Patient Care Skills for Health Professions Students Through a Nursing Facility-Based Immersion Rotation. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:11059. [PMID: 33409357 PMCID: PMC7780744 DOI: 10.15766/mep_2374-8265.11059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/01/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Interprofessional (IP) clinical care is ideally taught in authentic environments; however, training programs often lack authentic opportunities for health professions students to practice IP patient care. Skilled nursing facilities (SNFs) can offer such opportunities, particularly for geriatric patient care, but are underutilized as training sites. We present an IP nursing facility rotation (IP-SNF) in which medical, pharmacy, and physical therapy students provided collaborative geriatric patient care. METHODS Our 10-day immersion rotation focused on four geriatric competencies common to all three professions: appropriate/hazardous medications, patient self-care capacity, evaluating and treating falls, and IP collaboration. Activities included conducting medication reviews, quarterly care planning, evaluating functional status/fall risk, and presenting team recommendations at SNF meetings. Facility faculty/staff provided preceptorship and assessed team presentations. Course evaluations included students' pre/post objective-based self-assessment, as well as facility faculty/staff evaluations of interactions with students. RESULTS Thirty-two students (15 medical, 12 pharmacy, five physical therapy) participated in the first 2 years. Evaluations (n = 31) suggested IP-SNF filled gaps in students' geriatrics and IP education. Pre/post self-assessment showed significant improvement (p < .001) in self-confidence related to course objectives. Faculty/staff indicated students added value to SNF patient care. Challenges included maximizing patient care experiences while allowing adequate team work time. DISCUSSION IP-SNF showcases the feasibility of, and potential for, engaging learners in real-world IP geriatric patient care in a SNF. Activities and materials must be carefully designed and implemented to engage all levels/types of IP learners and ensure valuable learning experiences.
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Affiliation(s)
- Laura K. Byerly
- Assistant Professor of Medicine, Division of General Internal Medicine and Geriatrics, Oregon Health & Science University School of Medicine
| | - Leslie C. Floren
- Adjunct Associate Professor of BioEngineering and Therapeutic Sciences, University of California, San Francisco, School of Pharmacy
| | - Michi Yukawa
- Professor of Medicine, Division of Geriatrics, University of California, San Francisco, School of Medicine and San Francisco VA Medical Center
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23
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Hallen S. Redesigning the Clinical Learning Environment to Improve Interprofessional Care and Education: Multi-Method Program Evaluation of the iPACE Pilot Unit. J Grad Med Educ 2020; 12:598-610. [PMID: 33149830 PMCID: PMC7594784 DOI: 10.4300/jgme-d-19-00675.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/17/2020] [Accepted: 07/23/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In 2016, Maine Medical Center received an Accreditation Council for Graduate Medical Education Pursuing Excellence in Innovation grant to redesign the clinical learning environment to promote interprofessional care and education. The Interprofessional Partnership to Advance Care and Education (iPACE) model was developed and piloted on an adult inpatient medicine unit as an attempt achieve these aims. OBJECTIVE We describe the iPACE model and associated outcomes. METHODS Surveys and focus groups were employed as part of a multimethod pragmatic observational strategy. Team surveys included relational coordination (RC): a validated proprietary measure of interpersonal communication and relationships within teams. Pre-iPACE respondents were a representative historical sample from comparable inpatient medical units surveyed from March to April 2017. iPACE respondents were model participants surveyed March to August 2018 to allow for adequate sample size. RESULTS Surveys were administered to pre-iPACE (N = 113, response rate 74%) and iPACE (N = 32, 54%) teams. Summary RC scores were significantly higher for iPACE respondents (iPACE 4.26 [SD 0.37] vs 3.72 [SD 0.44], P < .0001), and these respondents were also more likely to report a professionally rewarding experience (iPACE 4.4 [SD 0.6] vs 3.5 [SD 1.0], P < .0001). Learners felt the model was successful in teaching interprofessional best practices but were concerned it may hinder physician role development. Patient experience was positive. CONCLUSIONS This pilot may have a positive effect on team functioning and team member professional experience and patient experience. Learner acceptance may be improved by increasing autonomy and preserving traditional learning venues.
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Busari JO, Yaldiz H, Gans ROB, Duits AJ. Clinical Leadership as an Agent for Change: A Health System Improvement Intervention in Curaçao. J Multidiscip Healthc 2020; 13:787-798. [PMID: 32884278 PMCID: PMC7431449 DOI: 10.2147/jmdh.s262415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/08/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction The healthcare system in Curaçao is complex, fragmented, and poorly organized and typifies a system in a resource-limited environment. Deficits in competencies and local cultural barriers are factors that hinder sustainable healthcare in such settings and a failure to meet WHO sustainable development goals. This study reports the potential cost-effectiveness and improved health outcomes of the first stage of a healthcare improvement project. The intervention, which is a multidisciplinary team-based leadership training program (MLP), reflects a promising strategy to tackle local healthcare needs. Methods A Multidisciplinary group of healthcare professionals in St. Elisabeth hospital, Curaçao, was selected to 1) participate in the MLP and 2) co-design a healthcare pathway on the management of decubitus ulcers. Using a qualitative research methodology, we conducted interviews to assess the perceived leadership growth, teamwork, and the barriers to the introduction of the new care pathway in their setting. Six themes were identified that explained the perceived leadership development and interprofessional collaboration. These included 1) Professional background, 2) Healthcare pathway design, 3) Resources, 4) Personal development, 5) Collaboration 6) Execution. Conclusion/Implication The participants valued the interdisciplinary approach of this health improvement project and acknowledged the added value of a training program that also addressed personal growth. This study shows how MLPs for health professionals can also serve as catalysts for health improvement efforts in resource-limited environments.
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Affiliation(s)
- Jamiu O Busari
- Department of Pediatrics, Horacio Oduber Hospital, Oranjestad, Aruba.,Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands
| | - Huriye Yaldiz
- Faculty of Medical Sciences, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Reinold O B Gans
- Department of Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Ashley J Duits
- Red Cross Blood Bank Foundation, Willemstad, Curaçao.,Institute for Medical Education, University Medical Center Groningen, Groningen, the Netherlands.,Department of Medical Education, Curaçao Medical Center, Willemstad, Curaçao
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25
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Teamness, burnout, job satisfaction and decision-making in the VA Centers of Excellence in Primary Care Education. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.xjep.2020.100328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Stefan MS, Pekow PS, Shea CM, Hughes AM, Hill NS, Steingrub JS, Lindenauer PK. Protocol for two-arm pragmatic cluster randomized hybrid implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation. Implement Sci Commun 2020; 1:46. [PMID: 32435762 PMCID: PMC7223919 DOI: 10.1186/s43058-020-00028-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background COPD is the fourth leading cause of death in the US, and COPD exacerbations result in approximately 700,000 hospitalizations annually. Patients with acute respiratory failure due to severe COPD exacerbation are treated with invasive (IMV) or noninvasive mechanical ventilation (NIV). Although IMV reverses hypercapnia/hypoxia, it causes significant morbidity and mortality. There is strong evidence that patients treated with NIV have better outcomes, and NIV is recommended as first line therapy in these patients. Yet, several studies have demonstrated substantial variation in the use of NIV across hospitals, leading to preventable morbidity and mortality. Through a series of mixed-methods studies, we have found that successful implementation of NIV requires physicians, respiratory therapists (RTs), and nurses to communicate and collaborate effectively, suggesting that efforts to increase the use of NIV in COPD need to account for the complex and interdisciplinary nature of NIV delivery and the need for team coordination. Therefore, we propose to compare two educational strategies: online education (OLE) and interprofessional education (IPE) which targets complex team-based care in NIV delivery. Methods and design Twenty hospitals with low baseline rates of NIV use will be randomized to either the OLE or IPE study arm. The primary outcome of the trial is change in the hospital rate of NIV use among patients with COPD requiring ventilatory support. In aim 1, we will compare the uptake change over time of NIV use among patients with COPD in hospitals enrolled in the two arms. In aim 2, we will explore mediators’ role (respiratory therapist autonomy and team functionality) on the relationship between the implementation strategies and implementation effectiveness. Finally, in aim 3, through interviews with providers, we will assess acceptability and feasibility of the educational training. Discussions This study will be among the first to carefully test the impact of IPE in the inpatient setting. This work promises to change practice by offering approaches to facilitate greater uptake of NIV and may generalize to other interventions directed to seriously-ill patients. Trial registration Name of registry: ClinicalTrials.gov Trial registration number: NCT04206735 Date of Registration: December 20, 2019
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Affiliation(s)
- Mihaela S Stefan
- 1Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA USA.,2Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA USA
| | - Penelope S Pekow
- 1Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA USA.,3School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA USA
| | - Christopher M Shea
- 4Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC USA
| | - Ashley M Hughes
- 5College of Applied Health Science, University of Illinois at Chicago, Chicago, IL USA
| | - Nicholas S Hill
- 6Division of Pulmonary and Critical Care Medicine, Tufts University School of Medicine, Boston, MA USA
| | - Jay S Steingrub
- 7Division of Pulmonary and Critical Care, Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA USA
| | - Peter K Lindenauer
- 1Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA USA.,2Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA USA.,8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA USA
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27
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Timm JR, Schnepper LL. A mixed-methods evaluation of an interprofessional clinical education model serving students, faculty, and the community. J Interprof Care 2020; 35:92-100. [PMID: 32013630 DOI: 10.1080/13561820.2019.1710117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The clinical learning environment significantly affects students' preparedness to enter practice. Nursing programs may struggle securing relevant clinical sites necessary for student learning and meeting accreditation standards. Programs must be creative in developing community-based experiences that facilitate students' learning. However, authentic interprofessional practice is often missing. We evaluated how an interprofessional clinical education model provided preventive health services through a faculty-student-led clinic and delivered an effective avenue to educate health profession students while serving the community. The model was implemented as a pilot project over the course of one semester. We used mixed-methods to analyze data from pre/post-instruments and focus groups to gain a comprehensive understanding of the effect of the model on students, faculty, and the community. Student growth in interprofessional competencies, measured with the Interprofessional Education Collaborative Self-Assessment Tool and the Interprofessional Socialization and Valuing Scale, indicates significant difference pre/post-participation. Four themes were identified from the focus groups highlighting the impact of the clinical education model: interprofessional teamwork, an unorthodox learning environment, delivery of primary and secondary prevention in the community, and reaching underserved populations. This clinical education model has promising utility in providing an interprofessional clinical learning environment while serving the community.
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Affiliation(s)
- Jennifer R Timm
- Department of Nursing, Winona State University , Winona, MN, USA
| | - Lisa L Schnepper
- Department of Nursing, Winona State University , Winona, MN, USA
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Abstract
This article addresses the current and desired future state of interprofessional practice in pediatric hospital medicine. It focuses on identifying optimal team composition and work patterns, describing the value of parent involvement on both the patient's care team and on operational teams, describing the need for interprofessional education, and identifying outcomes associated with interprofessional teamwork. The article also identifies challenges and opportunities for growth as interprofessional teamwork increasingly becomes a standard practice within healthcare settings.
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Affiliation(s)
- Jennifer Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #74, Los Angeles, CA 90027, USA.
| | - Michele Ashland
- Lucile Packard Children's Hospital Stanford, 725 Welch Road, Palo Alto, CA 94304, USA
| | - Glenn Rosenbluth
- Office of Graduate Medical Education, Pediatrics Residency Training Program, Department of Pediatrics, University of California, San Francisco, 5th Floor, Mission Hall Box 3214, 550 16th Street, San Francisco, CA 94143, USA
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29
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Frost JS, Hammer DP, Nunez LM, Adams JL, Chesluk B, Grus C, Harvison N, McGuinn K, Mortensen L, Nishimoto JH, Palatta A, Richmond M, Ross EJ, Tegzes J, Ruffin AL, Bentley JP. The intersection of professionalism and interprofessional care: development and initial testing of the interprofessional professionalism assessment (IPA). J Interprof Care 2018; 33:102-115. [PMID: 30247940 DOI: 10.1080/13561820.2018.1515733] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Valid assessment of interprofessional education and collaborative practice (IPECP) is challenging. The number of instruments that measure various aspects of IPECP, or in various sites is growing, however. The Interprofessional Professionalism Assessment (IPA) measures observable behaviors of health care professionals-in-training that demonstrate professionalism and collaboration when working with other health care providers in the context of people-centered care. The IPA instrument was created by the Interprofessional Professionalism Collaborative (IPC), a national group representing 12 entry-level health professions and one medical education assessment organization. The instrument was created and evaluated over several years through a comprehensive, multi-phasic process: 1) development of construct and observable behaviors, 2) instrument design, expert review and cognitive interviews, and 3) psychometric testing. The IPA contains 26 items representing six domains of professionalism (altruism and caring, excellence, ethics, respect, communication, accountability), and was tested by 233 preceptors rating health profession learners in the final year of their practical training. These preceptors represented 30 different academic institutions across the U.S., worked in various types of practice sites, and evaluated learners representing 10 different entry-level health professions. Exploratory factor analysis suggested four factors (communication, respect, excellence, altruism and caring) using 21 items with the least amount of missing data, and confirmed, for the most part, a priori expectations. Internal consistency reliability coefficients for the entire instrument and its four subscales were high (all greater than 0.9). Psychometric results demonstrate aspects of the IPA's reliability and validity and its use across multiple health professions and in various practice sites.
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Affiliation(s)
- Jody S Frost
- a Education Consultant and Facilitator , President-Elect, National Academies of Practice , Lusby , MD , USA
| | - Dana P Hammer
- b Faculty Lead, Student Professional Development , University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences , Aurora , CO , USA
| | - Loretta M Nunez
- c Director of Academic Affairs and Research Education , American Speech-Language-Hearing Association , Rockville , MD , USA
| | - Jennifer L Adams
- d Associate Dean of Academic Affairs , Idaho State University College of Pharmacy , Meridian , ID , USA
| | - Benjamin Chesluk
- e Clinical Research Associate in Quality Research , American Board of Internal Medicine , Philadelphia , PA , USA
| | - Catherine Grus
- f Deputy Executive Director , Education, American Psychological Association , Washington , DC , USA
| | - Neil Harvison
- g Academic and Scientific Affairs ; American Occupational Therapy Association , Bethesda , MD , USA
| | - Kathy McGuinn
- h Interprofessional Education and Practice Partnerships , Special Advisor for Quality Initiatives, American Association of Colleges of Nursing , Washington , DC , USA
| | - Luke Mortensen
- i Professional Affairs, American Association of Colleges of Osteopathic Medicine , Chevy Chase , MD , USA
| | - John H Nishimoto
- j Southern California College of Optometry at Marshall B. Ketchum University , Fullerton , CA , USA
| | - Anthony Palatta
- k Educational Program Development, Policy Center: Institutional Capacity Building , American Dental Education Association, The Voice of Dental Education , Washington , DC , USA
| | | | - Elisabeth J Ross
- m Student Affairs, American Association of Colleges of Pharmacy , Alexandria , VA , USA
| | - John Tegzes
- n Interprofessional Practice & Education, Western University of Health Sciences , Pomona , CA , USA
| | - Alexis L Ruffin
- o Medical Education/Academic Affairs, Association of American Medical Colleges , Washington , DC , USA
| | - John P Bentley
- p Pharmacy Administration, Department of Pharmacy Administration , University of Mississippi, School of Pharmacy , MS , USA
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30
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Gracía-Pérez ML, Gil-Lacruz M. The impact of a continuing training program on the perceived improvement in quality of health care delivered by health care professionals. EVALUATION AND PROGRAM PLANNING 2018; 66:33-38. [PMID: 28987860 DOI: 10.1016/j.evalprogplan.2017.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 08/30/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
There is abundant scientific literature concerning factors that affect patients' perceptions of the quality of health care. However, there are few published works that consider the opinions of health care professionals. This article aims to conjointly analyse two organisational strategies that determine professional health care practice: continuous training and quality of care. The objective is to examine the opinions of physicians and nurses on the improvement of the quality of care after a 'learning by doing' program. An evaluation method was designed that integrates the main variables that intervene in quality of care. An online questionnaire was utilised for collecting opinions on the effects of the training program. A total of 184 nurses and 180 other medical professionals participated in the program and all of them were asked to complete the questionnaire. A descriptive, and inferential statistical analysis was undertaken and results showed that there is a direct relationship between perceptions about: satisfaction, professional competence, training modality, optimisation of health resources and quality of care.
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Affiliation(s)
- María Luisa Gracía-Pérez
- Faculty of Social Sciences and Work, University of Saragossa, C. Violante de Hungria, 23, 50009 Saragossa, Spain.
| | - Marta Gil-Lacruz
- Faculty of Health Sciences, University of Saragossa, C. Domingo Miral s/n, 50009 Saragossa, Spain.
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O'Brien BC, Patel SR, Pearson M, Eastburn AP, Earnest GE, Strewler A, Gager K, Manuel JK, Dulay M, Bachhuber MR, Shunk R. Twelve tips for delivering successful interprofessional case conferences. MEDICAL TEACHER 2017; 39:1214-1220. [PMID: 28685632 DOI: 10.1080/0142159x.2017.1344353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Interprofessional case conferences (ICCs) offer an interactive, practical way to engage members of two or more health professions in discussions that involve learning and working together to improve patient care. Well-orchestrated ICCs provide opportunities to integrate interprofessional (IP) education into routine clinical practice. The authors provide 12 tips to support the conceptualization, planning, implementation, facilitation, evaluation, and sustainability of ICCs. They draw from extensive experience as IP educators and facilitators of ICCs and from literature on IP education, case-based learning, small-group facilitation, peer-assisted learning, and learner engagement - all of which offer insights into ICCs but have not been integrated and applied to this context.
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Affiliation(s)
- Bridget C O'Brien
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Shalini R Patel
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Meg Pearson
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Abigail P Eastburn
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Gillian E Earnest
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Anna Strewler
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- c Department of Community Health Systems , School of Nursing, University of California , San Francisco , CA , USA
| | - Krista Gager
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- c Department of Community Health Systems , School of Nursing, University of California , San Francisco , CA , USA
| | - Jennifer K Manuel
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- d Department of Psychiatry, School of Medicine , University of California , San Francisco , CA , USA
| | - Maya Dulay
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Melissa R Bachhuber
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
| | - Rebecca Shunk
- a San Francisco Veterans Affairs Medical Center , San Francisco , CA, USA
- b Department of Medicine, School of Medicine , University of California , San Francisco , CA , USA
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32
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Schmutz JB, Eppich WJ. Promoting Learning and Patient Care Through Shared Reflection: A Conceptual Framework for Team Reflexivity in Health Care. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1555-1563. [PMID: 28445215 DOI: 10.1097/acm.0000000000001688] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Health care teams are groups of highly skilled experts who may often form inexpert teams because of a lack of collective competence. Because teamwork and collaboration form the foundation of effective clinical practice, factors that promote collective competence demand exploration. The authors review team reflexivity (TR), a concept from the psychology and management literatures, and how it could contribute to the collective competence of health care teams. TR captures a team's ability to reflect collectively on group objectives, strategies, goals, processes, and outcomes of past, current, and future performance to process key information and adapt accordingly. As an overarching process that promotes team functioning, TR builds shared mental models as well as triggering team adaptation and learning.The authors present a conceptual framework for TR in health care, describing three phases in which TR may occur: pre-action TR (briefing before patient care), in-action TR (deliberations during active patient care), and post-action TR (debriefing after patient care). Depending on the phase, TR targets either goals, taskwork, teamwork, or resources and leads to different outcomes (e.g., optimal preparation, a shared mental model, adaptation, or learning). This novel conceptual framework incorporates various constructs related to reflection and unites them under the umbrella of TR. Viewing reflection through a team lens may guide future research about team functioning, optimize training efforts, and elucidate mechanisms for workplace learning, with better patient care as the ultimate goal.
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Affiliation(s)
- Jan B Schmutz
- J.B. Schmutz is researcher and lecturer, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland. W.J. Eppich is associate professor of pediatrics-emergency medicine and medical education, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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33
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Shrader S, Farland MZ, Danielson J, Sicat B, Umland EM. A Systematic Review of Assessment Tools Measuring Interprofessional Education Outcomes Relevant to Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2017; 81:119. [PMID: 28970620 PMCID: PMC5607729 DOI: 10.5688/ajpe816119] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/03/2016] [Indexed: 05/19/2023]
Abstract
Objective. To identify and describe the available quantitative tools that assess interprofessional education (IPE) relevant to pharmacy education. Methods. A systematic approach was used to identify quantitative IPE assessment tools relevant to pharmacy education. The search strategy included the National Center for Interprofessional Practice and Education Resource Exchange (Nexus) website, a systematic search of the literature, and a manual search of journals deemed likely to include relevant tools. Results. The search identified a total of 44 tools from the Nexus website, 158 abstracts from the systematic literature search, and 570 abstracts from the manual search. A total of 36 assessment tools met the criteria to be included in the summary, and their application to IPE relevant to pharmacy education was discussed. Conclusion. Each of the tools has advantages and disadvantages. No single comprehensive tool exists to fulfill assessment needs. However, numerous tools are available that can be mapped to IPE-related accreditation standards for pharmacy education.
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Affiliation(s)
- Sarah Shrader
- University of Kansas School of Pharmacy, Lawrence, Kansas
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34
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Brandt BF, Schmitz CC. The US National Center for Interprofessional Practice and Education Measurement and Assessment Collection. J Interprof Care 2017; 31:277-281. [DOI: 10.1080/13561820.2017.1286884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Barbara F. Brandt
- National Center for Interprofessional Practice and Education, University of Minnesota, Minneapolis, Minnesota, USA
| | - Constance C. Schmitz
- National Center for Interprofessional Practice and Education, University of Minnesota, Minneapolis, Minnesota, USA
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35
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Mundt MP, Swedlund MP. A human factors systems approach to understanding team-based primary care: a qualitative analysis. Fam Pract 2016; 33:721-726. [PMID: 27578837 PMCID: PMC5161491 DOI: 10.1093/fampra/cmw093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Research shows that high-functioning teams improve patient outcomes in primary care. However, there is no consensus on a conceptual model of team-based primary care that can be used to guide measurement and performance evaluation of teams. OBJECTIVE To qualitatively understand whether the Systems Engineering Initiative for Patient Safety (SEIPS) model could serve as a framework for creating and evaluating team-based primary care. METHODS We evaluated qualitative interview data from 19 clinicians and staff members from 6 primary care clinics associated with a large Midwestern university. All health care clinicians and staff in the study clinics completed a survey of their communication connections to team members. Social network analysis identified key informants for interviews by selecting the respondents with the highest frequency of communication ties as reported by their teammates. Semi-structured interviews focused on communication patterns, team climate and teamwork. RESULTS Themes derived from the interviews lent support to the SEIPS model components, such as the work system (Team, Tools and Technology, Physical Environment, Tasks and Organization), team processes and team outcomes. CONCLUSIONS Our qualitative data support the SEIPS model as a promising conceptual framework for creating and evaluating primary care teams. Future studies of team-based care may benefit from using the SEIPS model to shift clinical practice to high functioning team-based primary care.
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Affiliation(s)
- Marlon P Mundt
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI, USA and .,Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthew P Swedlund
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI, USA and
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