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Wongchan N, Nilmanat K, Chinnawong T. Situational Analysis of Barriers to Continuity of End-of-Life Care in Urban Areas, Bangkok. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2024; 20:48-64. [PMID: 37975832 DOI: 10.1080/15524256.2023.2282354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
This qualitative study was designed to describe the continuity of end-of-life care and identify barriers to continuity in urban Bangkok. Continuity of care is considered an essential part of palliative care to promote the quality of life of patients at the end of life. The majority of studies have been conducted exploring continuity of care in rural communities. However, few studies have focused on urban areas, particularly in big cities. Twelve healthcare providers were the participants, including nurses in inpatient units, and in the Health Community and Continuity of Care Unit, a palliative care physician, and social workers. The data collection consisted of individual interviews, field notes, and observations. Content analysis was used to analyze data and identify barriers. The continuity of end-of-life care in a selected setting was fragmented. Three main barriers to the continuity of end-of-life care consisted of misunderstandings about patients who required palliative care, staff workloads, and incomplete patient information. The development of a comprehensive patient information sheet for communication among a multidisciplinary team could promote continuity of end-of-life care from hospital to home. An interprofessional training course on continuity of end-of-life care is also recommended. Finally, the staff workload should be monitored and managed.
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Affiliation(s)
- Nisa Wongchan
- Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
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Hanskamp-Sebregts M, van Gurp PJ, Braspenning J. Design and Validation of a Questionnaire to Measure Interprofessional Collaborative Practice for Auditing Integrated Hospital Care: Empirical Research. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 44:00005141-990000000-00103. [PMID: 38015499 PMCID: PMC11338029 DOI: 10.1097/ceh.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Interprofessional teamwork is the key issue of delivering integrated hospital care; however, measuring interprofessional collaboration for auditing is fragmented. In this study, a questionnaire to measure InterProfessional collaborative Practice for Integrated Hospital care (IPPIH) has been developed and validated. METHODS A four-step iterative process was conducted: (1) literature search to find suitable questionnaires; (2) semistructured stakeholder interviews (individual and in focus groups) to discuss the topics and questions (face validity), (3) pretesting the prototype of the questionnaire in two different integrated care pathways for feasibility, usability, and internal consistency, and (4) testing (content and construct validity and responsiveness) of the revised questionnaire in eight integrated care pathways; the validation and responsiveness was tested by means of exploratory factor analysis, calculation of Cronbach alpha, item analysis, and linear mixed model analysis. RESULTS Based on six questionnaires and the opinion of direct stakeholders, the questionnaire IPPIH comprised 27 items. Five different domains could be distinguished: own skills, culture, coordination and collaboration, practical support, and appreciation with the Cronbach alpha varied from 0.91 to 0.48. The self-reported intensity of the collaboration within a specific care pathway significantly influenced the outcome ( P = .000). DISCUSSION The product is a questionnaire, IPPIH, which can measure the degree of interprofessional collaborative practice in integrated hospital care pathways. The IPPIH was initially developed for quality assurance. However, the IPPIH also seems to be suitable as a self-assessment tool for directors to monitor and improve the interprofessional collaboration and the quality of their integrated care pathway.
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Affiliation(s)
- Mirelle Hanskamp-Sebregts
- Dr. Hanskamp-Sebregts: Radboud University Medical Center, Institute of Quality Assurance and Patient Safety, Nijmegen, The Netherlands. Prof. van Gurp: Radboud University Medical Center, Institute of Quality Assurance and Patient Safety, Nijmegen, The Netherlands, and Department of General Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Prof. Braspenning: IQ Healthcare, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Petra J. van Gurp
- Dr. Hanskamp-Sebregts: Radboud University Medical Center, Institute of Quality Assurance and Patient Safety, Nijmegen, The Netherlands. Prof. van Gurp: Radboud University Medical Center, Institute of Quality Assurance and Patient Safety, Nijmegen, The Netherlands, and Department of General Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Prof. Braspenning: IQ Healthcare, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Jozé Braspenning
- Dr. Hanskamp-Sebregts: Radboud University Medical Center, Institute of Quality Assurance and Patient Safety, Nijmegen, The Netherlands. Prof. van Gurp: Radboud University Medical Center, Institute of Quality Assurance and Patient Safety, Nijmegen, The Netherlands, and Department of General Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Prof. Braspenning: IQ Healthcare, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
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Achtert K, Huchtemann T, Altendorf M, Kerkemeyer L, Haring M, Lummer C, Frenz L, Becking T, Friedmann J, Mildner P, Schwarze K, Steinhaus L, Amelung V, Warnecke T. Design and implementation of ParkinsonAKTIV: an interventional study to evaluate the effectiveness of a novel online platform to guide quickcard-based treatment decisions. Neurol Res Pract 2023; 5:23. [PMID: 37259124 DOI: 10.1186/s42466-023-00249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Patients with Parkinson's Disease (PD) require an all-encompassing and individualized care including pharmacological as well as non-pharmacological treatment approaches, such as physical therapy, occupational therapy and speech and swallowing therapy. ParkinsonAKTIV is an innovative, multidisciplinary, and comprehensive approach to guide this non-pharmacological PD treatment in northwestern Germany. Its online communication platform called JamesAKTIV has been developed to enhance and standardize PD healthcare professionals' communication. The implementation of ParkinsonAKTIV and JamesAKTIV is accompanied through a detailed process evaluation and to gather evidence on the impact on patient-related outcomes, such as health-related quality of life and healthcare costs for people with PD through an effectiveness evaluation. METHODS The study design contains two parts: (1) first, a quantitative effectiveness evaluation is conducted utilizing a prospective quasi-experimental approach with a control group which examines PD patient's health-related quality of life and physician-assessed PD patient's health status (Unified Parkinson Disease Rating Scale). Moreover, a health economic evaluation of the ParkinsonAKTIV intervention is conducted using patient-reported outcomes and cost data as well as routine data from a statutory health insurance. (2) Second, a mixed-methods process evaluation among healthcare professionals, which examines the feasibility and potential barriers and facilitators of ParkinsonAKTIV for routine care, is performed. Quantitative results from a social network analysis and a survey among healthcare professionals will be triangulated with data from qualitative stakeholder interviews and focus group discussions. PERSPECTIVE Findings are expected to provide evidence of an increase in quality of life of patients with PD, less severe PD symptoms, and a better ability to participate in activities of daily living. ParkinsonAKTIV has the potential of increasing PD patients' quality of care through sufficient and more tailored prescription of non-pharmacological therapies. It is anticipated that ParkinsonAKTIV will improve communication among health professionals. Results from the ParkinsonAKTIV study will provide first practice-oriented evidence and a roadmap for implementation of an online tool for a comprehensive, multidisciplinary care PD network for patients and their caregivers in routine care in Germany. Trial registration ClinicalTrials.gov: registration number NCT05251298 (retrospectively registered: https://clinicaltrials.gov/ct2/show/record/NCT05251298 ).
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Affiliation(s)
- Katharina Achtert
- Institute for Applied Health Services Research (inav GmbH), Schiffbauerdamm 12, 10117, Berlin, Germany
| | - Tessa Huchtemann
- Department of Neurology, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Maria Altendorf
- Institute for Applied Health Services Research (inav GmbH), Schiffbauerdamm 12, 10117, Berlin, Germany
| | - Linda Kerkemeyer
- Institute for Applied Health Services Research (inav GmbH), Schiffbauerdamm 12, 10117, Berlin, Germany
| | - Malte Haring
- Institute for Applied Health Services Research (inav GmbH), Schiffbauerdamm 12, 10117, Berlin, Germany
| | - Carina Lummer
- Institute for Applied Health Services Research (inav GmbH), Schiffbauerdamm 12, 10117, Berlin, Germany
| | - Lena Frenz
- Department of Neurology, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Theresa Becking
- Department of Neurology, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Jonas Friedmann
- ECONUM Unternehmensberatung GmbH, Martin-Luther-Str. 69, 71636, Ludwigsburg, Germany
| | - Philip Mildner
- Nuromedia GmbH, Schaafenstr. 25, 50676, Cologne, Germany
| | | | - Lars Steinhaus
- AOK Nordwest, Kopenhagener Straße 1, 44269, Dortmund, Germany
| | - Volker Amelung
- Institute for Applied Health Services Research (inav GmbH), Schiffbauerdamm 12, 10117, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Systems Research, Medical University Hannover, Karl-Wiechert-Allee 3, 30625, Hannover, Germany
| | - Tobias Warnecke
- Department of Neurology, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
- Department of Neurology and Neurorehabilitation, Klinikum Osnabrück - Academic Teaching Hospital of the University of Münster, Am Finkenhügel 1, 49076, Osnabrück, Germany.
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Muacevic A, Adler JR, Nittala MR, Duggar WN. The Emerging Boon of Information and Communication Technology in Multidisciplinary Cancer Care: A Force Multiplier With a Human Touch. Cureus 2023; 15:e33665. [PMID: 36788838 PMCID: PMC9917828 DOI: 10.7759/cureus.33665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 01/13/2023] Open
Abstract
Cancer care (CC) is incredibly complex and requires the coordination of multiple disciplines for optimal outcomes. Historically, this has been accomplished with multidisciplinary tumor boards (MDTBs), but the benefits, while perhaps intuitive, have not always been demonstrated with sufficient research robustness and validity. We hypothesize that this difficulty in demonstrating the benefit of MDTBs may be related to a delay in decision-making and operationalizing those decisions. The history and value of MDTBs are presented as well as their weaknesses and limited demonstration of improved outcomes. A major weakness highlighted by the challenges of MDTBs is the concept of total package time (TPT) (rather, the inability to keep it as short as possible); any significant delays in CC for any discipline may have a deleterious impact on any given patient's care outcome. Drawing on our own experience with utilizing information and communication technology (ICT) during an effort to apply accountability theory to improve specifically radiation therapy package time (RTPT), we argue that similar principles will be applicable in the improvement of not only the TPT which relies on multiple disciplines, but other factors of CC as well, such as coordination. Experience with improvement in RTPT is discussed and the underlying theory is demonstrated as a sound methodology to apply beyond RTPT to TPT involving coordination of multiple disciplines and stands to lead to the full realization of the benefits of the multidisciplinary approach. The complexity of cancer means that real solutions to optimal outcomes are also, by nature, complex, but here simple accountability theory is demonstrated that may unlock the next phase of multidisciplinary coordination. In this work, we argue that the benefits of the MDTB format can be fully realized with the addition of ICT, a technological breakthrough in the past two decades, while not forgetting about continued human factors.
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Kerkemeyer L, Claus I, Kutscher M, von Stülpnagel V, Zur Nieden P, Huchtemann T, Warnecke T. Strengthening Communication and Collaboration in the Fragmented German Healthcare System: A Mixed-Method Evaluation of an Interdisciplinary Network for Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1307-1317. [PMID: 35253779 DOI: 10.3233/jpd-213072] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND To improve Parkinson's disease (PD) care, interdisciplinary and patient-centered treatment is mandatory. A key problem in many healthcare systems is the limited and unspecific communication among different healthcare professionals. Optimal collaboration between various professionals involved is indispensable. Parkinson's Network Münsterland + (PNM +) is an interdisciplinary network of medical and non-medical experts involved in the treatment of PD patients in Germany. OBJECTIVE The aim of this evaluation was to analyze the network structures of PNM+ as well as communication and collaboration between PNM + partners. METHODS A mixed methods approach was applied consisting of a social network analysis, a validated questionnaire on team effectiveness and semi-structured interviews focusing on perceived barriers and supportive aspects of PNM + . RESULTS Quantitative and qualitative data suggested increased collaboration between professionals within PNM + . The reciprocity of connections was 0.522 in the network of professional contacts. Regular exchanges in terms of interdisciplinary panel meetings and working groups stimulated knowledge transfer, leading to greater specialization of general neurologists and therapists in PD. The progressive density of the network from 0.136 to 0.279 illustrates the growing cooperation of PNM + partners. Interviewed partners requested more patient-specific collaboration but expected this to happen as the network evolved. Overall, PNM + has already improved both diagnosis and therapy thanks to knowledge transfer. Structured treatment recommendations helped to improve communication between healthcare professionals. CONCLUSION PNM+ stimulated exchange between different healthcare professionals involved in the treatment of PD patients. This overcomes specific barriers within Germany's highly fragmented healthcare system, such as the lack of communication between these disciplines.
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Affiliation(s)
- Linda Kerkemeyer
- Institute for Applied Health Services Research (inav), Berlin, Germany
| | - Inga Claus
- Department of Neurology, University of Münster, Münster, Germany
| | - Michelle Kutscher
- Institute for Applied Health Services Research (inav), Berlin, Germany
| | | | | | - Tessa Huchtemann
- Department of Neurology, University of Münster, Münster, Germany
| | - Tobias Warnecke
- Department of Neurology, University of Münster, Münster, Germany
- Department of Neurology and Neurorehabilitation, Klinikum Osnabrück, University of Münster, Osnabrück, Germany
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Peltonen J, Leino-Kilpi H, Heikkilä H, Rautava P, Tuomela K, Siekkinen M, Sulosaari V, Stolt M. Instruments measuring interprofessional collaboration in healthcare - a scoping review. J Interprof Care 2019; 34:147-161. [PMID: 31331216 DOI: 10.1080/13561820.2019.1637336] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Worldwide there is growing understanding of the importance of interprofessional collaboration in providing well-functioning healthcare. However, little is known about how interprofessional collaboration can be measured between different health-care professionals. In this review, we aim to fill this gap, by identifying and analyzing the existing instruments measuring interprofessional collaboration in healthcare. A scoping review design was applied. A systematic literature search of two electronic databases, Medline (PubMed) and CINAHL, was conducted in 03/2018. The search yielded 1020 studies, of which 35 were selected for the review. The data were analyzed by content analysis. In total, 29 instruments measuring interprofessional collaboration were found. Interprofessional collaboration was measured predominantly between nurses and physicians with different instruments in various health-care settings. Psychometric testing was unsystematic, focusing predominantly on construct and content validity and internal consistency, thus further validation studies with comprehensive testing are suggested. The results of this review can be used to select instruments measuring interprofessional collaboration in practice or research. Future research is needed to strengthen the evidence of reliability and validity of these instruments.
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Affiliation(s)
- Johanna Peltonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Heli Heikkilä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Turku, Finland.,Turku Clinical Centre, Turku University Hospital, Turku, Finland
| | | | - Mervi Siekkinen
- Western Finland Cancer Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Virpi Sulosaari
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Health and Well-being, Turku University of Applied Sciences, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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Peterson K, Anderson J, Bourne D, Charns MP, Gorin SS, Hynes DM, McDonald KM, Singer SJ, Yano EM. Health Care Coordination Theoretical Frameworks: a Systematic Scoping Review to Increase Their Understanding and Use in Practice. J Gen Intern Med 2019; 34:90-98. [PMID: 31098976 PMCID: PMC6542910 DOI: 10.1007/s11606-019-04966-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Care coordination is crucial to avoid potential risks of care fragmentation in people with complex care needs. While there are many empirical and conceptual approaches to measuring and improving care coordination, use of theory is limited by its complexity and the wide variability of available frameworks. We systematically identified and categorized existing care coordination theoretical frameworks in new ways to make the theory-to-practice link more accessible. METHODS To identify relevant frameworks, we searched MEDLINE®, Cochrane, CINAHL, PsycINFO, and SocINDEX from 2010 to May 2018, and various other nonbibliographic sources. We summarized framework characteristics and organized them using categories from the Sustainable intEgrated chronic care modeLs for multi-morbidity: delivery, FInancing, and performancE (SELFIE) framework. Based on expert input, we then categorized available frameworks on consideration of whether they addressed contextual factors, what locus they addressed, and their design elements. We used predefined criteria for study selection and data abstraction. RESULTS Among 4389 citations, we identified 37 widely diverse frameworks, including 16 recent frameworks unidentified by previous reviews. Few led to development of measures (39%) or initiatives (6%). We identified 5 that are most relevant to primary care. The 2018 framework by Weaver et al., describing relationships between a wide range of primary care-specific domains, may be the most useful to those investigating the effectiveness of primary care coordination approaches. We also identified 3 frameworks focused on locus and design features of implementation that could prove especially useful to those responsible for implementing care coordination. DISCUSSION This review identified the most comprehensive frameworks and their main emphases for several general practice-relevant applications. Greater application of these frameworks in the design and evaluation of coordination approaches may increase their consistent implementation and measurement. Future research should emphasize implementation-focused frameworks that better identify factors and mechanisms through which an initiative achieves impact.
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Affiliation(s)
- Kim Peterson
- Department of Veterans Affairs, VA Portland Health Care System, Evidence-based Synthesis Program (ESP) Coordinating Center, Portland, OR, USA.
| | - Johanna Anderson
- Department of Veterans Affairs, VA Portland Health Care System, Evidence-based Synthesis Program (ESP) Coordinating Center, Portland, OR, USA
| | - Donald Bourne
- Department of Veterans Affairs, VA Portland Health Care System, Evidence-based Synthesis Program (ESP) Coordinating Center, Portland, OR, USA
| | - Martin P Charns
- VA HSR&D Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA.,Boston University School of Public Health, Boston, MA, USA
| | - Sherri Sheinfeld Gorin
- New York Physicians against Cancer (NYPAC), New York, NY, USA.,The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Denise M Hynes
- Department of Veterans Affairs, VA Portland Health Care System, Portland, OR, USA.,Oregon State University, Corvallis, OR, USA
| | | | - Sara J Singer
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University Graduate School of Business, Stanford, CA, USA
| | - Elizabeth M Yano
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Boston, MA, USA.,Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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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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Multidisciplinary teams and ICT: a qualitative study exploring the use of technology and its impact on multidisciplinary team meetings. BMC Health Serv Res 2018; 18:444. [PMID: 29898716 PMCID: PMC6001028 DOI: 10.1186/s12913-018-3242-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 05/28/2018] [Indexed: 01/14/2023] Open
Abstract
Background Multidisciplinary teams (MDTs) are an integral component in the delivery of health care. This is particularly evident in the delivery of cancer care, where multidisciplinary teams are internationally recognized as the preferred method for service delivery. The use of health information systems and technology are key enabling factors for building the capacity of MDTs to engage in improvement and implementation projects but there is scant research on how MDTs make use of technology and information systems or the kinds of systems needed for them to undertake improvement and implementation research. This paper reports findings on how seven MDTs in cancer care utilized technological and information systems and the barriers and enabling factors that impacted on their uptake. Methods Seven multidisciplinary teams from two large metropolitan hospitals participated in the study. Qualitative methods including structured observations and semi structured interviews that explored how teams engaged in research and improvement activities were utilized. Participants were also observed and interviewed in relation to their use of data and health information systems. Findings were subject to content analysis and key themes were identified. Interviews were transcribed and de-identified and key themes were subsequently discussed with participants to allow for member checking and further clarification of findings. Results A total of 43 MDT meetings across seven tumor streams were observed. Of these, observation notes from 13 meetings contained direct references to emerging technologies and health information systems. Findings from 15 semi-structured interviews were also analyzed in relation to how MDTs used technology in weekly meetings, and the perceived impact of technology. Three broad themes emerged: (1) methods for data collection and use by MDTs, (2) the impact of technology on the MDT meeting environment, and (3) the impact of technology and information systems on clinical decision making. Conclusion The study demonstrates that real time data collection and imaging may improve patient centered care coordination. However, ICTs can be used sub-optimally by teams. We therefore urge additional research to identify the enabling factors that support better collection and use of outcome data from ICT. Electronic supplementary material The online version of this article (10.1186/s12913-018-3242-3) contains supplementary material, which is available to authorized users.
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Clouston TJ, Whitcombe SW, Jenkins J, Mears J. Evaluation of interprofessional working on a therapist/nurse-led rehabilitation ward for older people in Wales. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.4.193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Judyth Jenkins
- Head of Dietetics Services, Cardiff & Vale University Health Board
| | - Julie Mears
- Head of Occupational Therapy Services, Cardiff and Vale University Health Board
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