Effective Strategies for Teaching Teamwork

2019 ◽  
Vol 39 (4) ◽  
pp. 40-47 ◽  
Author(s):  
Joni L. Dirks
Keyword(s):  
Critical Care ◽  
Health Care Providers ◽  
Ad Hoc ◽  
Care Providers ◽  
Ability To Work ◽  
Immediate Feedback ◽  
Effective Strategies ◽  
Effectiveness Of Training ◽  
Ad Hoc Teams ◽  
Term Management

Teamwork is essential for health care providers, who must work together to ensure safe and effective patient care. The ability to function effectively as a team is especially important in critical care, where ad hoc teams are brought together for short-term management of crisis situations. Teamwork training has been widely implemented, but ongoing education and practice are needed to maintain and improve competency. This article reviews some of the literature on team science and provides recommendations for enhancing training to promote development of a shared mental model. Strategies such as ensuring multidisciplinary participation, clarifying team resources and goals, and creating practice scenarios can increase the effectiveness of training for critical care teams. Evaluation can provide immediate feedback on learning outcomes and may facilitate subsequent transfer of learning to the clinical setting. Interventions that improve a team’s ability to work toward a common goal can improve outcomes for critically ill patients.

scholarly journals Innovative COVID-19 Programs to Rapidly Serve New Mexico

2020 ◽  
Vol 136 (1) ◽  
pp. 39-46
Author(s):  
Joanna G. Katzman ◽  
Laura E. Tomedi ◽  
Karla Thornton ◽  
Paige Menking ◽  
Michael Stanton ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Critical Care ◽  
New Mexico ◽  
General Education ◽  
Health Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Project Echo

Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico is a telementoring program that uses videoconferencing technology to connect health care providers in underserved communities with subject matter experts. In March 2020, Project ECHO created 10 coronavirus disease 2019 (COVID-19) telementoring programs to meet the public health needs of clinicians and teachers living in underserved rural and urban regions of New Mexico. The newly created COVID-19 programs include 7 weekly sessions (Community Health Worker [in English and Spanish], Critical Care, Education, First-Responder Resiliency, Infectious Disease Office Hours, and Multi-specialty) and 3 one-day special sessions. We calculated the total number of attendees, along with the range and standard deviation, per session by program. Certain programs (Critical Care, Infectious Disease Office Hours, Multi-specialty) recorded the profession of attendees when available. The Project ECHO research team collected COVID-19 infection data by county from March 11 through May 31, 2020. During that same period, 9765 health care and general education professionals participated in the COVID-19 programs, and participants from 31 of 35 (89%) counties in New Mexico attended the sessions. Our initial evaluation of these programs demonstrates that an interprofessional clinician group and teachers used the Project ECHO network to build a community of practice and social network while meeting their educational and professional needs. Because of Project ECHO’s large reach, the results of the New Mexico COVID-19 response suggest that the rapid use of ECHO telementoring could be used for other urgent national public health problems.

Guidelines for the Reporting of Nongynecologic Cytopathology Specimens

2009 ◽  
Vol 133 (11) ◽  
pp. 1743-1756
Author(s):  
Barbara A. Crothers ◽  
William D. Tench ◽  
Mary R. Schwartz ◽  
Joel S. Bentz ◽  
Ann T. Moriarty ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ad Hoc ◽  
Clinical Laboratory ◽  
Needle Aspiration ◽  
Health Care Team ◽  
Major Elements ◽  
Pathology Report ◽  
Care Providers ◽  
Healthcare Organizations

Abstract Context.—Gynecologic cytology terminology and report formatting have been nationally standardized since the implementation of The Bethesda System of 1988, but standard reporting for nongynecologic cytology has never been formally addressed on the same scale. Objectives.—To promote patient safety through uniform reporting in nongynecologic cytology (including fine-needle aspiration cytology) and to improve communication between laboratories and health care providers. Data Sources.—Sources include the College of American Pathologists Cytopathology Resource Committee; the College of American Pathologists Council on Scientific Affairs Ad Hoc Committee on Pathology Report Standardization; the College of American Pathologists Laboratory Accreditation Program inspection checklists; the Joint Commission for Accreditation of Healthcare Organizations; and the Clinical Laboratory Improvement Amendments of 1988. Conclusions.—We describe the major elements of quality nongynecologic cytology reporting and discuss areas of controversy in cytology reporting. Standardized nongynecologic specimen reporting will expand the concept of common report elements already widely implemented in gynecologic cytology reporting. The intent is to improve communication with the health care team while remaining in compliance with federal mandates and accreditation guidelines.

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

Faculty Reflections on Effective Strategies Utilized to Implement Simulation-Enhanced IPE for Future Health Care Providers

2020 ◽  
Vol 46 ◽  
pp. 22-29
Author(s):  
Penni I. Watts ◽  
Todd Peterson ◽  
Michelle Brown ◽  
Dawn Taylor Peterson ◽  
Tracie White ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Future Health ◽  
Effective Strategies ◽  
Future Health Care

Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi

2019 ◽  
Vol 14 (2) ◽  
pp. 152-168
Author(s):  
Lucinda Manda-Taylor ◽  
Alice Liomba ◽  
Terrie E. Taylor ◽  
Kristan Elwell
Keyword(s):  
Critical Care ◽  
Informed Consent ◽  
Clinical Research ◽  
Critically Ill ◽  
Health Care Providers ◽  
Pediatric Intensive Care ◽  
Research Participant ◽  
Critically Ill Children ◽  
Parental Distress ◽  
Care Providers

Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures.

A Novel ICU Hand-Over Tool: The Glass Door of the Patient Room

2016 ◽  
Vol 32 (8) ◽  
pp. 514-519 ◽  
Author(s):  
Brian T. Wessman ◽  
Carrie Sona ◽  
Marilyn Schallom
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Health Care Providers ◽  
Night Shift ◽  
Surgical Trauma ◽  
Care Providers ◽  
Improvement Project ◽  
Glass Door ◽  
Patient Handover ◽  
Communication Errors

Background: Poor communication among health-care providers is cited as the most common cause of sentinel events involving patients. Patient care in the critical care setting is incredibly complex. A consistent care plan is necessary between day/night shift teams and among bedside intensive care unit (ICU) nurses, consultants, and physicians. Our goal was to create a novel, easily accessible communication device to improve ICU patient care. Methods: This communication improvement project was done at an academic tertiary surgical/trauma/mixed 36-bed ICU with an average of 214 admissions per month. We created a glass door template embossed on the glass that included 3 columns for daily goals to be written: “day team,” “night team,” and “surgery/consultant team.” Assigned areas for tracking “lines,” “antibiotics,” “ventilator weaning,” and “Deep vein thrombosis (DVT) screening” were included. These doors are filled out/updated throughout the day by all of the ICU providers. All services can review current plans/active issues while evaluating the patient at the bedside. Patient-identifying data are not included. We retrospectively reviewed all ICU safety reported events over a 4-year period (2 years prior/2 years after glass door implementation) for specific handover communication-related errors and compared the 2 cohorts. Results: Information on the glass doors is entered daily on rounds by all services. Prior to implementation, 7.96% of reported errors were related to patient handover communication errors. The post glass-door era had 4.26% of reported errors related to patient handover communication errors with a relative risk reduction of 46.5%. Due to its usefulness, this method of communication was quickly adopted by the other critical care services (cardiothoracic, medical, neurology/neurosurgery, cardiology) at our institution and is now used for over 150 ICU beds. Conclusions: Our glass door patient handover tool is an easily adaptable intervention that has improved communication leading to an overall decrease in the number of handover communication errors.

Pediatric Triage and Allocation of Critical Care Resources During Disaster: Northwest Provider Opinion

2014 ◽  
Vol 29 (5) ◽  
pp. 455-460 ◽  
Author(s):  
Erin Margaret Johnson ◽  
Douglas S. Diekema ◽  
Mithya Lewis-Newby ◽  
Mary A. King
Keyword(s):  
Critical Care ◽  
Hurricane Katrina ◽  
Health Care Providers ◽  
Health Workers ◽  
Cognitive Outcome ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Publication Type ◽  
Pediatric Critical Care ◽  
Pediatric Hospitals

AbstractIntroductionFollowing Hurricane Katrina and the 2009 H1N1 epidemic, pediatric critical care clinicians recognized the urgent need for a standardized pediatric triage/allocation system. This study collected regional provider opinion on issues of care allocation and pediatric triage in a disaster/pandemic setting.MethodsThis study was a cross-sectional survey of United States (US) health care providers and public health workers who demonstrated interest in critical care and/or disaster care medicine by attending a Northwest regional pediatric critical care symposium on disaster preparation, held in 2012 at Seattle Children's Hospital in Seattle, Washington (USA). The survey employed an electronic audience response system and included demographic, ethical, and logistical questions. Differences in opinions between respondents grouped by professions and work locations were evaluated using a chi-square test.ResultsOne hundred and twelve (97%) of 116 total attendees responded to at least one question; however, four of these responders failed to answer every question. Sixty-two (55%) responders were nurses, 29 (26%) physicians, and 21 (19%) other occupations. Fifty-five (51%) responders worked in pediatric hospitals vs 53 (49%) in other locations. Sixty-three (58%) of 108 successful responses prioritized children predicted to have a good neuro-cognitive outcome. Seventy-one (68%) agreed that no pediatric age group should be prioritized. Twenty-two (43%) of providers working in non-pediatric hospital locations preferred a triage system based on an objective score alone vs 14 (26%) of those in pediatric hospitals (P = .038).JohnsonEM, DiekemaDS, Lewis-NewbyM, KingMA. Pediatric triage and allocation of critical care resources during disaster: Northwest provider opinion. Prehosp Disaster Med. 2014;29(5):1-6.

Behavioural Interventions in Primary Care: An Implementation Trial

2008 ◽  
Vol 27 (2) ◽  
pp. 179-189 ◽  
Author(s):  
Dan Bilsker ◽  
John Anderson ◽  
Joti Samra ◽  
Elliot Goldner ◽  
David Streiner
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Best Practice ◽  
Management Approach ◽  
Care Providers ◽  
Intervention Delivery ◽  
Effective Strategies ◽  
Best Practice Guidelines ◽  
Risky Alcohol ◽  
Depression Intervention

Developing effective strategies to keep health care providers' practice current with best practice guidelines has proven to be challenging. This trial was conducted to determine the potential for using brief educational sessions to generate significant change in physician delivery of mental health and substance use interventions in primary care. A 1-hour educational session outlining interventions for depression and risky alcohol use was delivered to a sample of 85 family physicians. The interventions used a supported self-management approach and included free patient access to appropriate selfmanagement resources. The study initially evaluated physicians' implementation of these interventions over a 2-month period. Physician uptake of the depression intervention was significantly greater than uptake of the risky-drinking intervention (32% versus 10%). A follow-up at 6-months posttraining (depression intervention only) demonstrated fairly good maintenance of intervention delivery. Implications of these findings are discussed.

Improving Health Care Provider Communication in End-of-Life Decision-Making

2017 ◽  
Vol 28 (2) ◽  
pp. 124-132 ◽  
Author(s):  
Tracey Wilson ◽  
Cathy Haut ◽  
Bimbola Akintade
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Critical Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Care Providers ◽  
Improvement Project ◽  
Daunting Task ◽  
End Of Life Decision ◽  
Life Decision

Critical care providers are responsible for many aspects of patient care, primarily focusing on preserving life. However, nearly 40% of patients who are admitted to an adult critical care unit will not survive. Initiating a conversation about end-of-life decision-making is a daunting task. Often, health care providers are not trained, experienced, or comfortable facilitating these conversations. This article describes a quality improvement project that identified current views on end-of-life communication in the intensive care unit and potential barriers that obstruct open discussion, and offering strategies for improvement.

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