Conceptualizing a Quantitative Measurement Suite to Evaluate Healthcare Teams

Background Current team assessment instruments in healthcare tend to involve rater-based evaluations that are susceptible to well-known biases. Recent advances in technology include portable devices to measure team-based activities. Consequently, the possibility exists to move away from rater-based assessments of team function by identifying quantitative measures to replace them. Aim This article aims to provide potential approaches to developing quantitative measurement suites involving large amounts of data to address the challenges of assessment presented by the complex nature of teamwork. Conclusion By addressing construct, measurement, and context components, we provide a practical approach to developing a suite to capture quantitative measurements that, through incorporation of social network analysis and aggregated other values, aligns with the Team Strategies & Tools to Enhance Performance and Patient SafetyTM (TeamSTEPPSTM) dimensions for fostering teamwork.

Undergraduate Medical Training in Communication Skills

Communication skills are important for physicians, as they are continuously in contact with human beings—patients, families, or members of healthcare teams—in various circumstances. At Universidad de los Andes' School of Medicine, these skills are a fundamental part of the curriculum and the subject of two undergraduate concentration courses. The purpose of this chapter is to present the experience of transitioning one of these courses, Communication Skills II, from face-to-face to a virtual learning environment as a response to the COVID-19 pandemic. It describes the rationale behind teaching communication skills, illustrates how the course was developed and taught face-to-face, presents the challenges posed the COVID-19 pandemic, explains the transition of the course to a virtual learning environment, and concludes by offering an overview of the evaluations and perceptions of the course, as taught in the virtual environment, by those involved in it.

Twelve tips to facilitate Interprofessional Education and Collaborative Practice with students on placements in healthcare settings

It is acknowledged that the adverse effects of the COVID-19 pandemic will be long-lasting on healthcare organisations. Consequently, healthcare teams will need to work more collaboratively, supporting each other better in the post-pandemic period. Pre-registration clinical placements in healthcare settings provide an ideal opportunity to instil Interprofessional Education and Collaborative Practice (IPECP) skills, values, and competencies in students early-on. It is a common belief that teams need to have students from two or more professions to facilitate IPECP. Whilst this may be the ideal scenario, healthcare settings were struggling even prior to the pandemic to orchestrate such placement opportunities given the complicated logistics and their resource-intensive nature. This 12 tips paper provides clinical educators with practical tips to facilitate IPECP across the whole continuum from a single student on placement, to several students from two or more professions on placement at the same time. These tips, by promoting IPECP in all student placements, have the potential to re-energise IPECP in healthcare settings, thereby contributing to better outcomes for healthcare professionals, organisations, and service users.

Effects of an external ventricular drain alert protocol on venticulostomy placement time in the emergency department

OBJECTIVE Timely ventriculostomy placement is critical in the management of neurosurgical emergencies. Prompt external ventricular drain (EVD) placement has been shown to improve long-term patient outcomes and decrease the length of ICU and hospital stays. Successful and efficient EVD placement requires seamless coordination among multiple healthcare teams. In this study, the authors sought to identify factors favoring delayed ventriculostomy via a quality improvement initiative and to implement changes to expedite EVD placement. METHODS Through process mapping, root cause analysis, and interviews with staff, the authors identified the lack of a standardized mechanism for alerting necessary healthcare teams as a major contributor to delays in EVD placement. In December 2019, an EVD alert system was developed to automatically initiate an EVD placement protocol and to alert the neurosurgery department, pharmacy, core laboratory, and nursing staff to prepare for EVD placement. The time to EVD placement was tracked prospectively using time stamps in the electronic medical record. RESULTS A total of 20 patients who underwent EVD placement between December 2019 and April 2021, during the EVD alert protocol initiation, and 18 preprotocol control patients (January 2018 to December 2019) met study inclusion criteria and were included in the analysis. The mean time to EVD placement in the control group was 71.88 minutes compared with 50.3 minutes in the EVD alert group (two-tailed t-test, p = 0.025). The median time to EVD placement was 64 minutes in the control group compared with 52 minutes in the EVD alert group (rank-sum test, p = 0.0184). All patients from each cohort exhibited behavior typical of stable processes, with no violation of Shewhart rules and no special cause variations on statistical process control charts. CONCLUSIONS A quality improvement framework helped identify sources of delays to EVD placement in the emergency department. An automated EVD alert system was a simple intervention that significantly reduced the time to EVD placement in the emergency department and can be easily implemented at other institutions to improve patient care.

Optimizing Military Medicine: A Team Approach

ABSTRACT In order to best optimize health care, we need the right combination of individuals working on interprofessional health care teams, each joining with the right mindset, in the right places, and at the right times. In this special issue of Military Medicine, Dr. Lara Varpio and her team share their findings investigating the unique dynamics of Military Interprofessional Healthcare Teams. Such research is fundamental to advance excellence of military health care by finding, exploring, and addressing existing gaps in what we currently employ and capitalizing on what we know works well. In doing so, we can improve the effectiveness of our care teams and, as a result, optimize care of our wounded on the battlefield.