scholarly journals MP21: Improving the relational aspects of trauma care through translational simulation

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S49-S50
Author(s):  
E. Purdy ◽  
C. Alexander ◽  
J. Matulich ◽  
V. Brazil
Keyword(s):  
Trauma Care ◽  
Simulation Program ◽  
Shared Knowledge ◽  
Free Text ◽  
Relational Coordination ◽  
Mutual Respect ◽  
Trauma Service ◽  
Shared Goals ◽  
The Impact ◽  
Inductive Analysis

Introduction: Major trauma care is complex, and requires individuals and teams to perform together in time critical, high stakes situations. Scenario based simulation is well established as a strategy for trauma teamwork improvement, but its role in the relational and cultural aspects of trauma care is less well understood. Relational Coordination theory offers a framework though which we aimed to understand the impact of an established trauma simulation program Methods: We studied simulation activities using a narrative survey of trauma providers from anaesthesia, emergency medicine, medical imaging, surgery, trauma service, intensive care and pre-hospital providers at Gold Coast University Hospital, in conjunction with data from an ethnography. Data analysis was performed using a recursive approach - a simultaneous deductive approach using the relational coordination framework and an inductive analysis. Results: 95/480 (19.8%) staff completed free text survey questions on simulation. Deductive analysis of data from this narrative survey results using the RC framework domains identified examples of shared goals, shared knowledge, communication, and mutual respect. Two major themes from the inductive analysis – “Behaviour, process and system change”, and “Culture and relationships” - aligned closely with findings from the RC analysis, with additional themes of “Personal and team learning” and the “Impact of the simulation experience” identified. Conclusion: Our findings suggest that an established trauma simulation program can have a profound impact on the relational aspects of care and the development of a collaborative culture, with perceived tangible impacts on teamwork behaviours and institutional systems and processes. The RC framework – shared knowledge, shared goals and mutual respect in the context of communication that is timely, accurate, frequent and problem-solving based – can provide a common language for simulation educators to design and debrief simulation exercises that aim to have a translational impact.

Managing the multiply injured patient: the impact of multidisciplinary teams

2019 ◽  
Vol 80 (12) ◽  
pp. 703-706
Author(s):  
Jonathan French ◽  
Lewis M Agius ◽  
Nemandra A Sandiford
Keyword(s):  
Trauma Care ◽  
Care Delivery ◽  
National Level ◽  
Injured Patient ◽  
Improve Patient Care ◽  
Multidisciplinary Teams ◽  
Team Approach ◽  
Trauma Service ◽  
Multiply Injured Patient ◽  
The Impact

Management of trauma has been tackled at a national level to improve patient care and mortality. Decision making through a multidisciplinary team approach has resulted in improved patient outcomes through a complex combination of changes. While the focus of trauma care delivery has been towards establishing an effective multidisciplinary trauma service, there are still improvements which can be made. This article reviews the history of trauma care in the UK, and the impact that multidisciplinary teams have had on the management of the multiply injured patient.

Revisiting Relational Coordination: A Systematic Review

2021 ◽  
pp. 002188632199159
Author(s):  
Rendelle Bolton ◽  
Caroline Logan ◽  
Jody Hoffer Gittell
Keyword(s):  
Systematic Review ◽  
Problem Solving ◽  
Empirical Evidence ◽  
Empirical Studies ◽  
Linear Structure ◽  
Shared Knowledge ◽  
Relational Coordination ◽  
Mutual Respect ◽  
Multiple Stakeholders ◽  
Process Outcomes

Work is increasingly complex, specialized, and interdependent, requiring coordination across roles, disciplines, organizations, and sectors to achieve desired outcomes. Relational coordination theory proposes that relationships of shared goals, shared knowledge, and mutual respect help to support frequent, timely, accurate, problem-solving communication, and vice versa, enabling stakeholders to effectively coordinate their work across boundaries. While the theory contends that cross-cutting structures can strengthen relational coordination, and that relational coordination promotes desired outcomes for multiple stakeholders, the empirical evidence supporting the theory has not previously been synthesized. In this article, we systematically review all empirical studies assessing the predictors and outcomes of relational coordination published from 1991 to 2019. We find evidence supporting the existing theory and discuss how that evidence supports expanding the theory from a linear structure–process–outcomes model to a dynamic model of change. An agenda for researchers and practitioners is proposed.

scholarly journals ESSENTIAL DRUG MANAGEMENT AT RSU KARSA HUSADA BATU: POLICY IMPLEMENTATION

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Setya Haksama ◽  
Yeni Farida Istanti ◽  
Windhu Purnomo ◽  
Stefanus Supriyanto ◽  
Samsul Arifin ◽  
...  
Keyword(s):  
Problem Solving ◽  
Quantitative Research ◽  
Public Hospital ◽  
Hospital Staff ◽  
Shared Knowledge ◽  
Mutual Respect ◽  
Drug Management ◽  
Essential Drug ◽  
Drug Procurement ◽  
Shared Goals

Coordination in hospital is important process needed to reach the organization’s goals. One of the process that need coordination among cross-functional unit is essential drug procurement. The essential drug in Karsa Husada Batu Public Hospital (RSU Karsa Husada Batu) were often in out of stock condition in some specific kinds of drug. The average of  essential drug  out of stock between year of 2017 until the first semester of 2018 reached 33,73%. This number was far from the ideal standard of 0% out of stock condition. This research was aimed to give recommendation for a better coordination of essential drug management. The study used quantitative research. The population in this research was all hospital staff who participate in essential  drug procurement in Karsa Husada Batu. Public Hospital. There were 29 samples as the respondents in this research. The variables in this research were frequently communication, timely communication, accurately communication, problem solving communication, shared knowledge, mutual respect, and shared goals. The result from the study showed that communication reached good result consist of frequently communication is good (69,00%), timely communication is good (65,50 %), accurately communicationis good (79,30%), problem solving communication is good (69,00%), shared knowledge is good (58,62%), but the mutual respect is not good (58,60%), and shared goals is not good (65,52%).

scholarly journals Organizational Differences among Universities in Three Socioeconomic Contexts: Finland, Spain and Ecuador. Relational Coordination Approach

2021 ◽  
Vol 11 (8) ◽  
pp. 445
Author(s):  
Cristina Checa-Morales ◽  
Carmen De-Pablos-Heredero ◽  
Angela Lorena Carreño ◽  
Sajid Haider ◽  
Antón García
Keyword(s):  
Discriminant Analysis ◽  
Problem Solving ◽  
Student Satisfaction ◽  
Shared Knowledge ◽  
Relational Coordination ◽  
Competitive Strategies ◽  
Discriminant Model ◽  
Organizational Differences ◽  
Shared Goals ◽  
Discriminant Power

The knowledge of local culture is essential to establish competitive strategies in higher education. The objective of this research was to identify the organizational differences among three universities with different international contexts and satisfaction level. An approach was made regarding Relational Coordination (RC) attributes: accurate, frequent and problem-solving communication, shared knowledge, mutual respect and shared goals, by discriminant analysis method. A random sample of 300 students, 100 belonging to each university, was surveyed on the 23 RC variables in 2017–2018. First, the RC variables were evaluated by general linear model (GLM). The three universities—Arcada University of Applied Science (ARCADA) in Finland, University of Cordoba (UCO) in Spain and Agricultural Polytechnic of Manabi “MFL” (ESPAM) in Ecuador—and the two levels of student satisfaction—Low and High—were used as fixed factors. Second, a discriminant model was built with RC variables. A higher level of RC practices concerning to accurate, frequent and problem-solving communication achieved higher levels of satisfaction, regardless of the universities’ socioeconomic context. RC differentiation among three universities showed that shared goals with lecturers and administrative officers and problem-solving communication among classmates were the variables with the highest discriminant power. Two clusters were obtained, where UCO was the most differentiated university. In conclusion, organizational practices made a difference among the three universities. Discriminant analysis can be adapted and extended to different universities to improve quality.

Burden of Congenital Rubella Syndrome (CRS) in Bangladesh: Systematic Review of Existing Literature and Transmission Modelling of Seroprevalence Studies

2020 ◽  
Vol 20 (3) ◽  
pp. 284-290
Author(s):  
Jocelyn Chan ◽  
Yue Wu ◽  
James Wood ◽  
Mohammad Muhit ◽  
Mohammed K. Mahmood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deterministic Model ◽  
Case Series ◽  
Controlled Vocabulary ◽  
Congenital Rubella Syndrome ◽  
Free Text ◽  
Childbearing Age ◽  
Vaccination Programs ◽  
Congenital Rubella ◽  
The Impact

Background and Objectives: Congenital Rubella Syndrome (CRS) is the leading cause of vaccine-preventable congenital anomalies. Comprehensive country-level data on the burden of CRS in low and middle-income countries, such as Bangladesh, are scarce. This information is essential for assessing the impact of rubella vaccination programs. We aim to systematically review the literature on the epidemiology of CRS and estimate the burden of CRS in Bangladesh. Methods: We conducted a systematic review of existing literature and transmission modelling of seroprevalence studies to estimate the pre-vaccine period burden of CRS in Bangladesh. OVID Medline (1948 – 23 November 2016) and OVID EMBASE (1974 – 23 November 2016) were searched using a combination of the database-specific controlled vocabulary and free text terms. We used an age-stratified deterministic model to estimate the pre-vaccination burden of CRS in Bangladesh. Findings: Ten articles were identified, published between 2000 and 2014, including seven crosssectional studies, two case series and one analytical case-control study. Rubella seropositivity ranged from 47.0% to 86.0% among all age population. Rubella sero–positivity increased with age. Rubella seropositivity among women of childbearing age was 81.0% overall. The estimated incidence of CRS was 0·99 per 1,000 live births, which corresponds to approximately 3,292 CRS cases annually in Bangladesh. Conclusion: The estimated burden of CRS in Bangladesh during the pre-vaccination period was high. This will provide important baseline information to assess the impact and cost-effectiveness of routine rubella immunisation, introduced in 2012 in Bangladesh.

scholarly journals Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

2021 ◽  
pp. 026921632110198
Author(s):  
Catriona R Mayland ◽  
Rosemary Hughes ◽  
Steven Lane ◽  
Tamsin McGlinchey ◽  
Warren Donnellan ◽  
...  
Keyword(s):  
Public Health ◽  
Family Support ◽  
Online Survey ◽  
Free Text ◽  
Professional Networks ◽  
Dying Patients ◽  
The Face ◽  
Individualised Care ◽  
The Impact ◽  
Informative Communication

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

scholarly journals Adult Learning Principles and Peer Delivery Improve Satisfaction of Electronic Medical Record Onboarding Education

ACI Open ◽  
2020 ◽  
Vol 04 (02) ◽  
pp. e114-e118
Author(s):  
Joanna Lawrence ◽  
Sharman Tan Tanny ◽  
Victoria Heaton ◽  
Lauren Andrew
Keyword(s):  
Adult Learning ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Junior Doctors ◽  
Free Text ◽  
Organizational Safety ◽  
Adult Learning Principles ◽  
Learning Practices ◽  
Learning Principles ◽  
The Impact

Abstract Objectives Given the importance of onboarding education in ensuring the safety and efficiency of medical users in the electronic medical record (EMR), we re-designed our EMR curriculum to incorporate adult learning principles, informed and delivered by peers. We aimed to evaluate the impact of these changes based on their satisfaction with the training. Methods A single site pre- and post-observational study measured satisfaction scores (four questions) from junior doctors attending EMR onboarding education in 2018 (pre-implementation) compared with 2019 (post-implementation). An additional four questions were asked in the post-implementation survey. All questions employed a Likert scale (1–5) with an opportunity for free-text. Raw data were used to calculate averages, standard deviations and the student t-test was used to compare the two cohorts where applicable. Results There were a total of 98 respondents in 2018 (pre-implementation) and 119 in 2019 (post-implementation). Satisfaction increased from 3.8/5 to 4.5/5 (p < 0.0001) following implementation of a peer-delivered curriculum in line with adult learning practices. The highest-rated factors were being taught by other doctors (4.9/5) and doctors having the appropriate knowledge to deliver training (4.9/5). Ninety-two percent of junior doctors were motivated to engage in further EMR education and 90% felt classroom support was adequate. Conclusion EMR onboarding education for medical users is a critical ingredient to organizational safety and efficiency. An improvement in satisfaction ratings by junior doctors was demonstrated after significant re-design of the curriculum was informed and delivered by peers, in line with adult learning principles.

scholarly journals The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

2021 ◽  
Author(s):  
Suzan Dijkink ◽  
Erik W. van Zwet ◽  
Pieta Krijnen ◽  
Luke P. H. Leenen ◽  
Frank W. Bloemers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Future Research ◽  
Severely Injured ◽  
Trauma Centers ◽  
Severely Injured Patients ◽  
The Right ◽  
Injured Patients ◽  
The Impact

Abstract Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

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