Five Tips for Successful Conflict Negotiation in the Breast Imaging Workplace

2020 ◽  
Author(s):  
Michael D C Fishman ◽  
Priscilla J Slanetz
Keyword(s):  
Patient Outcomes ◽  
Breast Imaging ◽  
Workplace Conflict ◽  
Team Members ◽  
Just Culture ◽  
Work Related ◽  
Conflict Negotiation ◽  
Difficult Conversations ◽  
Low Levels ◽  
Toxic Culture

Abstract Conflict in the workplace is inevitable and disruptive to the team dynamic, ultimately leading to suboptimal patient outcomes if not addressed. Especially in breast imaging, where an interprofessional team is commonplace, spending time to address conflict is critical to building and maintaining relationships among team members. Although institutions may adopt a just culture, workplace paradigms can be challenged when two or more team members encounter misunderstandings around work-related or personal issues. Multiple factors can contribute to promoting workplace conflict, including a toxic culture (the antithesis of just culture), ineffective leadership, hierarchy, unclear expectations or goals, pre-existing assumptions and beliefs, lack of effective communication, and low levels of trust. Developing skills to engage in the difficult conversations to address and resolve conflict are essential to create an efficient and effective team to care for patients. In this manuscript, we provide tips on how each of us can build skills in conflict management and resolution, illustrated in several vignettes. These tips provide practical advice, which ultimately will translate into allowing us to provide better patient care every day.

Abstract 105: Accuracy of Team Perception of Performance With Actual CPR Quality Metrics in Children

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Lynda Knight ◽  
Todd Sweberg ◽  
Pual Mullan ◽  
Anita Sen ◽  
Matthew Braga ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Language Processing ◽  
American Heart ◽  
Qualitative Content Analysis ◽  
Heart Association ◽  
Prospective Data ◽  
Team Members ◽  
Assessment Measure ◽  
Cpr Quality ◽  
Perception Of Performance

Background: American Heart Association (AHA) recommends high quality CPR to promote optimal patient outcomes. Few reports compare team members’ perceptions of CPR quality with quantitative CPR data during actual pediatric CPR. Hypothesis: Self-reported team perception of CPR performance will not meet quantitative CPR metrics using AHA BLS guideline criteria. Methods: Prospective data from an international pediatric (pediRES-Q) resuscitation collaborative from February 2016 to August 2017. A modified Team Emergency Assessment Measure framework for qualitative content analysis was used to assess data from “hot” debriefings (held soon after arrest) by language processing experts blinded to CPR data. Events without reported perception of CPR and quantitative CPR data were excluded. Comments regarding CPR perception were grouped as either Plus perceptions of performance (PPP) or Delta perceptions of performance (DPP). Grouped events were matched and compared to quantitative CPR data of chest compression (CC) fraction (CCF), rate, and depth as collected by CPR-recording defibrillators. Compliance with AHA BLS guidelines were defined as events with mean: CCF >60%, CC rate 100-120/min; and CC depth for infants <1yo, ~4 cm (3.6-4.4 cm.); children 1-18 yo, 5-≤6 cm. Results: Of 227 arrests, 108 (48%) hot debriefings were reported. Reported CPR perceptions with paired quantitative CPR data were available for 53/108 (49%) events; 32/53 (60%) PPP and 21/53 (39%) DPP. Event CPR metric summaries (median [IQR]) for PPP - CCF 0.87 [0.77, 0.93]; CC rate 116/min [108.5, 120]; CC depth age <1yo 2.35 [2.01, 3.0] cm; >1yr 4.2 [3.3, 5.05] cm. DPP - CCF 0.79 [0.69, 0.92]; CC rate 118/min [109,129]; CC depth < 1 yo 2.03 [1.95, 2.2] cm; >1yo 3.93 [3.3, 5.06] cm. PPP events, 28/32 (87%) met guideline criteria for CCF, 25/32 (78%) for CC rate; 6/32 (19%) for CC depth; and 4/32 (12%) met criteria for all 3 categories. For DPP events, 17/21 (80%) met guideline criteria for CCF; 15/21 (71%) for CC rate; and 3/21 (15%) for CC depth, and 2/21 (9%) met criteria for all 3 categories. Conclusions: Self-reported team perception of CPR quality does not match quantitative CPR metrics using AHA guideline criteria whether CPR was positively perceived or not, depth being main reason for non-compliance.

Organization and Structure of the Cardiothoracic Intensive Care Unit

2015 ◽  
pp. 86-104
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

A Matter of Perspective

2011 ◽  
pp. 125-147
Author(s):  
Rex Karsten
Keyword(s):  
Attribution Theory ◽  
Causal Attributions ◽  
User Interaction ◽  
End Users ◽  
End User ◽  
Team Members ◽  
Work Related ◽  
Is Professionals ◽  
Post Hoc ◽  
Relationship Of

The working relationship of information systems (IS) professionals and end users is an ongoing source of both research and practical concern. This study employs Attribution Theory to examine the causal attributions IS professionals and end users make for successful and unsuccessful user-system outcomes—end user attempts to use an information system to get the information needed to complete system-dependent, work-related tasks. Eighty-six IS professionals and 122 end users participated. The results show no differences in the nature of IS professional-end user attributions for successful outcomes, but very significant differences between them following unsuccessful outcomes. Post hoc analysis indicates that for unsuccessful user-system outcomes, the causal attributions of IS professionals and end users who are cross-functional team members are significantly less divergent than the causal attributions of those who are not. The implications of Attribution Theory for IS professional-end user interaction are discussed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

Oncology ◽  
2017 ◽  
pp. 709-727
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Noise in Endoscopic Sinus and Skull Base Surgery Operating Rooms

2020 ◽  
pp. 194589242097652
Author(s):  
Marc Levin ◽  
Kelvin Zhou ◽  
Ethan C. Sommer ◽  
Hitansh Purohit ◽  
Jeffery Wells ◽  
...  
Keyword(s):  
Skull Base ◽  
Patient Outcomes ◽  
Noise Exposure ◽  
Skull Base Surgery ◽  
Noise Measurement ◽  
Scrub Nurse ◽  
Noise Levels ◽  
Team Members ◽  
Noise Measurements ◽  
Or Team

Background Noise in the operating room (OR) contributes to miscommunication among team members and may negatively impact patient outcomes. Objectives This study aimed to quantify noise levels during endoscopic sinus and skull base surgery. The secondary aim was to understand how OR team members perceive noise during endoscopic sinus and skull base surgery. Methods Noise levels were measured using the validated phone application SoundMeter X 10.0.4 (r1865) (Faber Acoustical, Utah, USA) at the ear-level of the surgeon, scrub nurse, circulating nurse, and anesthesiologist. At the end of each surgery, OR team members were asked to complete a six-question questionnaire about noise during that surgery. Results One thousand four hundred and two noise measurements were recorded across 353 trials. The loudest mean noise measurement was 84.51 dB and maximum noise measurement was 96.21 dB at the ear-level of the surgeon. Noise was significantly higher at the ear-level of the surgeon and scrub nurse in comparison to the circulating nurse (p = .000) and anesthesiologist (p = .000). Forty percent of questionnaire respondents believed noise was a problem and 38% stated that noise caused communication issues during surgery. Conclusion Surgeons and scrub nurses have significantly higher noise exposure in comparison to circulating nurses and anesthesiologists during endoscopic sinus and skull base surgery. For these members of the OR team, noise is also identified as problematic and causing issues with communication. Mechanisms to reduce potential noise may be implemented to improve communication and patient outcomes in endoscopic sinus and skull base surgery.

787 Burn Resuscitation Critical Reflective Practice

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S228-S229
Author(s):  
Jennifer Schoonard ◽  
Jeanne Lee ◽  
Eli Strait ◽  
Jeremy Cabrera ◽  
Jen Garner
Keyword(s):  
Reflective Practice ◽  
Patient Outcomes ◽  
Interdisciplinary Teams ◽  
Communication Process ◽  
Team Members ◽  
Staff Members ◽  
Critical Reflective Practice ◽  
Trauma Bay ◽  
Burn Resuscitation ◽  
Parkland Formula

Abstract Introduction The Burn Resuscitation Critical Reflective Practice (CRP) was started as collaborative meetings to review 1st 48 hours of admission for burn resuscitations (resus) October 2018- July 2019. All multi- disciplinary teams were invited. The problem identified was on average burn resus patients (&gt;20% TBSA) were being over resuscitated in 1st 24 hours of admission. The goals of the CRP were: 1) Decrease resus fluid in the 1st 24 hours; 2) Increase knowledge of the current fluid resus pathway; 3) Increase communication with interdisciplinary teams during the resus. Methods CRP initiated in October 2018. 6 CRPs were held October 2018- July 2019.The average ml/ KG/ TBSA prior to CRP from January 2017- September 2018 was 5.17ml/kg/TBSA (goal: &lt; 4ml). Chart reviews were done to gather data from each resus (i.e. urine output, fluids, labs, events). Discussions held with staff involved in the 1st 24 hours of resus regarding any communication/process issues.Patient data was presented & staff members present would discuss questions/ issues that came up during the resus. Multi-disciplinary teams surveyed prior to CRP to assess comfort/competence with current resus pathway and communication. 46 surveys received prior to initiating CRP. After initiating CRP October 2018- July 2019, staff members that had attended &gt;1 CRP were post-surveyed. Results January 2017- October 2018 average ml/ KG/ TBSA was 5.17ml/kg/TBSA. October 2018- July 2019 POST CRP implementation, the avg ml/ KG/ TBSA was 3.86 ml LR/ kg/ TBSA in 1st 24 hours of resus. 3 new practices were implemented 1) Decrease fluids by 200ml/hr (instead of 100) when UOP is &gt;100/hr at least 2 hours into resus; 2) Double sign by 2 RNs required when calculating Parkland Formula; 3) Guideline created to guide communication between Burn RNs & trauma bay when burn resus arrives. Post- survey data showed increase in comfort communicating with physicians regarding resus & increase in comfort/confidence in calculating Parkland Formula. 2 additional subjective questions were added onto the post- CRP survey. Conclusions Fluids given in the 1st 24 hours decreased from 5.17 to 3.86 average ml/ kg/ TBSA post- CRP. 3 new practices were implemented as discussed in results. Staff felt more comfortable communicating with team & calculating Parkland formula. Staff had positive responses on the post- survey. Applicability of Research to Practice The monthly CRPs are to be continued to discuss all burn resus patients received during the prior month. Allows team members to continue to modify practice as needed by what’s learned through each CRP to help better our patient outcomes and decrease overall resus fluids.

First Impressions, Team Satisfaction and Work-Related Flow: A Multilevel Analysis

2018 ◽  
Vol 62 (1) ◽  
pp. 782-786
Author(s):  
Sarah Berger ◽  
Jeffery Hanrahan ◽  
Andrea Bizarro ◽  
Robert Henning
Keyword(s):  
Hierarchical Linear Modeling ◽  
Ad Hoc ◽  
First Impressions ◽  
Linear Modeling ◽  
Team Members ◽  
Work Related ◽  
Team Satisfaction ◽  
The Individual ◽  
Ad Hoc Teams ◽  
Flow Experiences

First impressions of fellow team members, as well as individual satisfaction with one’s team, are each related to work-related flow experiences but they are rarely studied in combination. To address this gap we collected measures of all three in a laboratory study of dyadic teams (N=55). First impressions were assessed prior to the start of a management simulation task, and both team satisfaction and work-related flow were assessed afterwards. Hierarchical linear modeling revealed that measures of team satisfaction at both the individual and team levels were predictive of work-related flow experiences; an interaction between the discrepancy in first impression ratings within each team and individual ratings of team satisfaction was also found. Findings suggest that discrepancies in first impressions interact with team satisfaction in ways that may negatively impact work-related flow experiences, which in turn has the potential to impair team formation and performance effectiveness of ad hoc teams.

Managing a Stroke Unit: An Example from Australia with an Emphasis on Nursing Roles

2007 ◽  
Vol 2 (3) ◽  
pp. 201-207 ◽  
Author(s):  
Louise Weir ◽  
Dominique A. Cadilhac
Keyword(s):  
Patient Outcomes ◽  
Clinical Care ◽  
Stroke Care ◽  
Multidisciplinary Teams ◽  
Special Report ◽  
Royal Melbourne Hospital ◽  
Team Members ◽  
Stroke Team ◽  
Nursing Roles ◽  
Participation In Research

Stroke care units (SCUs), which are co-ordinated by dedicated multidisciplinary teams and geographically located in one area, are currently the most generaliseable form of effective treatment for stroke. Although the evidence for SCUs is compelling, to date there has been limited evidence regarding the contribution of the different clinical team members who assist in producing the better patient outcomes observed in SCUs. In particular, there has been limited exploration of the different nursing roles. The purpose of this special report is to describe how an SCU operates and highlight the contribution of the various nursing roles as part of the multidisciplinary stroke team. The article is based on one of the longest established stroke services in Melbourne, Australia. The characteristics and composition of the Royal Melbourne Hospital stroke service in providing clinical care and management will be highlighted as an example. Further, the nursing roles related to avoiding complications, education for patients and families and other staff in the unit, as well as participation in research and future career development opportunities are discussed.

scholarly journals Multiple Chemical Sensitivity and the Workplace: Current Position and Need for an Occupational Health Surveillance Protocol

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
A. Martini ◽  
S. Iavicoli ◽  
L. Corso
Keyword(s):  
Multiple Chemical Sensitivity ◽  
Case Definition ◽  
Living Environment ◽  
Chemical Sensitivity ◽  
Current Position ◽  
Occupational Physicians ◽  
Work Related ◽  
Low Levels ◽  
Precise Relationship ◽  
Multiple Chemical

Multiple chemical sensitivity, commonly known as environmental illness, is a chronic disease in which exposure to low levels of chemicals causes correlated symptoms of varying intensity. With the continuous introduction of new substances, people with MCS suffer significant limitations to their living environment and frequently to their workplace. This paper describes the current situation as regards MCS and the critical points in its case definition, which is still not generally agreed upon; this makes it difficult to recognize with certainty, especially, its precise relationship with work. Other problems arise in relation to the occupational physician’s role in diagnosing and managing the worker with the disorder, the question of low levels of exposure to chemicals, and the best measures possible to prevent it. A diagnostic “route” is proposed, useful as a reference for the occupational physician who is often called in first to identify cases suspected of having this disease and to manage MCS workers. Work-related problems for people with MCS depend not only on occupational exposure but also on the incompatibility between their illness and their work. More occupational physicians need to be “sensitive” to MCS, so that these workers are recognized promptly, the work is adapted as necessary, and preventive measures are promoted in the workplace.

scholarly journals The Perceived Risk of Being Infected With COVID-19 at Work, Communication, and Employee Health: A Longitudinal Application of the Job Demands-Resources Model

2021 ◽  
Author(s):  
Alessandra Falco ◽  
Damiano Girardi ◽  
Alessandro De Carlo ◽  
Elvira Arcucci ◽  
Laura Dal Corso
Keyword(s):  
Perceived Risk ◽  
Protective Factor ◽  
Job Demands ◽  
Job Resources ◽  
Quality Information ◽  
Team Members ◽  
Work Related ◽  
Job Demand ◽  
Related Stress ◽  
Over Time

The perceived risk of being infected at work (PRIW) with COVID-19 represents a potential risk factor for workers during the current COVID-19 pandemic. In line with the job demands-resources (JD-R) model applied to safety at work, in this longitudinal study we propose that PRIW can be conceptualized as a job demand, whereas communication (i.e., the exchange of good-quality information across team members) can be conceived as a job resource. Accordingly, we hypothesized that PRIW at Time 1 (T1) would positively predict psychophysical strain at Time 2 (i.e., four months later). Furthermore, we hypothesized that communication at T1 would negatively predict psychophysical strain at T2. Overall, 297 workers took part in the study. The hypothesized relationships were tested using multiple regression analysis. Results supported our predictions: PRIW positively predicted psychophysical strain over time, whereas communication negatively predicted psychophysical strain over time. Also, results did not change after controlling for age, gender, and type of contract. Overall, this study suggests that PRIW and communication can be considered as a risk and a protective factor for work-related stress, respectively. Hence, to promote more sustainable working conditions, interventions should encourage organizations to optimize the balance between job demands and job resources related to COVID-19.

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