Ethical Bearing Is About Our Conduct: Ethics as an Essential Component of Military Interprofessional Healthcare Teams

2021 ◽  
Vol 186 (Supplement_3) ◽  
pp. 23-28 ◽  
Author(s):  
Holly S Meyer ◽  
Karlen S Bader-Larsen ◽  
Anthony Artino ◽  
Lara Varpio
Keyword(s):  
Healthcare Providers ◽  
Speaking Up ◽  
Moral Compass ◽  
Healthcare Teams ◽  
Ability To Act ◽  
Ethical Conflicts ◽  
Military Members ◽  
Military Healthcare ◽  
Interprofessional Healthcare ◽  
The Right

ABSTRACT Introduction The need to maintain medical ethical standards during conflict and peace has been the source of considerable academic discourse. Although still an unsolved challenge, scholars have made significant contributions to the literature, constructing categorizations that can help military providers contend with ethical conflicts. However, insights into the ethical comportment of military interprofessional healthcare teams (MIHTs) have yet to be reported. Materials and Methods This interview-based study collected insights from 30 military healthcare providers who participated in and/or led MIHTs. Altogether, participants represented 11 health professions, both officers and enlisted military members, and the U.S. Army, Navy, and Air Force. Following Grounded Theory methodology, data were collected and analyzed in iterative cycles until theme saturation was reached. Results The research team identified two themes of ethical bearing that enable MIHT success in and across care contexts. One theme of successful ethical bearing is “raising concerns,” referring to speaking up when something needs to be addressed. The other is “making compromises,” where individuals have to make sacrifices (e.g., lack of equipment, non-sterile environment, etc.) to give patient care. Conclusions These data suggest that effective MIHTs have a collective moral compass. This moral compass is the team’s ability to judge what is ethically right and wrong, as well as the team’s willingness and ability to act accordingly—to consistently “do the right thing.” There is a collective moral compass, and while the team may not all agree on what exactly is true north—they are all bending that way.

Military Interprofessional Healthcare Teams: Identifying the Characteristics That Support Success

2021 ◽  
Vol 186 (Supplement_3) ◽  
pp. 1-6 ◽  
Author(s):  
Lara Varpio ◽  
Karlen S Bader-Larsen ◽  
Steven J Durning ◽  
Anthony Artino ◽  
Meghan K Hamwey ◽  
...  
Keyword(s):  
Healthcare System ◽  
Military Medicine ◽  
Special Edition ◽  
Healthcare Teams ◽  
Military Members ◽  
Military Healthcare ◽  
Interprofessional Healthcare ◽  
The U.S ◽  
Military Healthcare System

ABSTRACT Military interprofessional healthcare teams (MIHTs) are foundational to the care provided to military members and their families. However, to date, very little research has investigated MIHTs. Notably, we have few insights into what distinguishes successful MIHTs. This manuscript presents findings from a program of research that was carried out to address this gap. We review what is known about MIHTs to date and the Uniformed Services University’s (USU) focused efforts to ensure that greater understanding of MIHTs was developed. We provide an overview of the USU-supported research and of the findings that were generated by that inquiry. After summarizing the manuscripts included in this special edition of Military Medicine, we close by acknowledging and thanking key members of the U.S. military healthcare system who supported this research.

Optimizing Military Medicine: A Team Approach

2021 ◽  
Vol 186 (Supplement_3) ◽  
pp. 51-52
Author(s):  
Kevin K Chung
Keyword(s):  
Health Care ◽  
Military Medicine ◽  
Team Approach ◽  
Special Issue ◽  
Health Care Teams ◽  
Military Health ◽  
Healthcare Teams ◽  
Military Health Care ◽  
Interprofessional Healthcare ◽  
The Right

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.

scholarly journals Situational Awareness: Forecasting Successful Military Medical Teams

2021 ◽  
Vol 186 (Supplement_3) ◽  
pp. 35-41 ◽  
Author(s):  
Danette F Cruthirds ◽  
Karlen S Bader-Larsen ◽  
Meghan Hamwey ◽  
Lara Varpio
Keyword(s):  
Situational Awareness ◽  
Healthcare Providers ◽  
Study Participant ◽  
Data Set ◽  
Military Healthcare ◽  
Healthcare Professions ◽  
Medical Teams ◽  
Interprofessional Healthcare ◽  
Army Air Force ◽  
Study Participants

ABSTRACT Introduction Military healthcare providers working in military interprofessional healthcare teams (MIHTs) require situational awareness (SA) to ensure safe and efficacious patient care. This study aimed to explore SA in MIHTs to understand how SA can be reinforced and maintained in MIHTs. The research team set out to answer two questions: “What aspects of individual and team SA are particularly important for MIHTs?” and “How can we enable military healthcare providers to be effective MIHTs members with robust SA?”. Methods This study used Grounded Theory methodology collecting perspectives from 30 study participants from various backgrounds, including 11 different healthcare professions from the U.S. Army, Air Force, and Navy. Each study participant had experiences participating in, leading one, or leading many MIHTs. Data were collected in three cycles and analyzed within each cycle until saturation was reached. Results Five themes were robustly represented in the data set regarding SA: (1) contextually informed adaptability, (2) readiness, (3) trust, (4) communication, and (5) mission focus. Conclusions The urgency often faced by MIHTs brings SA and the principles that underpin SA into sharper focus. The SA themes identified in this research may provide insight into training effectiveness, team strengths and weaknesses, and team performance.

scholarly journals New Insights About Military Interprofessional Healthcare Teams: Lessons Learned and New Directions From a Program of Research

2021 ◽  
Vol 186 (Supplement_3) ◽  
pp. 53-56
Author(s):  
Lara Varpio ◽  
Karlen S Bader-Larsen ◽  
Meghan K Hamwey ◽  
Holly S Meyer ◽  
Anthony Artino ◽  
...  
Keyword(s):  
Healthcare Delivery ◽  
Lessons Learned ◽  
Collaborative Teams ◽  
Healthcare Teams ◽  
Summary Paper ◽  
New Directions ◽  
Military Healthcare ◽  
Interprofessional Healthcare ◽  
Military Teams ◽  
The Military

ABSTRACT The success of the military is significantly supported by highly effective collaborative teams. While much is known about successful military teams outside the context of healthcare delivery, considerably less attention has been paid to teams working in patient care. Thus, this supplement has explored the features of successful military interprofessional healthcare teams (MIHTs). In this summary paper, the authors discuss what this supplement’s investigations have taught us about MIHTs and offer a series of proposed future investigations of MIHTs and their role in military healthcare.

scholarly journals Perseverance: An Essential Trait of Military Interprofessional Healthcare Teams

2021 ◽  
Vol 186 (Supplement_3) ◽  
pp. 29-34 ◽  
Author(s):  
Holly S Meyer ◽  
Steven J Durning ◽  
Karlen S Bader-Larsen ◽  
Meghan Hamwey ◽  
Lara Varpio
Keyword(s):  
Continuous Improvement ◽  
Air Force ◽  
Healthcare Professionals ◽  
Collaborative Work ◽  
Team Members ◽  
Healthcare Teams ◽  
Military Members ◽  
Interprofessional Healthcare ◽  
Force Data

ABSTRACT Introduction Perseverance—doing something despite difficulty—is an asset to healthcare professionals, yet not all providers display this trait. The literature offers no conceptualization of perseverance as it relates to military caregivers. This research sought to explore the perseverance displayed by members of military interprofessional healthcare teams (MIHTs) and to construct a framework for explaining the role of perseverance in MIHTs’ collaborative work. Methods Using Grounded Theory, this interview-based study collected insights from 30 individuals who had participated in MIHTs and/or led MIHTs. Participants represented 11 different health professions, both officers and enlisted military members, and three branches of the U.S. military (i.e., Army, Navy, and Air Force). Data were collected and analyzed in iterative cycles until theme saturation was achieved. Results We identified practices through which perseverance was exhibited by members of MIHTs: (1) humility, (2) mission focus, (3) team effort, (4) failure is not an option, (5) comfort with discomfort, and (6) continuous improvement. We then clustered these practices into three subcategories, reflecting how certain practices may connect to support MIHT perseverance. Conclusions These six practices appear connected in significant ways to support the MIHTs’ efforts. Humility, mission focus, and team effort can help team members collaborate as a unified and mutually supportive team. From this base, MIHTs seemed able to become comfortable with discomfort and to refuse failure as an option. These orientations then allowed the team to engage in continuous improvement. Together, these practices may enhance team perseverance and ultimately team performance.

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

scholarly journals P040 An unusual case of giant cell arteritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Jessica Ellis ◽  
Keziah Austin ◽  
Sarah Emerson
Keyword(s):  
Inflammatory Markers ◽  
Illicit Drugs ◽  
Unusual Case ◽  
Temporal Arteritis ◽  
White Cell Count ◽  
Healthcare Providers ◽  
Temporal Artery ◽  
Low Grade ◽  
Temporal Artery Biopsy ◽  
The Right

Abstract Background/Aims  A 49-year-old female of Nepalese heritage was referred with right-sided headache, scalp tenderness, and a painful swelling overlying the right temple. She denied any visual or claudicant symptoms but felt systemically unwell with a fever. There were no symptoms suggestive of an inflammatory arthritis, underlying connective tissue disease or vasculitis. She was normally fit and well with no past medical history. She did not take any regular medications and denied using over the counter or illicit drugs or recent travel. On review she had a low grade fever. There was a large tender, erythematous swelling overlying the right temple. Bilaterally the temporal arteries were palpable and pulsatile. Peripheral pulses were normal with no bruits. There was no evidence of shingles (HSV) or local infection. Full systemic examination revealed no other abnormalities. Laboratory tests showed: PV 2.56, CRP 101, total white cell count 14.38 (eosinophils 0.4), albumin 33, Hb 115. Urine dip was normal. Renal function, liver function and immunoglobulins were normal. ANCA was negative. Hypoechogenicity surrounding the right frontal branch of the right temporal artery was seen on ultrasound. There were no discrete masses suggestive of cysts, abscess or tumours. Temporal artery biopsy confirmed the presence of vasculitis; histology demonstrated transmural lymphohistiocytic inflammation, disruption of the elastic lamina and intimal proliferation. Prednisolone was started at 40mg daily. Four weeks after initially presenting she was asymptomatic and her inflammatory markers had normalised. Methods  The case is discussed below. Results  Temporal arteritis, or GCA, is primarily a disease of older adults; with age 50 often used as an inclusion criteria, and is more common in Caucasian populations. Limited reports exist of GCA in younger cohorts, but these are rare. An important differential in younger patients, such as ours, is juvenile temporal arteritis. This rare localised vasculitis affects almost exclusively the temporal artery. It is typically a disease of young males, who present with non-tender temporal swelling. Systemic symptoms are unusual and inflammatory markers are normal. Clinical or laboratory evidence of organ involvement, peripheral eosinophilia or fibrinoid necrosis on histology should prompt consideration of an AAV or PAN. Incidence of GCA increases in correlation with Northern latitude, with highest rates reported in Scandinavian and North American populations. GCA is rare in Asian populations. Higher diagnostic rates in countries where physicians have increased awareness of GCA proposed as an explanation for this difference; however differences in incidence are still observed between Asian and Caucasian populations presenting to the same healthcare providers. Conclusion  GCA is an uncommon diagnosis in younger and non-Caucasian patients. Thorough investigation through ultrasound and biopsy helped increase our diagnostic confidence in this unusual case. Rheumatologists must be alert to atypical presentations in order to deliver prompt and potentially sight-saving treatment. Disclosure  J. Ellis: None. K. Austin: None. S. Emerson: None.

The Power to be Ethical: Controlling Moral Assemblages in Border Militias

2021 ◽  
pp. 089124162110218
Author(s):  
John R. Parsons
Keyword(s):  
United States ◽  
The United States ◽  
Recent Interest ◽  
Ethical Conflicts ◽  
Moral Landscape ◽  
The Government ◽  
Moral Certainty ◽  
The Right ◽  
Ethical Response

Every year, hundreds of U.S. citizens patrol the Mexican border dressed in camouflage and armed with pistols and assault rifles. Unsanctioned by the government, these militias aim to stop the movement of narcotics into the United States. Recent interest in the anthropology of ethics has focused on how individuals cultivate themselves toward a notion of the ethical. In contrast, within the militias, ethical self-cultivation was absent. I argue the volunteers derived the power to be ethical from the control of the dominant moral assemblage and the construction of an immoral “Other” which provided them the power to define a moral landscape that limited the potential for ethical conflicts. In the article, I discuss two instances Border Watch and its volunteers dismissed disruptions to their moral certainty and confirmed to themselves that their actions were not only the “right” thing to do, but the only ethical response available.

scholarly journals The Teamwork Model: Proposing a Model for Studying Interprofessional Healthcare Teams

MedEdPublish ◽  
2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Matthew D'Angelo ◽  
Ronald Cervero ◽  
Steven Durning ◽  
Lara Varpio
Keyword(s):  
Healthcare Teams ◽  
Interprofessional Healthcare
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