Designing the careful and kind clinic: an evidence-based approach

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000538
Author(s):  
Sara Poplau ◽  
Mark Linzer ◽  
Dominique Allwood ◽  
Victor Montori ◽  
Ryan Armbruster ◽  
...  
Keyword(s):  
Time Pressure ◽  
Organisational Culture ◽  
Healthcare Team ◽  
Evidence Based ◽  
Team Members ◽  
Gender And Race ◽  
Optimal Health ◽  
Healthy Workplace ◽  
And Performance ◽  
Key Aspects

BackgroundThere is evidence that creating a ‘healthy workplace’ can be of profound importance for clinicians, team members and patients. Yet there have been few papers that have proposed mechanisms to take decades of research and translate this into a practical list of options for leaders and managers to take into account when structuring a clinic based on care and kindness to achieve optimal health.EvidenceWe bring together 20 years of scholarship linking care of the caregivers with outcomes for caregivers and patients. The data are used to support both structures and cultures that will result in satisfied and thriving healthcare team members, as well as satisfied and healthy patients.ResultsThe clinic based on care of the caregivers will be structured to address key aspects of worklife that are known to cause either satisfaction or burnout. Aspects of care, such as time pressure, chaotic environments and worker control of their workplace, will be taken into account in clinical design; organisational culture will be supportive and cohesive, emphasising quality, values and communication. Experiences based on gender and race will be measured and continuously improved; and performance will be evaluated in a new, human-centred manner.OutcomesThe careful and kind clinic will be a remarkable place to work; in contrast to industrialised healthcare, this will be an environment where health can indeed be optimised, for both workers and patients.

Healthcare personalism: a prolegomenon

2015 ◽  
Vol 3 (2) ◽  
pp. 228
Author(s):  
James Marcum
Keyword(s):  
Conceptual Framework ◽  
Evidence Based Medicine ◽  
Team Member ◽  
Clinical Encounter ◽  
Healthcare Team ◽  
Evidence Based ◽  
Human Suffering ◽  
Team Members ◽  
Quality Healthcare ◽  
Based Medicine

Healthcare personalism is an approach to providing quality healthcare that focuses on personhood with respect to each member of the healthcare team and not to anyone team member, whether patient or healthcare provider. To that end, the philosophy of personalism provides a conceptual framework for developing a dynamic notion of healthcare. Specifically, the person is uniquely original, relationally intersubjective, and communicatively solidaritous. Moreover, healthcare personalism is non-foundational in the sense that no one approach to providing healthcare suffices for the clinical encounter. Rather, the encounter must be open to a range of possibilities for providing healthcare. In contrast to evidence-based medicine, healthcare personalism does not hold to single foundation, i.e. evidence, for practicing healthcare. Evidence is important but not foundational. And, in contrast to patient-entered medicine, it does not privy the patient to the personhood of other healthcare team members. The personhood of everyone involved in healthcare is required for meeting the goal of quality healthcare—the relief of human suffering.

scholarly journals The Safe Harbors Youth Intervention Project: inter-sectoral collaboration to address sexual exploitation in Minnesota

2012 ◽  
Vol 2 (1) ◽  
pp. 4 ◽  
Author(s):  
Laurel Edinburgh ◽  
Emily Huemann ◽  
Kathryn Richtman ◽  
Andrea McDonald Marboe ◽  
Elizabeth Saewyc
Keyword(s):  
Best Practices ◽  
Single Case ◽  
Sexual Exploitation ◽  
Decision Makers ◽  
Healthcare Team ◽  
Evidence Based ◽  
Team Members ◽  
Protocol Development ◽  
Youth Intervention

The authors aimed to evaluate the Safe Harbors Youth Intervention Project inter-sectoral collaboration to improve continuity and appropriateness of services for sexually exploited children and adolescents. The study was carried on through an intensive, single case study, drawing on interviews and focus groups with experiential youths (n=125) and multi-sectoral stakeholders (n=196), documented activities, and repeated interviews with collaborating team members (n=29), teen clients (n=46) and parents (n=22). The collaboration was designed around an eight-step process for creating victim-centered protocols within and across organizations, altering services to bridge gaps in care, and creating training tools for the different sectors. The results of the study showed an initial needs assessment documented fragmented care and problematic communication across departments and sectors. The shared protocol development among decision makers from each agency, focused on best practices and evidence-based interventions, fostered trusting relationships, improved awareness of different roles and services, and speeded practice changes to remove barriers to care for sexually exploited youths. A task-focused collaboration with a shared community-wide protocol, increases transparency between services, and ongoing inter-sectoral training helps healthcare team foster a meaningful response to sexually exploited youths.

The Contingent Effect of Team Composition on the Performance of Entrepreneurial Teams

2019 ◽  
pp. 654-680
Author(s):  
Serghei Musaji ◽  
Julio De Castro
Keyword(s):  
Future Research ◽  
Team Composition ◽  
Team Members ◽  
Team Diversity ◽  
Entrepreneurial Teams ◽  
Knowledge Based ◽  
Fertile Ground ◽  
Active Debate ◽  
And Performance ◽  
The Relationship

Despite the continuous interest in studying entrepreneurial teams, the relationship between team composition and, particularly, team diversity and performance remains fertile ground for active debate. Taking roots in the knowledge-based view and organizational learning literatures, this chapter argues that performance in entrepreneurial teams is contingent on (a) the overlap between team members’ knowledge/competences and the content of the performed tasks, (b) the duplication of the team members’ knowledge in the areas with that content, (c) the nature of tasks (exploration or exploitation), (d) the team’s flexibility to adapt to changes in the content and nature of those tasks, and (e) the rate of environmental change. Because an important source of ambiguity in the understanding of how team diversity and performance are linked ties to issues of how team diversity is conceptualized and operationalized, the chapter also proposes a new way of looking at diversity in future research.

scholarly journals Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christine W. Hartmann ◽  
Ryann L. Engle ◽  
Camilla B. Pimentel ◽  
Whitney L. Mills ◽  
Valerie A. Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Evidence Based ◽  
National Program ◽  
Extensive Experience ◽  
Evidence Based Practices ◽  
Team Members ◽  
Virtual Experience ◽  
Key Points ◽  
Program Content

Abstract Background Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program. Model and recommendations Success in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program. Summary These principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

scholarly journals Information Quality Assessment for Data Fusion Systems

Data ◽  
2021 ◽  
Vol 6 (6) ◽  
pp. 60
Author(s):  
Miguel A. Becerra ◽  
Catalina Tobón ◽  
Andrés Eduardo Castro-Ospina ◽  
Diego H. Peluffo-Ordóñez
Keyword(s):  
Data Fusion ◽  
Information Quality ◽  
Engineering Process ◽  
Comprehensive Description ◽  
Research Issues ◽  
Fusion Systems ◽  
General Data ◽  
Fusion Engineering ◽  
And Performance ◽  
Key Aspects

This paper provides a comprehensive description of the current literature on data fusion, with an emphasis on Information Quality (IQ) and performance evaluation. This literature review highlights recent studies that reveal existing gaps, the need to find a synergy between data fusion and IQ, several research issues, and the challenges and pitfalls in this field. First, the main models, frameworks, architectures, algorithms, solutions, problems, and requirements are analyzed. Second, a general data fusion engineering process is presented to show how complex it is to design a framework for a specific application. Third, an IQ approach, as well as the different methodologies and frameworks used to assess IQ in information systems are addressed; in addition, data fusion systems are presented along with their related criteria. Furthermore, information on the context in data fusion systems and its IQ assessment are discussed. Subsequently, the issue of data fusion systems’ performance is reviewed. Finally, some key aspects and concluding remarks are outlined, and some future lines of work are gathered.

The Role and Activities of Board-Certified Chaplains in Advance Care Planning

2021 ◽  
pp. 104990912198999
Author(s):  
Jung Kwak ◽  
Soyeon Cho ◽  
George Handzo ◽  
Brian P. Hughes ◽  
Sami S. Hasan ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Self Report ◽  
Healthcare Team ◽  
Care Planning ◽  
Cross Sectional ◽  
Team Members ◽  
Roles And Responsibilities ◽  
Healthcare Settings ◽  
Academic Medical ◽  
Advance Care

Background: Healthcare chaplains have key roles in providing palliative support to patients and families, and they are well-suited to facilitate advance care planning (ACP). However, empirical data on the roles and responsibilities of chaplains in facilitating ACP are limited. Objectives: To examine the roles of board-certified healthcare chaplains in ACP in various healthcare settings. Methods: A cross-sectional, web-based self-report survey was conducted with 585 board-certified chaplains recruited from 3 major professional chaplains’ organizations in the U.S. The survey data included chaplains’ demographic and professional characteristics, their roles and responsibilities, and responses regarding communication and participation with other healthcare team members in facilitating ACP, including experienced barriers. Results: More participants worked in community hospital settings (42%) and academic medical centers (19.6%) than in any other setting. Over 90% viewed ACP as an important part of their work, 70% helped patients complete advance directives, and 90% helped patients discuss their preferences about end-of-life treatments. Many chaplains were not consistently included in team discussions regarding decision-making, although most chaplains reported that they could always find ways to communicate with their teams. Conclusion: Professional board-certified chaplains regularly engage in facilitating ACP discussions with patients and families in various healthcare settings. There is a need to recognize and provide systematic support for the role of chaplains in facilitating ACP conversations and to integrate chaplains into routine interdisciplinary team and family meetings.

scholarly journals Visual search behavior and performance in luggage screening: effects of time pressure, automation aid, and target expectancy

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Tobias Rieger ◽  
Lydia Heilmann ◽  
Dietrich Manzey
Keyword(s):  
Visual Search ◽  
Target Location ◽  
Time Pressure ◽  
Response Times ◽  
Search Behavior ◽  
High Time ◽  
Luggage Screening ◽  
Negative Effect ◽  
And Performance ◽  
Automated Support

AbstractVisual inspection of luggage using X-ray technology at airports is a time-sensitive task that is often supported by automated systems to increase performance and reduce workload. The present study evaluated how time pressure and automation support influence visual search behavior and performance in a simulated luggage screening task. Moreover, we also investigated how target expectancy (i.e., targets appearing in a target-often location or not) influenced performance and visual search behavior. We used a paradigm where participants used the mouse to uncover a portion of the screen which allowed us to track how much of the stimulus participants uncovered prior to their decision. Participants were randomly assigned to either a high (5-s time per trial) or a low (10-s time per trial) time-pressure condition. In half of the trials, participants were supported by an automated diagnostic aid (85% reliability) in deciding whether a threat item was present. Moreover, within each half, in target-present trials, targets appeared in a predictable location (i.e., 70% of targets appeared in the same quadrant of the image) to investigate effects of target expectancy. The results revealed better detection performance with low time pressure and faster response times with high time pressure. There was an overall negative effect of automation support because the automation was only moderately reliable. Participants also uncovered a smaller amount of the stimulus under high time pressure in target-absent trials. Target expectancy of target location improved accuracy, speed, and the amount of uncovered space needed for the search.Significance Statement Luggage screening is a safety–critical real-world visual search task which often has to be done under time pressure. The present research found that time pressure compromises performance and increases the risk to miss critical items even with automation support. Moreover, even highly reliable automated support may not improve performance if it does not exceed the manual capabilities of the human screener. Lastly, the present research also showed that heuristic search strategies (e.g., areas where targets appear more often) seem to guide attention also in luggage screening.

Flow Coefficient Evaluation of Poppet Valves Used in Reciprocating Compressors for LDPE

2008 ◽  
Author(s):  
Enzo Giacomelli ◽  
Massimo Schiavone ◽  
Fabio Manfrone ◽  
Andrea Raggi
Keyword(s):  
Pressure Drop ◽  
Time Pressure ◽  
Experimental Tests ◽  
Operating Conditions ◽  
Flow Coefficient ◽  
Operating Life ◽  
High Fatigue ◽  
Strongly Connected ◽  
And Performance ◽  
Poppet Valves

Poppet valves have been used for a long time for very high pressure reciprocating compressors, as for example in the case of Low Density Polyethylene. These applications are very critical because the final pressure can reach 350 MPa and the evaluation of the performance of the machines is strongly connected to the proper operation and performance of the valve itself. The arrangement of cylinders requires generally a certain compactness of valve to withstand high fatigue stresses, but at the same time pressure drop and operating life are very important. In recent years the reliability of the machines has been improving over and over and the customers’ needs are very stringent. Therefore the use of poppet valves has been extended to other cases. In general the mentioned applications are heavy duty services and the simulation of the valves require some coefficients to be used in the differential equations, able to describe the movement of plate/disk or poppet and the flow and related pressure drop through the valves. Such coefficients are often determined in an experimental way in order to have a simulation closer to the real operating conditions. For the flow coefficients it is also possible today to use theoretical programs capable of determining the needed values in a quick and economical way. Some investigations have been carried out to determine the values for certain geometries of poppet valves. The results of the theory have been compared with some experimental tests. The good agreement between the various methods indicates the most suitable procedure to be applied in order to have reliable data. The advantage is evident as the time necessary for the theoretical procedure is faster and less expensive. This is of significant importance at the time of the design and also in case of a need to provide timely technical support for the operating behavior of the valves. Particularly for LDPE, the optimization of all the parameters is strongly necessary. The fatigue stresses of cylinder heads and valve bodies have to match in fact with gas passage turbulence and pressure drop, added to the mechanical behavior of the poppet valve components.

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