The Learning Curve for a Fetal Cardiac Intervention Team

Objectives. Multiple technical difficulties are encountered when a multidisciplinary team of subspecialists begins a minimally-invasive fetal cardiac interventional program. We describe the learning curve.Study Design. Ten pregnant sheep underwent ultrasound-guided balloon valvuloplasty of the aortic valve. Team members and their roles remained constant through the trial. The time between needle insertion and entrance of the left ventricle at the aortic root was recorded.F-test was used to assess significance (P≤.05).Results. The time required to accurately position the needle tip at the aortic root decreased significantly over the course of the trial, from 12 minutes with the first attempt to one minute with the last (P=.003).Conclusion. A significant learning curve is encountered when a multidisciplinary team begins a minimally-invasive fetal cardiac intervention program. However, technical proficiency can be achieved with practice. Institutions interested in developing such a program should consider practice in an animal model before proceeding to the human fetus.

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Food for Thought

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.2.68 ◽

2012 ◽

Vol 21 (2) ◽

pp. 68-72 ◽

Cited By ~ 7

Author(s):

Caryn Easterling

Keyword(s):

Multidisciplinary Team ◽

Clinical History ◽

Team Members ◽

Speech Language Pathologist ◽

Expected Outcome

Our professional American Speech-Language-Hearing Association (ASHA) guidelines state, if a speech-language pathologist suspects on the basis of the clinical history that there may be an esophageal disorder contributing to the patient's dysphagia, then “An esophageal screening can be incorporated into most [videofluoroscopic swallowing studies, or] VFSS” (ASHA, 2004). However, the esophageal screen has not been defined by ASHA or by the American College of Radiology. This “Food for Thought” column suggests deglutologists work together to determine the procedure and expected outcome for the esophageal screen so that there is acceptance and consensus among the multidisciplinary team members who evaluate patients with dysphagia.

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The learning curve in minimally invasive percutaneous nephrolitholapaxy: a 1-year retrospective evaluation of a novice and an expert

World Journal of Urology ◽

10.1007/s00345-010-0553-3 ◽

2010 ◽

Vol 29 (6) ◽

pp. 749-753 ◽

Cited By ~ 27

Author(s):

David Schilling ◽

Georgios Gakis ◽

Ute Walcher ◽

Arnulf Stenzl ◽

Udo Nagele

Keyword(s):

Minimally Invasive ◽

Learning Curve ◽

Retrospective Evaluation

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Multidisciplinary team meetings in community mental health: a systematic review of their functions

Mental Health Review Journal ◽

10.1108/mhrj-03-2015-0010 ◽

2016 ◽

Vol 21 (2) ◽

pp. 119-140 ◽

Cited By ~ 6

Author(s):

Caoimhe Nic a Bháird ◽

Penny Xanthopoulou ◽

Georgia Black ◽

Susan Michie ◽

Nora Pashayan ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Community Mental Health ◽

Multidisciplinary Team ◽

Community Mental Health Services ◽

Content Type ◽

Team Members ◽

Team Meetings ◽

Unwarranted Variation ◽

The Uk

Purpose – Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers. Design/methodology/approach – Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings. Findings – None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration. Practical implications – Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care. Originality/value – This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

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Palliative care in paediatric oncology: perceptions, expertise and practices from the perspective of the multidisciplinary team

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2015.02.46299 ◽

2015 ◽

Vol 36 (2) ◽

pp. 56-62 ◽

Cited By ~ 8

Author(s):

Adriana Ferreira da Silva ◽

Helena Becker Issi ◽

Maria da Graça Corso da Motta ◽

Daisy Zanchi de Abreu Botene

Keyword(s):

Palliative Care ◽

Multidisciplinary Team ◽

Structured Interview ◽

Paediatric Oncology ◽

Lessons Learned ◽

Team Members ◽

Descriptive Research ◽

The Family ◽

Research Questions ◽

Oncology Unit

OBJECTIVE: To reveal the perceptions, expertise and practices of multi-professional teams providing palliative care to children in a paediatric oncology unit. The research questions were based on everyday care, facilitations and difficulties, essential aspects of professional approaches, and the inter-disciplinary focus of care for children in palliative care and their families. METHOD: Qualitative, exploratory and descriptive research. Data were collected from June to October 2013 from nine professional multidisciplinary team members by means of a semi-structured interview submitted to thematic analysis. RESULTS: The following four themes emerged from analysis: palliative care: conceptions of the multi-professional team; the construction of singular care; the facilitations and difficulties experienced by the team and significant lessons learned. CONCLUSIONS: The subjects revealed that the team also suffers with the death of a child and, like the family, moves toward the construction of coping mechanisms for the elaboration of mourning. Paradoxically, the team shares knowledge to determine the foundations of a singular therapeutic project and inserts the family in this process so that it can be the protagonist of the child's care.

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