scholarly journals Formal Assessment of Teamwork Among Cancer Health Care Professionals in Three Large Tertiary Centers in Nigeria

2020 ◽  
pp. 560-568 ◽  
Author(s):  
Abiola F. Ibraheem ◽  
Mihai Giurcanu ◽  
Anthonia Chima Sowunmi ◽  
Olutosin Awolude ◽  
Muhammad Habeebu ◽  
...  

PURPOSE There are strategies to bring quality cancer care to underserved patients, but poor use of the principles of teamwork is a major barrier to achieving quality services. The intent of this study was to assess teamwork as perceived by health care workers caring for patients with cancer. METHODS We conducted a survey among health care professionals in cancer care at 3 tertiary centers in southwestern Nigeria from July to November 2016. Respondents rated teamwork using the Safety Attitudes Questionnaire; we focused on the teamwork climate subscale comparing health care providers and institutions using analysis of variance and on collaboration using logistic regression. RESULTS Three hundred seventy-three professionals completed the survey: 177 physicians (47%), 51 nurses (14%), 21 pharmacists (6%), 31 laboratory technicians (8%), and 88 others (24%); 5 (1%) participants had missing professional information. The average teamwork climate score across all professionals in the study was 70.5 (SD = 24.2). Pharmacists rated the teamwork climate the lowest, with a mean score of 63.9 (SD = 29.5); nurses and laboratory technicians rated teamwork higher, with means of 74.5 (SD = 21.7) and 74.2 (SD = 27.1), respectively; and physicians rated teamwork 66.0 (SD = 23.6). Collaboration with other health care providers was reported as poorer by physicians compared with nurses and pharmacists. CONCLUSION Although overall teamwork scores were consistent with ambulatory studies in the United States, important subgroup variations provide targets for intervention. Physicians rated collaboration as poor both intra- and interprofessionally. Pharmacists rated interprofessional teamwork with nurses as poor. Efforts to transform cancer care must focus on building trust among the key stakeholders. This is critical in low-resource settings, which must maximize the use of limited resources to improve patient outcomes.

Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.


2020 ◽  
Vol 35 (10) ◽  
pp. 446-464
Author(s):  
Joshua Chou ◽  
Merton Lee ◽  
Taylor Kaminsky ◽  
Tarlan Namvar ◽  
Catherine E. Cooke ◽  
...  

OBJECTIVE: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.<br/> DESIGN: Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).<br/> SETTING: Interviews were conducted in multiple cities within the United States during June-July 2019.<br/> PATIENTS, PARTICIPANTS: FGI participants (N=36) included community dwelling adults, 65 years of age or older, who took 5+ chronic medications, or their caregivers. KII participants (N=15) included health care professionals caring for similar populations.<br/> INTERVENTIONS: Participants were given samples of blister packs and pouches and asked about medication management and appearance and usability of medication packaging. Interviews were audio-recorded with participants' consent, then transcribed and coded using Atlas. ti. Recurrent and emergent themes were identified, and selected quotes served as examples of identified themes.<br/> MAIN OUTCOME MEASURE: Participants' perceptions regarding medication packaging.<br/> RESULTS: Participants' preferences varied for different multi-medication packaging systems. Similarly, most FGI participants did not communicate a strong attitude for or against their existing management systems. However, many FGI participants perceived a need for larger font size than seen on the either of the multimedication packaging samples. KII participants also preferred a larger font size on both packagings. KII participants thought the blister packs offered better visual organization and enabled caregivers to quickly assess adherence. However, KII participants expressed concern about integrating as-needed and short-term use medications and noted difficulty opening both types of packages.<br/> CONCLUSION: Visual appearance is important to both patients and health care providers. Continued research in this area is vital for tailoring packaging types and technology to patients.


2012 ◽  
Vol 6 (4) ◽  
pp. 342-348 ◽  
Author(s):  
Gavin J. Putzer ◽  
Mirka Koro-Ljungberg ◽  
R. Paul Duncan

ABSTRACTObjective: Disaster preparedness has become a health policy priority for the United States in the aftermath of the anthrax attacks, 9/11, and other calamities. It is important for rural health care professionals to be prepared for a bioterrorist attack or other public health emergency. We sought to determine the barriers impeding rural physicians from being prepared for a human-induced disaster such as a bioterrorist attack.Methods: This study employed a qualitative methodology using key informant interviews followed by grounded theory methods for data analysis. Semistructured interviews were conducted with 6 physicians in the state of Florida from federally designated rural areas.Results: The interview participants articulated primary barriers and the associated factors contributing to these barriers that may affect rural physician preparedness for human-induced emergencies. Rural physicians identified 3 primary barriers: accessibility to health care, communication between physicians and patients, and rural infrastructure and resources. Each of these barriers included associated factors and influences. For instance, according to our participants, access to care was affected by a lack of health insurance, a lack of finances for health services, and transportation difficulties.Conclusions: Existing rural organizational infrastructure and resources are insufficient to meet current health needs owing to a number of factors including the paucity of health care providers, particularly medical specialists, and the associated patient-level barriers. These barriers presumably would be exacerbated in the advent of a human-induced public health emergency. Thus, strategically implemented health policies are needed to mitigate the barriers identified in this study.(Disaster Med Public Health Preparedness. 2012;6:342–348)


2016 ◽  
Vol 3 (1) ◽  
pp. 24
Author(s):  
Gerald Monk ◽  
Stacey Sinclair ◽  
Michael Nelson

Despite the overwhelming evidence that suggests that patients, families and health care systems benefit from offering appropriate disclosures and apologies to patients and families following the aftermath of medical errors, few health care organizations in the U.S. invest in providing systemic training in disclosure and apology. Using a narrative analysis this paper explores the cultural barriers in the United States healthcare environment that impede health care providers from engaging in restorative conversations with patients and families when things go wrong. The paper identifies a handful of programs and models that provide disclosure and apology training and argues for the unique contributions of narrative mediation to assist health care professionals to disclose adverse events to patients and families to restore trust.


2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18126-e18126 ◽  
Author(s):  
Abiola Falilat Ibraheem ◽  
Olutosin Alaba Awolude ◽  
Myhammad-yaqub Murtazha Habeebu ◽  
Anthonia Chima Sowunmi ◽  
Popoola Abiodun Olaniyi ◽  
...  

e18126 Background: Cancer is fast becoming a common cause of death in developing world. Over the last decade, there have been strategies to bring quality cancer care to underserved patients around the world. In low-income countries, poor utilization of principles of teamwork is a major barrier to achieving quality services. The intent of this study is to assess teamwork as perceived by the health care workers caring for cancer patients Methods: We conducted a survey among health care professionals involved in cancer care in 3 tertiary centers in the southwestern part of Nigeria from July to November 2016. Respondents rated teamwork using the previously validated ÒSafety Attitudes QuestionnaireÓ. For this analysis we focused on the teamwork climate subscale. This subscale is scored on a scale of 0-100 with mean (SD) values,in US ambulatory population of 69.7 (17). We compared ratings by professionals using analysis of variance Results: Overall 373 professionals completed the survey: Physicians (47%), nurses (14%), pharmacists (6%) and others (33%). Some results are shown in table Conclusions: Cancer care is complex and depends on teamwork amongst health care professionals to achieve optimal outcomes. While overall teamwork scores was consistent with US ambulatory studies , there are important variations that provide targets for intervention. Physicians rated teamwork poorly both intra and inter professionally. Pharmacists rated inter professional teamwork with nurses particularly poorly. Further data on additional subscales of the instrument and by individual centers will be presented. Efforts to transform cancer care need to focus on building trust among the key stakeholders. This is true in developing world where there is a need to maximize the use of limited resources to improve patient outcomes. [Table: see text]


2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 119-122 ◽  
Author(s):  
Shirley A. Blanchard ◽  
Rob Rivers ◽  
Winnie Martinez ◽  
Lawrence Agodoa

Background: To address the myriad of health problems and disparities that affect the United States (US) population, the mix of health care professionals and researchers must reflect the full diversity of the nation. There continues to be discrepancy between the number of trained scientists and bio­medical researchers from underrepresented populations relative to the overall popula­tion. A scarcity of formal and informal net­working opportunities for minority research­ers and health care providers contribute to this lack of diversity.Objective: The purpose of this article is to report the outcomes of an established junior minority faculty mentoring program. The Network of Minority Health Research Investigators (NMRI) was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in 2002. We present outcome data from 2008 to the present.Methods: The Oversight and Planning Committees of the NMRI developed an 18-question survey. The NMRI program analyst conducted a pilot test of the survey and made modifications to ensure readabil­ity and understanding. From 2008 – 2018, we administered the survey in both paper and electronic versions to junior and senior members of NMRI. Descriptive results identified the participants. We used open coding to extrapolate recurring statements, words, and themes that were organized into four final categories: reasons for attending NMRI; mentoring; career development; and social support.Results: Participants were primarily post-doctoral researchers or assistant professors seeking promotion to instructor or associ­ate professor with tenure (64%). Consistent reasons for participating in the Network included: career development; emotional support; mentorship for research; devel­oping or refining skills for grant writing; lab management; poster presentations; and applying for tenure. Areas of research interest included diabetes, kidney diseases, nutrition, obesity, and bioinformatics.Conclusions: While the number of respons­es to the survey varied annually, the qualita­tive results suggest that career development and social support provided through the Network were the largest motivators for participation. Ethn Dis. 2019;29(Suppl 1):119-122; doi:10.18865/ed.29.S1.119. 


2011 ◽  
Vol 25 (5) ◽  
pp. 497-502 ◽  
Author(s):  
Karen F. Marlowe ◽  
Richard Geiler

Pain continues to be a serious health care concern in the United States. Patients with chronic pain experience the impact of the disease throughout their lives including their social interactions, family relationships, and in many cases economic productivity. Multiple surveys have found that many pharmacists hold misconceptions regarding opioids, pain disease states, and their understandings of current regulations. Multiple barriers affect the ability of pharmacists to deliver care to patients' prescribed opioid therapy. Inadequate communication between health care professionals and patients is one of the hurdles, which prevents quality care. Increased communication between health care providers including access to health information is one step, which is crucial to improving provision of pharmacotherapy. Finally, the quality of educational opportunities relative to opioids and pain management specifically for pharmacists needs to be increased, and consideration needs to be given for making appropriate pain management education mandatory.


2020 ◽  
Vol 35 (10) ◽  
pp. 446-464
Author(s):  
Joshua Chou ◽  
Merton Lee ◽  
Taylor Kaminsky ◽  
Tarlan Namvar ◽  
Catherine E. Cooke ◽  
...  

OBJECTIVE: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.<br/> DESIGN: Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).<br/> SETTING: Interviews were conducted in multiple cities within the United States during June-July 2019.<br/> PATIENTS, PARTICIPANTS: FGI participants (N=36) included community dwelling adults, 65 years of age or older, who took 5+ chronic medications, or their caregivers. KII participants (N=15) included health care professionals caring for similar populations.<br/> INTERVENTIONS: Participants were given samples of blister packs and pouches and asked about medication management and appearance and usability of medication packaging. Interviews were audio-recorded with participants' consent, then transcribed and coded using Atlas. ti. Recurrent and emergent themes were identified, and selected quotes served as examples of identified themes.<br/> MAIN OUTCOME MEASURE: Participants' perceptions regarding medication packaging.<br/> RESULTS: Participants' preferences varied for different multi-medication packaging systems. Similarly, most FGI participants did not communicate a strong attitude for or against their existing management systems. However, many FGI participants perceived a need for larger font size than seen on the either of the multimedication packaging samples. KII participants also preferred a larger font size on both packagings. KII participants thought the blister packs offered better visual organization and enabled caregivers to quickly assess adherence. However, KII participants expressed concern about integrating as-needed and short-term use medications and noted difficulty opening both types of packages.<br/> CONCLUSION: Visual appearance is important to both patients and health care providers. Continued research in this area is vital for tailoring packaging types and technology to patients.


2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 119-122
Author(s):  
Shirley A. Blanchard ◽  
Rob Rivers ◽  
Winnie Martinez ◽  
Lawrence Agodoa

Background: To address the myriad of health problems and disparities that affect the United States (US) population, the mix of health care professionals and researchers must reflect the full diversity of the nation. There continues to be discrepancy between the number of trained scientists and bio­medical researchers from underrepresented populations relative to the overall popula­tion. A scarcity of formal and informal net­working opportunities for minority research­ers and health care providers contribute to this lack of diversity.Objective: The purpose of this article is to report the outcomes of an established junior minority faculty mentoring program. The Network of Minority Health Research Investigators (NMRI) was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in 2002. We present outcome data from 2008 to the present.Methods: The Oversight and Planning Committees of the NMRI developed an 18-question survey. The NMRI program analyst conducted a pilot test of the survey and made modifications to ensure readabil­ity and understanding. From 2008 – 2018, we administered the survey in both paper and electronic versions to junior and senior members of NMRI. Descriptive results identified the participants. We used open coding to extrapolate recurring statements, words, and themes that were organized into four final categories: reasons for attending NMRI; mentoring; career development; and social support.Results: Participants were primarily post-doctoral researchers or assistant professors seeking promotion to instructor or associ­ate professor with tenure (64%). Consistent reasons for participating in the Network included: career development; emotional support; mentorship for research; devel­oping or refining skills for grant writing; lab management; poster presentations; and applying for tenure. Areas of research interest included diabetes, kidney diseases, nutrition, obesity, and bioinformatics.Conclusions: While the number of respons­es to the survey varied annually, the qualita­tive results suggest that career development and social support provided through the Network were the largest motivators for participation. Ethn Dis. 2019;29(Suppl 1):119-122; doi:10.18865/ed.29.S1.119. 


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