A Process of Multidisciplinary Team Communication to Individualize Stroke Rehabilitation of an 84-Year-Old Stroke Patient

2016 ◽  
Vol 17 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Fukumi Hiragami ◽  
Shogo Hiragami ◽  
Yasuo Suzuki
Keyword(s):  
Multidisciplinary Team ◽  
Treatment Options ◽  
Communication Process ◽  
Knowledge Assessment ◽  
Team Members ◽  
Mobility Impairments ◽  
Patient Families ◽  
Initial Meeting

Previously, we have used a multidisciplinary team (MDT) approach to individualize rehabilitation of very old stroke patients as a means to establish intervention points for addressing impaired activities of daily living (ADL). However, this previous study was limited because of a lack in describing the communication process over time. This case study characterized the MDT communication process in the rehabilitation of an 84-year-old patient over the course of 15 weeks. The MDT consisted of 3 nurses, 1 doctor, 6 therapists, and the patient/families. Meetings (15 minutes each) were held at 4, 6, 8, and 15 weeks following the patient’s admission. To individualize the rehabilitation, the communication process involved gaining knowledge about ADL impairments, sharing assessments, providing treatment options, and reflecting on desired treatment outcomes—a process termed KATR. The knowledge, assessment, treatment, and reflection (KATR) process established intervention points focusing on specific ADL impairments. The team members focused the interventions on the impaired ADL identified in the KATR process, and individualized rehabilitation was generated from the MDT information-sharing knowledge. In the initial meeting (Week 4), intervention points derived from the KATR process focused on rehabilitation of self-care impairments. These impairments improved by Week 15. By the last meeting, the MDT intervention points focused on mobility impairments. Having an organized communication process (i.e., KATR) facilitates individualization of rehabilitation without lengthy and frequent MDT meetings and enhances the quality of rehabilitation after a stroke.

scholarly journals Patient and caregiver perspectives on a tool to identify undiagnosed dementia: A qualitative study

2021 ◽  
Author(s):  
Lorella Palazzo ◽  
Clarissa Hsu ◽  
Deborah Barnes ◽  
Marlaine Figueroa-Gray ◽  
Mikael Anne Greenwood-Hickman ◽  
...  
Keyword(s):  
At Risk ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Dementia Diagnosis ◽  
Kaiser Permanente ◽  
Team Members ◽  
Dementia Risk ◽  
Patients At Risk ◽  
Improve Patient

Abstract BACKGROUND Early detection of dementia may improve patient care and quality of life, yet as many as half of patients are undiagnosed. Electronic health record (EHR) data could potentially be used to help to identify patients at risk of having undiagnosed dementia who could be targeted for outreach and assessment, but acceptability to patients and caregivers is unknown. METHOD We conducted five focus groups at Kaiser Permanente Washington, an integrated healthcare system in Washington State, to explore feelings about timing of dementia diagnosis, use of EHR-33 based tools to predict risk of undiagnosed dementia, and communication about risk. Two team members analyzed transcripts using inductive thematic coding. RESULTS Participant groups included: patients with dementia or mild cognitive impairment, patients with neither diagnosis, and caregivers. People who were non-white or Hispanic were oversampled. Forty patients and caregivers (63% women; 59% non-white/Hispanic) participated in focus 39 groups. Participants supported early diagnosis, describing benefits such as time to adjust to the disease, plan, involve caregivers, and identify resources. They also acknowledged the possible psychosocial toll of receiving the diagnosis. Participants also supported use of an EHR-based tool, but some worried about accuracy and privacy. Participants emphasized that information about dementia risk should be communicated thoughtfully by a trusted provider and should include advice about prognosis, treatment options and other resources. CONCLUSION Overall, patients and caregivers supported using EHR-based tools to help identify patients at risk of having undiagnosed dementia. Such tools must be implemented carefully to address concerns and ensure patients and caregivers are adequately supported.

scholarly journals Interprofessional collaboration: A gastrointestinal unit case study

2018 ◽  
Vol 8 (9) ◽  
pp. 73
Author(s):  
Yiying Fang ◽  
Yulin Feng ◽  
Yan Xu
Keyword(s):  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Vital Role ◽  
Critical Element ◽  
Interprofessional Practice ◽  
Ability To Work ◽  
Team Members ◽  
Upper Gastrointestinal

Interprofessional collaboration plays a vital role in improving patient outcomes. The ability to work with professionals from different disciplines is considered a critical element of interprofessional practice. In this article, a case of a patient with upper gastrointestinal tract hemorrhage in a gastrointestinal unit is reported and analyzed from the perspective of interprofessional practice. Strategies are also introduced in the article. Enhancing mutual understanding and communication skills is conductive to interprofessional collaboration. Meanwhile, interprofessional education, as another strategy, is proved to improve the quality of health care by enhancing the cooperation among different medical team members.

scholarly journals How Teams Communicate about the Quality of ML Models: A Case Study at an International Technology Company

2021 ◽  
Vol 5 (GROUP) ◽  
pp. 1-24
Author(s):  
Jumana Almahmoud ◽  
Robert DeLine ◽  
Steven M. Drucker
Keyword(s):  
User Experience ◽  
General Term ◽  
Mitigation Strategies ◽  
Mixed Methods Study ◽  
Team Members ◽  
Software Products ◽  
Crucial Component ◽  
Technical Issues

Machine learning (ML) has become a crucial component in software products, either as part of the user experience or used internally by software teams. Prior studies have explored how ML is affecting development team roles beyond data scientists, including user experience designers, program managers, developers and operations engineers. However, there has been little investigation of how team members in different roles on the team communicate about ML, in particular about the quality of models. We use the general term quality to look beyond technical issues of model evaluation, such as accuracy and overfitting, to any issue affecting whether a model is suitable for use, including ethical, engineering, operations, and legal considerations. What challenges do teams face in discussing the quality of ML models? What work practices mitigate those challenges? To address these questions, we conducted a mixed-methods study at a large software company, first interviewing15 employees in a variety of roles, then surveying 168 employees to broaden our understanding. We found several challenges, including a mismatch between user-focused and model-focused notions of performance, misunderstandings about the capabilities and limitations of evolving ML technology, and difficulties in understanding concerns beyond one's own role. We found several mitigation strategies, including the use of demos during discussions to keep the team customer-focused.

scholarly journals Perioperative communication from the perspective of patients undergoing bariatric surgery

2014 ◽  
Vol 23 (2) ◽  
pp. 347-355 ◽  
Author(s):  
Caroline Lemes Pozza Morales ◽  
Jenefer Garcez Alexandre ◽  
Suzana Prim ◽  
Lúcia Nazareth Amante
Keyword(s):  
Bariatric Surgery ◽  
Multidisciplinary Team ◽  
Surgical Care ◽  
Perioperative Period ◽  
Communication Process ◽  
University Hospital ◽  
Southern Brazil ◽  
Individual Interviews ◽  
Surgical Unit

This was a qualitative and descriptive study that aimed to determine how patients understand instructions provided by a multidisciplinary team during perioperative periods of bariatric surgery. Data were collected through three individual interviews. Six patients admitted to a surgical unit of a university hospital in southern Brazil, in April and May 2012, participated in the study. Thematic analysis revealed three categories: communication in the perioperative period of bariatric surgery; quality of life and post- surgical care following bariatric surgery; and communication in the work process of the multidisciplinary team. The results showed satisfaction with the information received, but problems in the communication process and apprehension about life after surgery were highlighted. Furthermore, the absence of outpatient nursing care was demonstrated.

scholarly journals The passenger service improvement using fuzzy QFDbased on evidence reasoning approach; case study

2013 ◽  
Vol 2 (2) ◽  
pp. 138-153 ◽  
Author(s):  
A Mirzazadeh
Keyword(s):  
Service Quality ◽  
Quality Function Deployment ◽  
Evaluation Criteria ◽  
Service Improvement ◽  
Transportation Industry ◽  
Team Members ◽  
Intelligent Decision ◽  
Human Thinking

The airline service quality is an important issue in the international air travel transportation industry. Thefirstpassengers' encounter with airline staff is at the airport and therefore, improving the quality of passenger services is one of the main objectives of airlines.The study applies an extension of the Quality Function Deployment to examine the performance of Iran Air in passenger service and propose suggestions for improvement.Human judgments are often vague, and it is not easy for passengers to express the weights of evaluation criteria and the satisfaction of airline service quality using an exact numerical value. Fuzzy logic is a methodology to deal with ill-defined nature of the customer's linguistic judgments required in the QFD.Also, the evidential reasoning based QFD is a methodology for synthesizing various types of assessment information provided by QFD team members. The presented model can be considers vagueness of human thinking style.The Intelligent Decision System (IDS) software has been used to solve the problem. The results have been demonstrated that the stafftrainingand the appropriate delayed flight handling are the most important elements of customer satisfaction and the highlighted areas for service improvement.

scholarly journals Perceptions of multidisciplinary renal team members towards home dialysis therapies

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0006222020
Author(s):  
Krishna Poinen ◽  
Mary Van Der Hoek ◽  
Michael A. Copland ◽  
Karthik Tennankore ◽  
Mark Canney
Keyword(s):  
Quality Of Life ◽  
Multidisciplinary Team ◽  
Allied Health ◽  
Further Education ◽  
System Level ◽  
Health Staff ◽  
Home Dialysis ◽  
Team Members ◽  
Dialysis Nurses

Background: Patients with end stage kidney disease are encouraged to pursue home dialysis therapy with the aims of improving quality of life, increasing patient autonomy and reducing cost to health care systems. In a multidisciplinary team setting, patients interact with nephrologists, nurses and allied health staff, all of whom may influence a patient's modality choice. Our objective was to evaluate the perceptions of all renal team members towards home dialysis therapies. Methods: Cross-sectional survey of multidisciplinary renal team members across five renal programs in British Columbia, Canada. The survey contained questions regarding primary work area, modality preference, patient and system factors that may influence modality candidacy, perceived knowledge of home therapies and need for further education. Results: A total of 334 respondents (22 nephrologists, 172 hemodialysis nurses, 49 home nurses, 20 pre-dialysis nurses, and 71 allied health) were included (48% response rate). All respondents felt that home dialysis was beneficial for patients who work or study, improved patients' quality of life, and provided cost-savings to the system. Compared to in-center hemodialysis nurses, home therapies nurses were between 5 and 9 times more likely to favor a home therapy for patients of older age, lower socioeconomic status, lower educational level, higher burden of comorbidities and those lacking social supports. Nephrologists and patients were felt to have the most impact on modality choice, while dialysis nurses were seen as having the least impact on modality choice. Most respondents felt the need for further education in home therapies. Conclusions: The majority of multidisciplinary team members, including allied health staff, acknowledged the benefits of home therapies. There were significant discrepancies amongst team members regarding patient/system-level factors that may impact home therapies candidacy. Structured, focused and repeated education sessions for all renal team members may help to address misperceptions around factors that influence modality candidacy.

scholarly journals Improving Quality of Cancer Care by Participating in Quality Oncology Practice Initiative Certification Program

2020 ◽  
pp. 1087-1092
Author(s):  
Abdul Rahman Jazieh ◽  
Nafisa Abdelhafiez ◽  
Nashmia Al Mutairi ◽  
Ahmed Hashem ◽  
Mohammad Alkaiyat ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Essential Elements ◽  
Outpatient Services ◽  
Team Members ◽  
Ensure Patient Safety ◽  
Oncology Practice ◽  
The Right ◽  
A Site ◽  
The Impact

PURPOSE ASCO developed the Quality Oncology Practice Initiative (QOPI) to ensure patient safety in oncology outpatient services. We evaluated the impact of participation in QOPI certification on patient care at our institution. METHODS To participate in QOPI, we created a multidisciplinary team, and we chose the required modules and began QOPI participation per program requirement. In the initial round, we scored lower than the required score of 75% to be eligible for QOPI certification. We then implemented multiple measures and interventions, and we conducted multiple Plan, Do, Study, Act cycles (PSDA) cycles to achieve our goal. RESULTS Our score in the initial round was 68%; in the second round, our score remained low at 65%; in the third round, we exceeded the target score by achieving 93%. We completed the certification process with a site visit. In October 2018, we became the first QOPI-certified center in the Middle East and Asia. CONCLUSION We learned many lessons during our journey toward QOPI certification. Essential elements of success included timely assembly of the right multidisciplinary team and clear communication between team members within the institution and with the ASCO QOPI team.

scholarly journals Treating Early Knee Osteoarthritis with the Atlas® Unicompartmental Knee System in a 26-Year-Old Ex-Professional Basketball Player: A Case Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Konrad Slynarski ◽  
Lukasz Lipinski
Keyword(s):  
Knee Osteoarthritis ◽  
Treatment Options ◽  
Disease Status ◽  
Interesting Case ◽  
Young Age ◽  
Basketball Player ◽  
Tibial Osteotomy ◽  
Surgical Treatments

Knee osteoarthritis (OA) is a leading cause of disability among adults. Within the affected population, there exists a group of patients who have exhausted conservative treatment options and yet are not ideal candidates for current surgical treatments due to young age, early disease severity, or neutral mechanical knee alignment. For these patients, a new potential treatment option may be considered. We present an interesting case report of a young, ex-professional athlete treated with a minimally invasive load-altering implant (Atlas System) whose young age (26 years), disease status (tibiofemoral kissing lesions), and neutral mechanical limb alignment eliminated all traditional surgical treatment options such as high tibial osteotomy or arthroplasty. At 6 months after surgery, our patient demonstrated positive outcomes improvement in pain, function, and quality of life and had returned to high-impact athletic activity without symptoms. These initial results are promising, and longer follow-up data on the treatment will be necessary.

scholarly journals Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Lucas B. Chartier ◽  
Amy H.Y. Cheng ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt
Keyword(s):  
Quality Improvement ◽  
Professional Training ◽  
Problem Statement ◽  
Improvement Project ◽  
Team Members ◽  
Root Cause ◽  
Change Team ◽  
Patient Safety Incidents

ABSTRACTEmergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses—Ishikawa diagrams, Pareto charts and process mapping—and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

scholarly journals The perspective of medical staff on improving the integrated communication process – A pilot study

2021 ◽  
Vol 14 (4) ◽  
pp. 578-586
Author(s):  
Mirela Morcov ◽  
◽  
◽  
Iuliana-Raluca Gheorghe ◽  
Maria Veronica Morcov ◽  
...  
Keyword(s):  
Physical Therapists ◽  
Statistical Significance ◽  
Communication Process ◽  
Working Relationships ◽  
Medical Team ◽  
Chi Square ◽  
Team Members ◽  
Communication Difficulties ◽  
Chi Square Test

The quality of working relationships among medical team members is influenced by communication, which has a significant impact on patient safety. Our study took place at the Dr. Nicolae Robanescu National Neurorehabilitation Center for Children, Bucharest, between October and December 2019 and included 44 participants that were grouped into three categories: physicians, physical therapists, and nurses (32 women and 12 men), aged between 23 and 53, all of whom were employed in the same unit. A total of 5 questions were used to select data on communication difficulties. The chi-square test used for statistical analysis revealed no significant differences between the professional categories participating in the research (p>0.05). We suggest increasing the group size in a future study to increase the statistical significance.

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