scholarly journals Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance

2021 ◽  
Vol 6 ◽  
Author(s):  
Stephanie Zajac ◽  
Amanda Woods ◽  
Scott Tannenbaum ◽  
Eduardo Salas ◽  
Courtney L. Holladay
Keyword(s):  
Patient Care ◽  
Team Effectiveness ◽  
Qualitative Data ◽  
Healthcare Professionals ◽  
Management Decision ◽  
Evidence Based ◽  
Science Literature ◽  
Structured Interviews ◽  
Healthcare Teams ◽  
Administrative Functions

Background: Safe and effective patient care depends on the teamwork of multidisciplinary healthcare professionals. Unfortunately, the field currently lacks an evidence-based framework for effective teamwork that can be incorporated into medical education and practice across health professions. We introduce a comprehensive framework for team effectiveness. Common challenges to teamwork in healthcare are identified along with evidence-based strategies for overcoming them.Methods: The framework was developed in four steps: 1) grounding in the existing team science literature, 2) semi-structured interviews (N = 13), 3) thematic analysis and initial framework development, and 4) revision of the framework through input from healthcare professionals representative of different functions across the healthcare system (N = 13). A diagnostic tool consisting of one survey item per team competency was developed to complement the framework. The survey was then administered to healthcare teams across clinical and administrative functions (N = 10 teams, 96 individuals), and results were compiled and then used to conduct debriefs with individual team members and teams. A set of common teamwork challenges were identified using the survey and qualitative data. Qualitative data was analyzed to explore the unique ways these challenges manifest in both clinical and administrative teams.Results: The five most common challenges that face healthcare teams relate to accountability, conflict management, decision-making, reflecting on progress, and coaching. These challenges were similar across both clinical and administrative team types. Based on the authors' collective experience designing and implementing Team Development Interventions (TDIs), strategies for managing each challenge are provided.Conclusions: The proposed framework is unique in two ways. First, it's generally applicable across the many types of teams that contribute to the quality and safety of patient care. Second, the levels of the framework build upon each other to contribute to the development of the ideal team states. The framework and accompanying strategies can provide guidance for where and how to target developmental efforts.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Building Capacity for Implementation – The KT Challenge

2020 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the KT Challenge program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Building Capacity for Implementation – The KT Challenge

2021 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Position Statement: A Pragmatic Approach for Medical Cannabis and Patients with Rheumatic Diseases

2019 ◽  
Vol 46 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Mary-Ann Fitzcharles ◽  
Omid Zahedi Niaki ◽  
Winfried Hauser ◽  
Glen Hazlewood ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Patient Care ◽  
Healthcare Professionals ◽  
Symptom Relief ◽  
Position Statement ◽  
Evidence Based ◽  
Medical Cannabis ◽  
Pragmatic Approach ◽  
Short Term ◽  
Natural Treatment

Objective.Pain is one reason some rheumatology patients may consider use of medical cannabis, a product increasingly perceived as a safe and neglected natural treatment option for many conditions. Legalization of recreational cannabis in Canada will promote access to cannabis. Physicians must therefore provide patients with the best evidence-based information regarding the medicinal effects and harm of cannabis.Methods.The Canadian Rheumatology Association (CRA) mandated the development of a position statement for medical cannabis and the rheumatology patient. The current literature regarding the effects of medical cannabis for rheumatology patients was assessed, and a pragmatic position statement to facilitate patient care was developed by the Therapeutics Committee of the CRA and approved by the CRA board.Results.There are no clinical trials of medical cannabis in rheumatology patients. Evidence is insufficient about the benefit of pharmaceutical cannabinoids in fibromyalgia, osteoarthritis, rheumatoid arthritis, and back pain, but there is evidence of a high risk of harm. Extrapolating from other conditions, medical cannabis may provide some symptom relief for some patients. Short-term risks of psychomotor effects can be anticipated, but longterm risks have not been determined and are of concern.Conclusion.Despite lack of evidence for use of medical cannabis in rheumatology patients, we acknowledge the need to provide empathetic and pragmatic guidance for patient care. This position statement aims to facilitate the dialogue between patients and healthcare professionals in a mutually respectful manner to ensure harm reduction for patients and society.

“I think like if Albert Einstein and Superman had a baby, that's what it would take”: The experiences and perceptions of community and hospital healthcare professionals in a seniors’ patient navigator program

2021 ◽  
pp. 205343452110634
Author(s):  
Kristina M Kokorelias ◽  
Stephanie Posa ◽  
Tracey DasGupta ◽  
Naomi Ziegler ◽  
Sander L Hitzig
Keyword(s):  
Patient Care ◽  
Healthcare Professionals ◽  
Patient Navigation ◽  
Healthcare Providers ◽  
Albert Einstein ◽  
Patient Navigator ◽  
Role Clarity ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Navigators

Introduction The success of new patient navigation programs have mostly been described from the perspectives of patient outcomes. Little is known about how patient navigators interact with healthcare professionals in the community and in hospital settings. Methods A qualitative study using a phenomenological analysis was undertaken to depict the lived experiences of Ontario (Canada) healthcare providers who have interacted with a patient navigator. Semi-structured interviews were conducted with 42 healthcare professionals, including frontline care providers ( n = 25) and administrators ( n = 16) from hospital ( n = 21) and community care settings ( n = 21). Results Participants’ experiences were reflected in one overarching theme: role clarity and three emergent themes related to the overarching theme: (i) concerns over accountability of patient care (ii) trust (iii) attainable-but-not. Participants described an inconsistent understanding of the role of patient navigators which led to uncertainty regarding their role in patient care. The current nature of the healthcare system influenced participants’ belief in the sustainability of patient navigation model of care. Despite these experiences, participants felt that patient navigators could help healthcare providers care for patients by preventing potential crises from developing and enhancing their knowledge about services. Discussion This study expands our understanding of patient navigation programs by exploring the experiences and perceptions of healthcare professionals, thereby providing new perspectives into components that support the successful health outcomes of older adults being supported by a patient navigator. The implications of findings for research, clinical practice, and policy are described.

Interprofessional Conflict Among Healthcare Teams in Nigeria: Implications on Quality of Patient Care

2021 ◽  
Author(s):  
Edwin O. Nwobodo ◽  
Cajetan U. Nwadinigwe ◽  
Ugochukwu Bond Anyaehie ◽  
Princewill Ikechukwu Ugwu ◽  
Nkoli F. Nwobodo ◽  
...  
Keyword(s):  
Patient Care ◽  
Healthcare Professionals ◽  
Online Questionnaire ◽  
Healthcare Teams ◽  
Healthcare Settings ◽  
Interprofessional Teamwork ◽  
Institutional Issues ◽  
Quality Of Patient Care ◽  
Care Outcomes

Abstract Background: Patient care in Nigeria is essentially an interprofessional teamwork. The functionality of the team may have substantial implications on the quality of patient care as well as the professional satisfaction of individual professionals in the health team. This study was designed to identity if interprofessional conflicts existed in health teams in health institutions in southeast Nigeria, and to explore their nature, course, identify the extant resolution mechanisms and to start to identify and document feasible mechanisms to mitigate the conflicts. The aim is to enhance the functionality of health teams for an overall better patient care outcome.Method: An online questionnaire survey collected data from 58 health healthcare professionals in four healthcare settings in the southeast of Nigeria. Quantitative and qualitative analyses were conducted resulting in seven central themes of conflict. The paper adopted narrative qualitative survey tools to survey a cohort of healthcare professionals who have practiced for varying periods. This study investigated the existence, or otherwise, and nature of the conflicts within health teams, probes the most at conflict as well as approaches being used in conflict resolution.Results: Many institutional conflicts exist among the healthcare teams. There are several conflict resolutions approaches that are being employed to resolve the conflicts. Most resolutions are simply the avoidance approach. Many of the conflicts potentially affect patient care outcomes but these are issues that could be resolved on a permanent to semi-permanent basis at local levels whilst others are broader institutional issues that will require external fixes. Discussion: There is a need to improve on the team process for healthcare professional early and systematically. Key or essential steps for doing this based on the importance of continued attentions to better patient care approaches are provided in this paper.

scholarly journals Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review

2020 ◽  
Author(s):  
Suzannah Stuijfzand ◽  
Camille Deforges ◽  
Vania Sandoz ◽  
Consuela-Thais Consuela-Thais Sajin ◽  
Cécile Jaques ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Care ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Psychological Impact ◽  
Health Problems ◽  
Drug Misuse ◽  
Mental Wellbeing ◽  
Rapid Review ◽  
Evidence Based

Abstract Background: Epidemics or pandemics, such as the current Coronavirus Disease 2019 (COVID-19) crisis, pose unique challenges to healthcare professionals (HCPs). Caring for patients during an epidemic/pandemic may impact negatively on the mental health of HCPs. There is a lack of evidence-based advice on what would be effective in mitigating this impact. Objectives: This rapid review synthesizes the evidence on the psychological impact of pandemics/epidemics on the mental health of HCPs, what factors predict this impact, and the evidence of prevention/intervention strategies to reduce this impact. Method: According to rapid review guidelines, systematic searches were carried out in Embase.com, PubMed, APA PsycINFO-Ovid SP, and Web of Science (core collection). Searches were restricted to the years 2003 or later to ensure inclusion of the most recent epidemic/pandemics, such as Severe Acute Respiratory Syndrome (SARS). Papers written in French or English, published in peer-reviewed journals, and of quantitative design using validated measures of mental health outcomes were included. Of 1308 papers found, 50 were included. The full protocol for this rapid review was registered with Prospero ( reg.no. CRD42020175985). Results: Results show that exposed HCPs working with patients during an epidemic/pandemic are at heightened risk of mental health problems in the short and longer term, particularly: psychological distress, insomnia, alcohol/drug misuse, and symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, burnout, anger, and higher perceived stress. These mental health problems are predicted by organizational, social, personal, and psychological factors and may interfere with the quality of patient care. Few evidence-based early interventions exist so far. Discussion: HCPs need to be provided with psychosocial support to protect their mental wellbeing if they are to continue to provide high quality patient care. Several recommendations relevant during and after an epidemic/pandemic, such as COVID-19, and in preparation for a future outbreak, are proposed.

scholarly journals Harmonious Healthcare Teams: What Healthcare Professionals Can and Cannot Learn from Chamber Musicians

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Clare M.C. Whitehead ◽  
Cynthia Whitehead ◽  
Gabrielle F.D. McLaughlin ◽  
Zubin Austin
Keyword(s):  
Interprofessional Education ◽  
Healthcare Professionals ◽  
Structured Interviews ◽  
Professional Musicians ◽  
Group Function ◽  
Group Interactions ◽  
Team Members ◽  
Healthcare Teams ◽  
Effective Group

Background: As healthcare becomes increasingly team based, we need new ways of educating trainees to be collaborative team members. One approach is to look to other professions that have developed highly effective ways of collaborating. Doctors have already turned to musicians for specific lessons; however, as of yet, there has been little empirical study of the ways that musicians interact in ensembles, or analysis of how this might provide insights for healthcare. Our hypothesis is that healthcare teams might learn from understanding collaborative practices of chamber musicians.Methods and Findings: We undertook an exploratory study of professional musicians playing in non-conducted ensembles. We used semi-structured interviews to explore factors the musicians considered important for effective group function. The interviews were transcribed and coded thematically. We identified three prominent themes that have relevance for healthcare teams.Conclusions: The highly individual nature of each musical group’s identity suggests that a focus on generic interprofessional education skills development may be insufficient. Furthermore, musicians’ understanding of the fundamental role of non-melodic parts provides the possibility of more nuanced leadership models. Finally, essential differences between musicians’ interactions in rehearsals and performances highlight the importance of varied forms of group interactions.

scholarly journals Promoting Evidence-based Veterinary Medicine through the online resource ‘EBVM Learning’: User feedback

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ellie Sellers ◽  
Sarah Baillie ◽  
Rachel Dean ◽  
Sheena Warman ◽  
Heidi Janicke ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Qualitative Data ◽  
Worked Examples ◽  
Steady Increase ◽  
Evidence Based ◽  
Structured Interviews ◽  
Stakeholder Groups ◽  
Online Resource ◽  
International Audience ◽  
Online Form

Abstract ‘EBVM Learning’ is a freely available resource created in 2015 by an international team with the support of RCVS Knowledge. The resource comprises a series of online modules teaching the fundamental concepts of evidence-based veterinary medicine (EBVM) (Ask, Acquire, Appraise, Apply & Assess) supported by case studies, exercises, worked examples and quizzes. The aim of the current study (undertaken in 2019) was to review ‘EBVM Learning’ to ensure its ongoing relevance and usefulness to the range of learners engaged in EBVM. Feedback was gathered from stakeholder groups using website statistics and feedback forms, a survey and semi-structured interviews to provide a combination of quantitative and qualitative data. Website statistics revealed an international audience and a steady increase in visitors exceeding 1,000 per month in August 2020. Feedback via the online form (n=35) and survey (n=71) indicated that the resource was well structured, with an appropriate level and amount of content, useful examples and quizzes and the majority of respondents would use it again. Semi-structured interviews of educators (n=5) and veterinarians (n=8) identified three themes: features of the ‘EBVM Learning’ resource (strengths, suggestions for improvement), embedding the resource in education (undergraduate, postgraduate) and promoting EBVM (challenges, motivation for engagement). At a project team workshop the results were used to plan updates to the existing content and to identify new ways to promote learning and engagement. An updated version of ‘EBVM Learning’ was developed. ‘EBVM Learning’ is helping to produce the next generation of evidence-based practitioners and enabling to engage in the concepts of EBVM as part of their clinical practice.  

scholarly journals Take Care and Care Well

2017 ◽  
Vol 49 (2) ◽  
pp. 43-45
Author(s):  
Mary Coughlin McNeil
Keyword(s):  
Clinical Practice ◽  
Best Practices ◽  
Patient Care ◽  
Patient Outcomes ◽  
Healthcare Professionals ◽  
Care Process ◽  
Evidence Based ◽  
Quality And Safety ◽  
Patient Values ◽  
Patient Care Process

Evidence-based practice supports the patient care process by integrating patient values and preferences with clinician expertise and the best available evidence. This approach to patient care focuses on quality and safety with the aim of improving patient outcomes. Despite its obvious value, healthcare professionals struggle to integrate evidence-based best practices into their clinical practice

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