Co-designing a Community Pharmacy Pharmacogenomics Testing Service In The UK

Introduction: Pharmacogenomics (PGx) testing services have been delivered through community pharmacies across the globe, though not yet in the UK. This paper is reporting a focus group study, the first stage of a participatory co-design process to increase the chance of a successful implementation of a PGx service through community pharmacy in the UK.Aim: To identify the barriers and enablers to implementing a community pharmacy based PGx service in the UK.Method: Three focus groups were conducted with community pharmacists (n= 10), prescribers (n= 8) and patients (n=8) in England. The focus groups were recorded, transcribed and thematically analysed using the Braun and Clarke six step reflexive thematic analysis approach.Results: The analysis identified five themes about PGx testing in community pharmacies: (1) In- principle receptiveness, (2) Appreciation of the benefits, (3) Lack of implementation resources (4) Ambiguity about implications for implementation and (5) Interprofessional relationship challenges.Conclusion: The identified enablers for implementation of a PGx service were at a macro health system strategic level; the concerns were more at a granular operational procedural level. Overall receptiveness was noted by all three participant groups, and both prescriber and pharmacist groups appreciated the potential benefits for patients and the healthcare system. Prior to implementation in the UK, there is a need to disambiguate health professional’s concerns of the guidance, resources, and knowledge required to set up and deliver the service and to resolve patient concerns about the nature of genomics.

“For Me, This Has Been Transforming”: A Qualitative Analysis of Interprofessional Relationship-Centered Communication Skills Training

In 2018, Yale Medicine (YM)—an academic multispecialty practice—and Yale New Haven Health System (YNHH), partnered with the Academy of Communication in Healthcare to develop a one-day interprofessional workshop to introduce relationship-centered communication skills to all of their nurses and physicians. Relationship-centered communication skills include showing positive regard, listening actively and expressing empathy and have been demonstrated to improve patient outcomes. A professionally diverse group of 12 nurses and physicians, committed to improving patient experiences, were purposefully selected for training to teach the workshop. Individual interviews with trainers 3 months post training revealed themes reflecting the intrapersonal, interpersonal, and organizational impact of participation in the Train-the-Trainer program. At the intrapersonal level, training contributed to personal growth, skillfulness, and confidence. At the interpersonal level, it expanded and strengthened professional networks. As an organizational catalyst, training transformed the work experience among nurse and physician trainers, thereby supporting YM/YNHH’s vision to provide interprofessional relationship-centered care. Results suggest that trainer training had additional benefits beyond learning to deliver the workshop, including improving the quality of trainers’ personal and professional relationships, and enhancing organizational efficiency and interprofessionalism.

Sclerostin Modulation Holds Promise for Dental Indications

Sclerostin modulation is a novel therapeutic bone regulation strategy. The anti-sclerostin drugs, proposed in medicine for skeletal bone loss may be developed for jaw bone indications in dentistry. Alveolar bone responsible for housing dentition share common bone remodeling mechanisms with skeletal bone. Manipulating alveolar bone turnover can be used as a strategy to treat diseases such as periodontitis, where large bone defects from disease are a surgical treatment challenge and to control tooth position in orthodontic treatment, where moving teeth through bone in the treatment goal. Developing such therapeutics for dentistry is a future line for research and therapy. Furthermore, it underscores the interprofessional relationship that is the future of healthcare.

The professionalism of psychiatry registrars as perceived by patients and various health practitioners at Weskoppies Psychiatric Hospital, Pretoria

Objectives: Amidst calls for improved professionalism, this study examined the professionalism of psychiatry registrars at Weskoppies Hospital as evaluated by their patients, themselves, their consultants and other health practitioners. The second objective was to examine the perceived importance of aspects of professionalism and compare these descriptively among the various health practitioners and patients.Method: Participants completed the Professionalism Mini-Evaluation Exercise Questionnaire in evaluating the professionalism of the registrar. The number of questionnaires completed by patients, allied health practitioners, consultant psychiatrists and psychiatry registrars were, respectively, 100, 50, 25 and 20; thus, 195 in total. This previously validated questionnaire consists of 21 items that enquire about doctor-patient relationship skills, reflective skills, time management and interprofessional relationship skills. Participants also ranked the three items of the questionnaire that they considered most important.Results: Highly statistically significant differences among four groups emerged for both the total and all four subscale scores, with patients generally rating the professionalism of registrars as lower, and not meeting with expectations. All four groups ranked ‘listened actively to patient’ and ‘showed interest in patient as person’ highly. Patients and allied health practitioners ranked the attribute ‘was on time’ highly, while consultants and registrars did not.Conclusion: Improving professionalism requires that the attributes ‘listening actively to patient’ and ‘recognising and meeting patient needs’ are taken seriously. Doing so requires that patients also evaluate the professionalism of registrars, rather than relying merely on the evaluation by consultants as being sufficient.

Teamwork in a coronary care unit: facilitating and hindering aspects

OBJECTIVE To identify, within a multidisciplinary team, the facilitating and hindering aspects for teamwork in a coronary care unit. METHOD A descriptive study, with qualitative and quantitative data, was carried out in the coronary care unit of a public hospital. The study population consisted of professionals working in the unit for at least one year. Those who were on leave or who were not located were excluded. The critical incident technique was used for data collection, by means of semi-structured interviews. For data analysis, content analysis and the critical incident technique were applied. RESULTS Participants were 45 professionals: 29 nursing professionals; 11 physicians; 4 physical therapists; and 1 psychologist. A total of 49 situations (77.6% with negative references); 385 behaviors (54.2% with positive references); and 182 consequences emerged (71.9% with negative references). Positive references facilitate teamwork, whereas negative references hinder it. A collaborative/communicative interprofessional relationship was evidenced as a facilitator; whereas poor collaboration among agents/inadequate management was a hindering aspect. CONCLUSION Despite the prevalence of negative situations and consequences, the emphasis on positive behaviors reveals the efforts the agents make in order to overcome obstacles and carry out teamwork.

Humanização em Saúde: Relação Entre os Profissionais de Saúde / Humanization in Health: Relationship Between Health Professionals

Objetivos: Caracterizar o nível de satisfação dos profissionais de saúde frente ao relacionamento interprofissional em um Hospital Escola do Sul de Minas Gerais. Materiais e Métodos: Trata-se de uma pesquisa qualitativa embasada no relato dos próprios membros da equipe. As entrevistas foram gravadas e, após transcrição, estudadas com base no referencial da análise de conteúdo em sua vertente temática. O referencial teórico articulou contribuições da Política Nacional de Humanização (PNH, 2003). Resultados: Observou-se ineficiência da comunicação entre os profissionais, pouca abrangência do tema de PNH, além de discórdias entre os profissionais. Conclusão: A relação entre os profissionais de saúde que trabalham na instituição em que a pesquisa foi realizada não satisfaz seus membros, pois quase a totalidade ressalta principalmente a ausência de comunicação, item dito essencial para uma relação interprofissional de qualidade.Palavras-chave: Relação Profissional, Humanização da Assistência Hospitalar, Atendimento em Equipe.ABSTRACTObjective: To characterize the satisfaction level of Health Professionals Front interprofessional relationship in a Hospital School in southern Minas Gerais. Materials and Methods: Qualitative research based on the reporting of the team own members. The interviews were recorded and, after transcription, they were studied based on content analysis of reference in its thematic aspect. The theoretical framework articulated contributions of the National Humanization Policy (PNH 2003). Results: Inefficiency of communication between professionals, the limited scope of the topic of PNH with the workers, and disagreement between professionals were observed. Conclusion: The relationship between health professionals working in the institution where the research was carried out does not satisfy its members, since almost all of them highlight the lack of communication, which they consider an essential item for an inter-relationship quality.Keywords: Professional Corporation, Humanization of Healthcare, Health Care Team