Review article: video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management?

PubMed

Paolini, Jean-Baptiste; Donati, François; Drolet, Pierre

2013-02-01

An adequate airway management plan is essential for patient safety. Recently, new tools have been developed as alternatives to direct laryngoscopy and intubation. Among these, video-laryngoscopy has enjoyed a rapid increase in popularity and is now considered by many as the first-line technique in airway management. This paradigm shift may have an impact on patient safety. Studies show that video-laryngoscopes are associated with better glottic visualization, a higher success rate for difficult airways, and a faster learning curve, resulting in a higher success rate for intubations by novice physicians. Thus, unanticipated difficult intubations may be less frequent if video-laryngoscopy is used as the first-line approach. In addition, on-screen viewing by the operator creates a new dynamic interaction during airway management. The entire operating room team can assess progress in real time, which enhances communication and improves teaching. However, if video-laryngoscopes become standard tools for tracheal intubation, these more costly devices will need to be widely available in all locations where airway management is conducted. Furthermore, algorithms for difficult intubation will require modification, and the question of selecting alternate devices will arise. If the incidence of difficult intubation decreases, the lack of motivation to teach and learn the use of alternative devices might adversely impact patient safety. The greater effectiveness of video-laryngoscopes associated with multi-person visualization could enhance overall patient safety during airway management. However, the routine use of video-laryngoscopy also introduces some issues that need to be addressed to avoid potentially dangerous pitfalls.

A scoping review of crisis teams managing dementia in older people

PubMed Central

Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

2017-01-01

Background Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. Methods For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. Results The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Conclusion Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness. PMID:29042760

Self-Managed Work Teams in Nursing Homes: Implementing and Empowering Nurse Aide Teams

ERIC Educational Resources Information Center

Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney

2004-01-01

Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…

Setting up an energy management team

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mashburn, W.H.

1995-12-31

Many people that are assigned the responsibility of reducing energy costs within an organization are technically inclined, and may have little organizational or management skills. A number of companies have achieved great savings with just a technical energy manager acting in a prima donna role. However, so much more can be achieved if energy management is integrated throughout the whole organization, with input from all levels. The energy management team is the key to an organized approach, and establishing one is the place to start. The Industrial Energy Center at Virginia Tech is sponsored by both electric and natural gasmore » utilities who ask for assistance in conducting energy surveys of industrial firms. One requirement of the companies the author surveys is that they agree to establish an energy management team. During the first few hours with the company he helps organize and train the team. The objective is to have a high implementation rate of the energy conservation opportunities found during the survey. By leaving in place an in-house energy management team, the prospects for this are better. The author has found that most large corporations have some type of energy management program, but not much has transcended to company level. This paper is directed toward establishing an energy management team at company level.« less

A Data Scheduling and Management Infrastructure for the TEAM Network

NASA Astrophysics Data System (ADS)

Andelman, S.; Baru, C.; Chandra, S.; Fegraus, E.; Lin, K.; Unwin, R.

2009-04-01

TEAM protocols with the logistical scheduling needs of each TEAM Site. For example, each TEAM protocol defines when data must be collected (e.g. time of day, number of times per year, during which seasons, etc) as well as where data must be collected (from which sampling units, which trees, etc). Each TEAM Site has a limited number of resources and must create plans that will both satisfy the requirements of the protocols as well as be logistically feasible for their TEAM Site. With 15 TEAM Sites (and many more coming soon) the schedules of each TEAM Site must be communicated to the Network Office to ensure data are being collected as scheduled and to address the many problems when working in difficult environments like Tropical Forests. The Sampling Schedule provides built-in proposal and approval functionality to ensure that the TEAM Sites are and the Network office are in sync as well as provides the capability to modify schedules when needed. The Data Management Framework The Data Management framework is a three-tier data ingestion, edit and review application for protocols defined in the TEAM network. The data ingestion framework provides online web forms for field personnel to submit and edit data collected at TEAM Sites. These web forms will be accessible from the TEAM content management site. Once the data is securely uploaded, cured, processed and approved, it will be made publicly available for consumption by the scientific community. The Data Management framework, when combined with the Sampling Scheduler provides a closed loop Data Scheduling and Management infrastructure. All information starting from data collection plan, tools to input, modify and curate data, review and run QA/QC tests, as well as verify data are collected as planed are included. Finally, TEAM Network data are available for download via the Data Query and Download Application. This application utilizes a Google Maps custom interface to search, visualize, and download TEAM Network data

Putting the "Team" in the Fine Arts Team: An Application of Business Management Team Concepts

ERIC Educational Resources Information Center

Fisher, Ryan

2007-01-01

In this article, the author discusses current challenges to the idea of teamwork in fine arts teams, redefines the terms team and collaboration using a business management perspective, discusses the success of effective teams in the business world and the characteristics of those teams, and proposes the implementation of the business model of…

Panel management, team culture, and worklife experience.

PubMed

Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; O'Brien, Bridget; Earnest, Gillian; Gupta, Reena; Shunk, Rebecca; Grumbach, Kevin

2015-09-01

Burnout and professional dissatisfaction are threats to the primary care workforce. We investigated the relationship between panel management capability, team culture, cynicism, and perceived "do-ability" of primary care among primary care providers (PCPs) and staff in primary care practices. We surveyed 326 PCPs and 142 staff members in 10 county-administered, 6 university-run, and 3 Veterans Affairs primary care clinics in a large urban area in 2013. Predictor variables included capability for performing panel management and perception of team culture. Outcome variables included 2 work experience measures--the Maslach Burnout Inventory cynicism scale and a 1-item measure of the "do-ability" of primary care this year compared with last year. Generalized Estimation Equation (GEE) models were used to account for clustering at the clinic level. Greater panel management capability and higher team culture were associated with lower cynicism among PCPs and staff and higher reported "do-ability" of primary care among PCPs. Panel management capability and team culture interacted to predict the 2 work experience outcomes. Among PCPs and staff reporting high team culture, there was little association between panel management capability and the outcomes, which were uniformly positive. However, there was a strong relationship between greater panel management capability and improved work experience outcomes for PCPs and staff reporting low team culture. Team-based processes of care such as panel management may be an important strategy to protect against cynicism and dissatisfaction in primary care, particularly in settings that are still working to improve their team culture. (c) 2015 APA, all rights reserved).

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

PubMed Central

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-01-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the ‘can't intubate, can't oxygenate’ situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how

[Quality assurance in airway management: education and training for difficult airway management].

PubMed

Kaminoh, Yoshiroh

2006-01-01

Respiratory problem is one of the main causes of death or severe brain damage in perioperative period. Three major factors of respiratory problem are esophageal intubation, inadequate ventilation, and difficult airway. The wide spread of pulse oximeter and capnograph reduced the incidences of esophageal intubation and inadequate ventilation, but the difficult airway still occupies the large portion in the causes of adverse events during anesthesia. "Practice guideline for management of the difficult airway" was proposed by American Society of Anesthesiologists (ASA) in 1992 and 2002. Improvement of knowledge, technical skills, and cognitive skills are necessary for the education and training of the difficult airway management. "The practical seminar of difficult airway management (DAM practical seminar)" has been cosponsored by the Japanese Association of Medical Simulation (JAMS) in the 51 st and 52 nd annual meetings of Japanese Society of Anesthesiologists and the 24th annual meeting of Japanese Society for Clinical Anesthesia. The DAM practical seminar is composed of the lecture session for ASA difficult airway algorithm, the hands-on training session for technical skills, and the scenario-based training session for cognitive skills. Ninty six Japanese anesthesiologists have completed the DAM practical seminar in one year. "The DAM instructor course" should be immediately prepared to organize the seminar more frequently.

Morbidly obese parturient: Challenges for the anaesthesiologist, including managing the difficult airway in obstetrics. What is new?

PubMed Central

Rao, Durga Prasada; Rao, Venkateswara A

2010-01-01

The purpose of this article is to review the fundamental aspects of obesity, pregnancy and a combination of both. The scientific aim is to understand the physiological changes, pathological clinical presentations and application of technical skills and pharmacological knowledge on this unique clinical condition. The goal of this presentation is to define the difficult airway, highlight the main reasons for difficult or failed intubation and propose a practical approach to management Throughout the review, an important component is the necessity for team work between the anaesthesiologist and the obstetrician. Certain protocols are recommended to meet the anaesthetic challenges and finally concluding with “what is new?” in obstetric anaesthesia. PMID:21224967

The Origins of Team Management

ERIC Educational Resources Information Center

Swift, James S.

1971-01-01

An analysis of the factors that have led to team management, including classical principles of management, the human relations or behavioral school of management, and the systems theory both closed and open. (JF)

Effective team management by district nurses.

PubMed

Bliss, Julie

2004-12-01

This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.

Improving Virtual Teams through Knowledge Management: A Case Study

ERIC Educational Resources Information Center

Laughridge, James F.

2012-01-01

Within the dynamic globalized operating environment, organizations are increasingly relying on virtual teams to solve their most difficult problems, leverage their expertise and expand their presence. The use of virtual teams by organizations continues to increase greatly as the technologies supporting them evolve. Despite improvements in…

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics.

PubMed

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-11-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to

Endoscopic management of difficult common bile duct stones

PubMed Central

Trikudanathan, Guru; Navaneethan, Udayakumar; Parsi, Mansour A

2013-01-01

Endoscopy is widely accepted as the first treatment option in the management of bile duct stones. In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones. Most biliary stones can be removed with an extraction balloon, extraction basket or mechanical lithotripsy after endoscopic sphincterotomy. Endoscopic papillary balloon dilation with or without endoscopic sphincterotomy or mechanical lithotripsy has been shown to be effective for management of difficult to remove bile duct stones in selected patients. Ductal clearance can be safely achieved with peroral cholangioscopy guided laser or electrohydraulic lithotripsy in most cases where other endoscopic treatment modalities have failed. Biliary stenting may be an alternative treatment option for frail and elderly patients or those with serious co morbidities. PMID:23345939

Improving Pediatric Rapid Response Team Performance Through Crew Resource Management Training of Team Leaders.

PubMed

Siems, Ashley; Cartron, Alexander; Watson, Anne; McCarter, Robert; Levin, Amanda

2017-02-01

Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively. Multiple quartile (median) and logistic regression models were developed to evaluate change in performance scores or completion of specific tasks. Team leader and team introductions (40% to 90%, P = .004; 7% to 45%, P = .03), floor team presentations in Situation Background Assessment Recommendation format (20% to 65%, P = .01), and confirmation of the plan (7% to 70%, P = .002) improved after training in patients transferred to the ICU (n = 35). The Team Emergency Assessment Measure metric was improved in all 4 categories: leadership (2.5 to 3.5, P < .001), teamwork (2.7 to 3.7, P < .001), task management (2.9 to 3.8, P < .001), and global scores (6.0 to 9.0, P < .001) for teams caring for patients who required transfer to the ICU. Targeted crew resource management training of the team leader resulted in improved team performance and dynamics for patients requiring transfer to the ICU. The intervention demonstrated that training the team leader improved behavior in RRT members who were not trained. Copyright © 2017 by the American Academy of Pediatrics.

Self-Managed Teams for Library Management: Increasing Employee Participation via Empowerment.

ERIC Educational Resources Information Center

Poon-Richards, Craig

1995-01-01

Investigates the growing prevalence of participatory management in libraries. The operation of self-managed teams is discussed both in theory and in practice, the latter with examples from Sterling Library at Yale University. Research is summarized that relates to management teams and how they create a sense of empowerment by building shared…

Simulation Based Training Improves Airway Management for Helicopter EMS Teams

NASA Technical Reports Server (NTRS)

Dhindsa, Harinder S.; Reid, Renee; Murray, David; Lovelady, James; Powell, Katie; Sayles, Jeff; Stevenson, Christopher; Baker, Kathy; Solada, Brian; Carroll, Scott;

Self-Managed Career Services: A Team Approach.

ERIC Educational Resources Information Center

Nonnamaker, John; Hagenbaugh, Stacie; Grote, Ann DiMeola; Denon, Gregory; Jessup, Kara

2001-01-01

Taking a lead from corporate culture, many colleges and universities are experimenting with the self-managed team model, an alternative to traditional hierarchical structures. This article discusses Boston's Emerson College career services staff's experience with becoming a self-managed team. They were able to improve service delivery, reduce…

Managing Intercultural Teams: The eOrganization Exercise

ERIC Educational Resources Information Center

Humes, Michelle; Reilly, Anne H.

2008-01-01

In today's global environment, intercultural teams may become the most effective teams in an organization when their diversity is managed as an asset. However, because of miscommunication and conflict, intercultural teams often become dysfunctional. This experiential group exercise demonstrates how cultural dimensions such as individualism and…

Problem Solving Teams in a Total Quality Management Environment.

ERIC Educational Resources Information Center

Towler, Constance F.

1993-01-01

Outlines the problem-solving team training process used at Harvard University (Massachusetts), including the size and formation of teams, roles, and time commitment. Components of the process are explained, including introduction to Total Quality Management (TQM), customer satisfaction, meeting management, Parker Team Player Survey, interactive…

Self-managing teams: a strategy for quality improvement.

PubMed

Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen

2003-01-01

Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.

Managing Communication within Virtual Intercultural Teams.

ERIC Educational Resources Information Center

Grosse, Christine Uber

2002-01-01

Suggests that business students need to be prepared to manage the communication of intercultural teams. Discusses strategies for success such as: developing a network of good relationships built on trust and understanding; showing respect for other cultures and languages; and understanding how diversity strengthens the team. (SG)

Management Guidelines for Database Developers' Teams in Software Development Projects

NASA Astrophysics Data System (ADS)

Rusu, Lazar; Lin, Yifeng; Hodosi, Georg

Worldwide job market for database developers (DBDs) is continually increasing in last several years. In some companies, DBDs are organized as a special team (DBDs team) to support other projects and roles. As a new role, the DBDs team is facing a major problem that there are not any management guidelines for them. The team manager does not know which kinds of tasks should be assigned to this team and what practices should be used during DBDs work. Therefore in this paper we have developed a set of management guidelines, which includes 8 fundamental tasks and 17 practices from software development process, by using two methodologies Capability Maturity Model (CMM) and agile software development in particular Scrum in order to improve the DBDs team work. Moreover the management guidelines developed here has been complemented with practices from authors' experience in this area and has been evaluated in the case of a software company. The management guidelines for DBD teams presented in this paper could be very usefully for other companies too that are using a DBDs team and could contribute towards an increase of the efficiency of these teams in their work on software development projects.

7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...

7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...

7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...

7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...

7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...

How management teams can have a good fight.

PubMed

Eisenhardt, K M; Kahwajy, J L; Bourgeois, L J

1997-01-01

Top-level managers know that conflict over issues is natural and even necessary. Management teams that challenge one another's thinking develop a more complete understanding of their choices, create a richer range of options, and make better decisions. But the challenge--familiar to anyone who has ever been part of a management team--is to keep constructive conflict over issues from degenerating into interpersonal conflict. From their research on the interplay of conflict, politics, and speed in the decision--making process of management teams, the authors have distilled a set of six tactics characteristic of high-performing teams: They work with more, rather than less, information. They develop multiple alternatives to enrich debate. The establish common goals. They make an effort to inject humor into the workplace. They maintain a balanced corporate power structure. They resolve issues without forcing a consensus. These tactics work because they keep conflict focused on issues; foster collaborative, rather than competitive, relations among team members; and create a sense of fairness in the decision-making process. Without conflict, groups lose their effectiveness. Managers often become withdrawn and only superficially harmonious. The alternative to conflict is not usually agreement but rather apathy and disengagement, which open the doors to a primary cause of major corporate debacles: groupthink.

Team Development for High Performance Management.

ERIC Educational Resources Information Center

Schermerhorn, John R., Jr.

1986-01-01

The author examines a team development approach to management that creates shared commitments to performance improvement by focusing the attention of managers on individual workers and their task accomplishments. It uses the "high-performance equation" to help managers confront shared beliefs and concerns about performance and develop realistic…

Curriculum Management: "Driving the School Management Team Frantic"

ERIC Educational Resources Information Center

Lumadi, M. W.

2012-01-01

This study explores factors which have a negative impact, on the role of the School Management Team (SMT) that serves as the fulcrum of the curriculum management process. The SMT is compelled to execute its responsibilities in an efficient and effective manner thus keeping a delicate balance between the often-conflicting pressures from parents,…

STS-121: Discovery Mission Management Team Briefing

NASA Technical Reports Server (NTRS)

2006-01-01

The briefing opened with Bruce Buckingham (NASA Public Affairs) introducing John Shannon (Chairman, Mission Management Team, JSC), John Chapman (External Tank Project Manager), Mike Leinbach (Shuttle Launch Director), and 1st Lt. Kaleb Nordgren (USAF 45th Weather Squadron). John Shannon reported that the team for hydrogen loading was proceeding well and the external tank detanking was completed. During detanking the inspection team cracked foam caused by condensation and ice formation as the tank expanded and contracted. Aerothermal analysis and analysis fro ice formation will be completed before launch. John Chapman explained the mechanics of the external tank design, the foam cracking, bracket design, etc. Mike Leinbach discussed the inspection teams and their inspection final inspection for ice formation before and after external tank filling. The inspection team of eight very experienced personnel also use telescopes with cameras to find any problems before launch. Kaleb Nordgren discussed weather and said there was a 40% chance of weather prohibiting launch. The floor was the opened for questions from the press.

A Difficult Journey: Reflections on Driving and Driving Cessation From a Team of Clinical Researchers.

PubMed

Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A

2017-02-01

Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

STS-114 Mission Management Team Meeting

NASA Image and Video Library

2005-08-04

JSC2005-E-32012 (4 August 2005) --- John Muratore, Manager of Space Shuttle Systems Engineering & Integration Office, discusses a key STS-114 issue during the Mission Management Team (MMT) session of the afternoon of August 4. The MMT meets daily in Houston's Mission Control Center.

Managing Team Learning in a Spanish Commercial Bank

ERIC Educational Resources Information Center

Doving, Erik; Martin-Rubio, Irene

2013-01-01

Purpose: The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach: The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings: The…

Crisis management teams in health organisations.

PubMed

Canyon, Deon V

2012-01-01

Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

Head and neck multidisciplinary team meetings: Effect on patient management.

PubMed

Brunner, Markus; Gore, Sinclair M; Read, Rebecca L; Alexander, Ashlin; Mehta, Ankur; Elliot, Michael; Milross, Chris; Boyer, Michael; Clark, Jonathan R

2015-07-01

The purpose of this study was for us to present our findings on the prospectively audited impact of head and neck multidisciplinary team meetings on patient management. We collected clinical data, the pre-multidisciplinary team meeting treatment plan, the post-multidisciplinary team meeting treatment plans, and follow-up data from all patients discussed at a weekly multidisciplinary team meeting and we recorded the changes in management. One hundred seventy-two patients were discussed in 39 meetings. In 52 patients (30%), changes in management were documented of which 20 (67%) were major. Changes were statistically more likely when the referring physician was a medical or radiation oncologist, when the initial treatment plan did not include surgery, and when the histology was neither mucosal squamous cell cancer nor a skin malignancy. Compliance to the multidisciplinary team meeting treatment recommendation was 84% for all patients and 70% for patients with changes in their treatment recommendation. Head and neck multidisciplinary team meetings changed management in almost a third of the cases. © 2014 Wiley Periodicals, Inc.

"That's not how we do it": managing the inherited medical practice team.

PubMed

Hills, Laura

2013-01-01

Most medical practice managers who take a new job will inherit an existing team. Those first few days on the job are critical because they can determine whether or not the new manager will succeed. This article provides a game plan for new medical practice managers so they get off on the right foot with their inherited teams. It suggests strategies for learning about the team's culture and for demonstrating visibly that there is a new manager in the job. It offers guidelines about introducing the new manager to the inherited team, discussing past experiences, and establishing new expectations. This article further provides practical tips for serving as a role model, gaining allies, and dealing with troublemakers quickly and effectively. It suggests strategies for speaking about the previous practice manager and for creating excitement with the inherited team. Finally, this article offers a set of 15 questions a new manager can ask members of the inherited team to get to know them, an additional 25-point team assessment instrument, and a step-by-step strategy for raising the bar for mediocre, lackluster, or dysfunctional inherited teams.

Exploring Academics' Approaches to Managing Team Assessment

ERIC Educational Resources Information Center

Augar, Naomi; Woodley, Carolyn J.; Whitefield, Despina; Winchester, Maxwell

2016-01-01

Purpose: The purpose of this paper is to develop an understanding of academics' approaches to managing team assessment at an Australian University with a view to informing policy development and assessment design. Design/methodology/approach: The research was conducted using a single exploratory case study approach focussing on the team assessment…

Functional Heterogeneity and Senior Management Team Effectiveness

ERIC Educational Resources Information Center

Benoliel, Pascale; Somech, Anit

2016-01-01

Purpose: There has been an increasing trend toward the creation of senior management teams (SMTs) which are characterized by a high degree of functional heterogeneity. Although such teams may create better linkages to information, along with the benefits of functional heterogeneity comes the potential for conflicts that stem from the value…

Building an exceptional imaging management team: from theory to practice.

PubMed

Hogan, Laurie

2010-01-01

Building a strong, cohesive, and talented managerial team is a critical endeavor for imaging administrators, as the job will be enhanced if supported by a group of high-performing, well-developed managers. For the purposes of this article, leadership and management are discussed as two separate, yet equally important, components of an imaging administrator's role. The difference between the two is defined as: leadership relates to people, management relates to process. There are abundant leadership and management theories that can help imaging administrators develop managers and ultimately build a better team. Administrators who apply these theories in practical and meaningful ways will improve their teams' leadership and management aptitude. Imaging administrators will find it rewarding to coach and develop managers and witness transformations that result from improved leadership and management abilities.

Aircrew team management program

NASA Technical Reports Server (NTRS)

Margerison, Charles; Mccann, Dick; Davies, Rod

1987-01-01

The key features of the Aircrew Team Management Workshop which was designed for and in consultation with Trans Australia Airlines are outlined. Five major sections are presented dealing with: (1) A profile of the airline and the designers; (2) Aircrew consultation and involvement; (3) Educational design and development; (4) Implementation and instruction; and (5) Evaluation and assessment. These areas are detailed.

Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient.

PubMed

Rodriguez, Amanda I; Zupancic, Steven; Song, Michael M; Cordero, Joehassin; Nguyen, Tam Q; Seifert, Charles

2017-03-01

Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach. To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system. Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other. A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation. Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns. Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained

Management team learning orientation and business unit performance.

PubMed

Bunderson, J Stuart; Sutcliffe, Kathleen M

2003-06-01

Although research has suggested that teams can differ in the extent to which they encourage proactive learning and competence development among their members (a team learning orientation), the performance consequences of these differences are not well understood. Drawing from research on goal orientation and team learning, this article suggests that, although a team learning orientation can encourage adaptive behaviors that lead to improved performance, it is also possible for teams to compromise performance in the near term by overemphasizing learning, particularly when they have been performing well. A test of this proposition in a sample of business unit management teams provides strong support. The results confirm that an appropriate emphasis on learning can have positive consequences for team effectiveness.

Managing Conflict in School Teams: The Impact of Task and Goal Interdependence on Conflict Management and Team Effectiveness

ERIC Educational Resources Information Center

Somech, Anit

2008-01-01

Purpose: Although conflict has traditionally been considered destructive, recent studies have indicated that conflict management can contribute to effective teamwork. The present study explores conflict management as a team phenomenon in schools. The author examined how the contextual variables (task interdependence, goal interdependence) are…

A case for safety leadership team training of hospital managers.

PubMed

Singer, Sara J; Hayes, Jennifer; Cooper, Jeffrey B; Vogt, Jay W; Sales, Michael; Aristidou, Angela; Gray, Garry C; Kiang, Mathew V; Meyer, Gregg S

2011-01-01

Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety. The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training. Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity. Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas. Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.

Mobile crisis management teams as part of an effective crisis management system for rural communities.

PubMed

Trantham, Doug; Sherry, Anne

2012-01-01

Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.

Clinicians' recognition and management of emotions during difficult healthcare conversations.

PubMed

Martin, Elliott B; Mazzola, Natalia M; Brandano, Jessica; Luff, Donna; Zurakowski, David; Meyer, Elaine C

2015-10-01

To examine the most commonly reported emotions encountered among healthcare practitioners when holding difficult conversations, including frequency and impact on care delivery. Interprofessional learners from a range of experience levels and specialties completed self-report questionnaires prior to simulation-based communication workshops. Clinicians were asked to describe up to three emotions they experienced when having difficult healthcare conversations; subsequent questions used Likert-scales to measure frequency of each emotion, and whether care was affected. 152 participants completed questionnaires, including physicians, nurses, and psychosocial professionals. Most commonly reported emotions were anxiety, sadness, empathy, frustration, and insecurity. There were significant differences in how clinicians perceived these different emotions affecting care. Empathy and anxiety were emotions perceived to influence care more than sadness, frustration, and insecurity. Most clinicians, regardless of clinical experience and discipline, find their emotional state influences the quality of their care delivery. Most clinicians rate themselves as somewhat to quite capable of recognizing and managing their emotions, acknowledging significant room to grow. Further education designed to increase clinicians' recognition of, reflection on, and management of emotion would likely prove helpful in improving their ability to navigate difficult healthcare conversations. Interventions aimed at anxiety management are particularly needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults.

PubMed

Myatra, Sheila Nainan; Shah, Amit; Kundra, Pankaj; Patwa, Apeksh; Ramkumar, Venkateswaran; Divatia, Jigeeshu Vasishtha; Raveendra, Ubaradka S; Shetty, Sumalatha Radhakrishna; Ahmed, Syed Moied; Doctor, Jeson Rajan; Pawar, Dilip K; Ramesh, Singaravelu; Das, Sabyasachi; Garg, Rakesh

2016-12-01

The All India Difficult Airway Association (AIDAA) guidelines for management of the unanticipated difficult airway in adults provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in adults. They have been developed based on the available evidence; wherever robust evidence was lacking, or to suit the needs and situation in India, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists. We recommend optimum pre-oxygenation and nasal insufflation of 15 L/min oxygen during apnoea in all patients, and calling for help if the initial attempt at intubation is unsuccessful. Transnasal humidified rapid insufflations of oxygen at 70 L/min (transnasal humidified rapid insufflation ventilatory exchange) should be used when available. We recommend no more than three attempts at tracheal intubation and two attempts at supraglottic airway device (SAD) insertion if intubation fails, provided oxygen saturation remains ≥ 95%. Intubation should be confirmed by capnography. Blind tracheal intubation through the SAD is not recommended. If SAD insertion fails, one final attempt at mask ventilation should be tried after ensuring neuromuscular blockade using the optimal technique for mask ventilation. Failure to intubate the trachea as well as an inability to ventilate the lungs by face mask and SAD constitutes 'complete ventilation failure', and emergency cricothyroidotomy should be performed. Patient counselling, documentation and standard reporting of the airway difficulty using a 'difficult airway alert form' must be done. In addition, the AIDAA provides suggestions for the contents of a difficult airway cart.

Factors affecting fire suppression costs as identified by incident management teams

Treesearch

Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

2006-01-01

This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

Managing for Results Through Teams.

ERIC Educational Resources Information Center

Chand, Sunil; Holm, Maudie L.

1998-01-01

Using examples from Cuyahoga Community College, this article examines the nature of teams, how they are suited to community college management, and how they can increase the effectiveness of community colleges. Presents tangible implementation strategies and unique applications for community colleges, including the use of faculty as team…

Optimising the management of patients with difficult asthma.

PubMed

Palmer, Evelyn; Higgins, Bernard

2015-11-01

Asthma affects 5.4 million people in the UK, around 1 in 12 of the population. Between 5 and 10% of asthma (depending on the definition used) is categorised as difficult asthma, a term which generally refers to patients who continue to experience symptoms and frequent exacerbations despite the prescription of high-dose asthma therapy. Difficult asthma is an indication for specialist review by an appropriate respiratory physician, but close liaison between primary, secondary and tertiary care is critical and it is therefore important that primary care health professionals should be aware of the principles of management. One of the most important questions to ask is whether the individual with difficult asthma is taking their treatment Identifying this, however, is not easy. GPs could assess prescription uptake, looking for low use of preventers and excess use of short-acting bronchodilators. Newer means of assessing adherence have been developed. Inhaler devices that can monitor completion and timing of actuations have been produced. Meters that measure FeNO are available. A recent UK study found that 12 out of 100 patients referred for difficult asthma did not have reversible airflow obstruction or a history suggestive of asthma. Diagnoses included COPD, cystic fibrosis, cardiomyopathy, respiratory muscle dysfunction and severe anxiety with vocal cord dysfunction.

Managing Communication among Geographically Distributed Teams: A Brazilian Case

NASA Astrophysics Data System (ADS)

Almeida, Ana Carina M.; de Farias Junior, Ivaldir H.; de S. Carneiro, Pedro Jorge

The growing demand for qualified professionals is making software companies opt for distributed software development (DSD). At the project conception, communication and synchronization of information are critical factors for success. However problems such as time-zone difference between teams, culture, language and different development processes among sites could difficult the communication among teams. In this way, the main goal of this paper is to describe the solution adopted by a Brazilian team to improve communication in a multisite project environment. The purposed solution was based on the best practices described in the literature, and the communication plan was created based on the infrastructure needed by the project. The outcome of this work is to minimize the impact of communication issues in multisite projects, increasing productivity, good understanding and avoiding rework on code and document writing.

Power, politics, and top management team characteristics: do they matter?

PubMed

Gerowitz, M B

1998-01-01

This study assesses the contributions of the leader power and top management team characteristics to perceived strategic capability. Low age heterogeneity and low tenure heterogeneity were found to have a positive association with perceived adaptability. High diversity in educational specialization was also found to be positively associated with adaptability. Top management perceptions of CEO power were, however, lower among high adaptors. Implications for leadership research, senior management recruitment, and the design of management development for top management teams are discussed.

Team-Based Interprofessional Competency Training for Dementia Screening and Management.

PubMed

Tan, Zaldy S; Damron-Rodriguez, JoAnn; Cadogan, Mary; Gans, Daphna; Price, Rachel M; Merkin, Sharon S; Jennings, Lee; Schickedanz, Heather; Shimomura, Sam; Osterweil, Dan; Chodosh, Joshua

2017-01-01

As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress. Registrants were organized into teams of five members, with at least one member of each profession per team. The teams rotated through all stations, completing assigned tasks through interprofessional collaboration. A total of 117 professionals (51 physicians, 11 nurses, 20 pharmacists, 24 social workers, 11 others) successfully completed the program. Change scores showed significant improvements in overall competence in dementia assessment and intervention (very low = 1; very high = 5; average change 1.12, P < .001), awareness of importance of dementia screening (average change 0.85, P < .001), and confidence in managing medication (average change 0.86, P < .001). Eighty-seven participants (82.9%) reported feeling confident or very confident using the dementia toolkit at their home institution. In a survey administered 3 months after the session, 48 respondents reported that they had changed their approach to administering the Mini-Cog test (78%), differential diagnosis (49%), assessment of caregiver stress (74%), and accessing community support and services (69%). In conclusion, team-based interprofessional competency training is a team teaching model that can be used to enhance competency in dementia screening and management in medical, nursing, pharmacy, and social work practitioners. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Multidisciplinary Difficult Airway Course: An Essential Educational Component of a Hospital-Wide Difficult Airway Response Program.

PubMed

Leeper, W Robert; Haut, Elliott R; Pandian, Vinciya; Nakka, Sajan; Dodd-O, Jeffrey; Bhatti, Nasir; Hunt, Elizabeth A; Saheed, Mustapha; Dalesio, Nicholas; Schiavi, Adam; Miller, Christina; Kirsch, Thomas D; Berkow, Lauren

2018-04-05

A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management. The MDAC occurs within the Johns Hopkins Medicine Simulation Center approximately four times per year and uses a combination of didactic lectures, hands-on sessions, and high-fidelity simulation training. Participation in MDAC is the main intervention being investigated in this study. Data were collected prospectively using course evaluation survey with quantitative and qualitative components, and prepost course knowledge assessment multiple choice questions (MCQ). Outcomes include course evaluation scores and themes derived from qualitative assessments, and prepost course knowledge assessment MCQ scores. Tertiary care academic hospital center PARTICIPANTS: Students, residents, fellows, and practicing physicians from the departments of Surgery, Otolaryngology Head and Neck Surgery, Anesthesiology/Critical Care Medicine, and Emergency Medicine; advanced practice providers (nurse practitioners and physician assistants), nurse anesthetists, nurses, and respiratory therapists. Totally, 23 MDACs have been conducted, including 499 participants. Course evaluations were uniformly positive with mean score of 86.9 of 95 points. Qualitative responses suggest major value from high-fidelity simulation, the hands-on skill stations, and teamwork practice. MCQ scores demonstrated significant improvement: median (interquartile range) pre: 69% (60%-81%) vs post: 81% (72%-89%), p < 0.001. Implementation of a MDAC successfully disseminated principles and protocols to all airway providers. Demonstrable

Role of medical, technical, and administrative leadership in the human resource management life cycle: a team approach to laboratory management.

PubMed

Wilkinson, D S; Dilts, T J

1999-01-01

We believe the team approach to laboratory management achieves the best outcomes. Laboratory management requires the integration of medical, technical, and administrative expertise to achieve optimal service, quality, and cost performance. Usually, a management team of two or more individuals must be assembled to achieve all of these critical leadership functions. The individual members of the management team must possess the requisite expertise in clinical medicine, laboratory science, technology management, and administration. They also must work together in a unified and collaborative manner, regardless of where individual team members appear on the organizational chart. The management team members share in executing the entire human resource management life cycle, creating the proper environment to maximize human performance. Above all, the management team provides visionary and credible leadership.

Team research at the biology-mathematics interface: project management perspectives.

PubMed

Milton, John G; Radunskaya, Ami E; Lee, Arthur H; de Pillis, Lisette G; Bartlett, Diana F

2010-01-01

The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics background and an experimentally oriented biology student. The team mentors typically ranked the students' performance very good to excellent over a range of attributes that included creativity and ability to conduct independent research. However, the research teams experienced problems meeting prespecified deadlines due to poor time and project management skills. Because time and project management skills can be readily taught and moreover typically reflect good research practices, simple modifications should be made to undergraduate curricula so that the promise of initiatives, such as MATH-BIO 2010, can be implemented.

Teaching Tip: Managing Software Engineering Student Teams Using Pellerin's 4-D System

ERIC Educational Resources Information Center

Doman, Marguerite; Besmer, Andrew; Olsen, Anne

2015-01-01

In this article, we discuss the use of Pellerin's Four Dimension Leadership System (4-D) as a way to manage teams in a classroom setting. Over a 5-year period, we used a modified version of the 4-D model to manage teams within a senior level Software Engineering capstone course. We found that this approach for team management in a classroom…

The Perspective of Women Managing Research Teams in Social Sciences

ERIC Educational Resources Information Center

Tomas, Marina; Castro, Diego

2013-01-01

This article presents a research study that focuses on how women manage research teams. More specifically, the study aims to ascertain the perception of female researchers who are leaders of research groups in social sciences with regard to the formation, operation and management of their research teams. Fifteen interviews were carried out, eight…

NREL: U.S. Life Cycle Inventory Database - Project Management Team

Science.gov Websites

Project Management Team Information about the U.S. Life Cycle Inventory (LCI) Database project management team is listed on this page. Additional project information is available about the U.S. LCI Mechanical Engineering, Colorado State University Professional History Michael has worked as a Senior

How to Manage Hospital-Based Palliative Care Teams Without Full-Time Palliative Care Physicians in Designated Cancer Care Hospitals: A Qualitative Study.

PubMed

Sakashita, Akihiro; Kishino, Megumi; Nakazawa, Yoko; Yotani, Nobuyuki; Yamaguchi, Takashi; Kizawa, Yoshiyuki

2016-07-01

To clarify how highly active hospital palliative care teams can provide efficient and effective care regardless of the lack of full-time palliative care physicians. Semistructured focus group interviews were conducted, and content analysis was performed. A total of 7 physicians and 6 nurses participated. We extracted 209 codes from the transcripts and organized them into 3 themes and 21 categories, which were classified as follows: (1) tips for managing palliative care teams efficiently and effectively (7 categories); (2) ways of acquiring specialist palliative care expertise (9 categories); and (3) ways of treating symptoms that are difficult to alleviate (5 categories). The findings of this study can be used as a nautical chart of hospital-based palliative care team (HPCT) without full-time PC physician. Full-time nurses who have high management and coordination abilities play a central role in resource-limited HPCTs. © The Author(s) 2015.

Multidisciplinary team management in thoracic oncology: more than just a concept?

PubMed

Powell, Helen A; Baldwin, David R

2014-06-01

Multidisciplinary team (MDT) management in thoracic oncology has been introduced over the past two decades with the aim of improving outcomes for patients. While MDT management has become the standard of care in some countries, not all healthcare systems have adopted this practice. In this article we review the history and implementation of MDT care in thoracic oncology and explore the evidence for, and challenges associated with, this system of working. There are many advantages of an MDT both to the patient, the clinicians and the wider population, but it is difficult to demonstrate a beneficial effect on outcomes such as treatment rates or survival given the substantial number of coexistent changes in the management of thoracic malignancies over the same time period. There are also some disadvantages associated with MDT working, particularly the costs of setting up the service and the time commitment from each of the healthcare professionals involved. Barriers to effective MDT working include poor attendance by some specialists, inadequate preparation and poor quality information about the patient. Variation in quality of MDTs has been reported so it is important that practice is monitored and areas for improvement identified. ©ERS 2014.

76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-04

...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...

Managing Senior Management Team Boundaries and School Improvement: An Investigation of the School Leader Role

ERIC Educational Resources Information Center

Benoliel, Pascale

2017-01-01

The present study purpose was to investigate the unique role and activities of school principals in managing their senior management team (SMT) boundaries. The study examined how school principals' internal and external activities mediate the relationship of principals' personal factors from the Big Five typology, the team and contextual…

Team Risk Management: A New Model for Customer-Supplier Relationships

DTIC Science & Technology

1994-07-01

Management : A New Model for Customer - Supplier Relationships Ronald P. Higuera "Audrey J. Dorofee Julie A. Walker Ray C. Williams July 1994 ""•// 94...N/A N/A N/A 11. TITLE (Include Secuity Claaaificatioa) Team Risk Management : A New Model for Customer -Supplier Relationships 12. PERSONAL AUTHOR(S...by block number) FIELD GROUP SUB. GR. Customer - Supplier Relationships Risk Team Risk Management 19. ABSTRACT (cominus on = if necesaryd id’y by block

A Multidisciplinary Approach to a Pediatric Difficult Airway Simulation Course.

PubMed

Lind, Meredith Merz; Corridore, Marco; Sheehan, Cameron; Moore-Clingenpeel, Melissa; Maa, Tensing

2018-02-01

Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork. Participants completed pre- and postworkshop questionnaires. Results Thirty-nine trainees participated over the 3-year study period. Compared with their precourse responses, participants' postcourse responses indicated either agreement or strong agreement that the multidisciplinary format (1) helped in the development of team communication skills and (2) was preferred over single-discipline training. Improvement in confidence in managing critical airway situations and in advanced airway management skills was significant ( P < .05). Eighty-one percent of participants had improved confidence in following the hospital's critical airway protocol, and 64% were better able to locate advanced airway management equipment. Discussion Multiple subspecialists manage pediatric respiratory failure, where successful care requires complex handoffs and teamwork. Multidisciplinary education to teach advanced airway management, teamwork, and communication skills is practical and preferred by learners and is possible to achieve despite differences in experience. Future study is required to better understand the impact of this course on patient care outcomes. Implications for Practice Implementation of a pediatric difficult airway course through simulation-based team training is feasible and preferred by learners among multiple disciplines. A multidisciplinary approach exposes previously unrecognized knowledge gaps and allows for

Enteral nutritional support management in a university teaching hospital: team vs nonteam.

PubMed

Brown, R O; Carlson, S D; Cowan, G S; Powers, D A; Luther, R W

1987-01-01

Current hospital cost containment pressures have prompted a critical evaluation of whether nutritional support teams render more clinically effective and efficient patient care than nonteam management. To address this question with regard to enteral feeding, 102 consecutive hospitalized patients who required enteral nutritional support (ENS) by tube feeding during a 3 1/2-month period were prospectively studied. Fifty patients were managed by a nutritional support team; the other 52 were managed by their primary physicians. Choice of enteral formula, formula modifications, frequency of laboratory tests, and amounts of energy and protein received were recorded daily. In addition, each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. Team-managed (T) and nonteam-managed (NT) patients received ENS for 632 and 398 days, respectively. The average time period for ENS was significantly longer in the team-managed patients (12.6 +/- 12.1 days vs 7.7 +/- 6.2 days, p less than 0.01). Significantly more of the team patients attained 1.2 X basal energy expenditure (BEE) (37 vs 26, p less than 0.05). Total number of abnormalities in each group was similar (T = 398, NT = 390); however, the abnormalities per day were significantly lower in the team group (T = 0.63 vs NT = 0.98, p less than 0.01). Mechanical (T = 0.05 vs NT = 0.11, p less than 0.01), gastrointestinal (T = 0.99 vs NT = 0.14, p less than 0.05), and metabolic (T = 0.49 vs NT = 0.72, p less than 0.01) abnormalities per day all were significantly lower in the team-managed patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Management of difficult airway in intratracheal tumor surgery.

PubMed

Goyal, Amit; Tyagi, Isha; Tewari, Prabhat; Agarwal, Surendra K; Syal, Rajan

2005-06-07

Tracheal malignancies are usual victim of delay in diagnosis by virtue of their symptoms resembling asthma. Sometimes delayed diagnosis may lead to almost total airway obstruction. For difficult airways, not leaving any possibility of manipulation into neck region or endoscopic intervention, femorofemoral cardiopulmonary bypass can be a promising approach. We are presenting a case of tracheal adenoid cystic carcinoma (cylindroma) occupying about 90% of the tracheal lumen. It was successfully managed by surgical excision of mass by sternotomy and tracheotomy under femorofemoral cardiopulmonary bypass (CPB). Any patient with recurrent respiratory symptoms should be evaluated by radiological and endoscopic means earlier to avoid delay in diagnosis of such conditions. Femorofemoral cardiopulmonary bypass is a relatively safe way of managing certain airway obstructions.

Management of difficult airway in intratracheal tumor surgery

PubMed Central

Goyal, Amit; Tyagi, Isha; Tewari, Prabhat; Agarwal, Surendra K; Syal, Rajan

2005-01-01

Background Tracheal malignancies are usual victim of delay in diagnosis by virtue of their symptoms resembling asthma. Sometimes delayed diagnosis may lead to almost total airway obstruction. For difficult airways, not leaving any possibility of manipulation into neck region or endoscopic intervention, femorofemoral cardiopulmonary bypass can be a promising approach. Case Presentation We are presenting a case of tracheal adenoid cystic carcinoma (cylindroma) occupying about 90% of the tracheal lumen. It was successfully managed by surgical excision of mass by sternotomy and tracheotomy under femorofemoral cardiopulmonary bypass (CPB). Conclusion Any patient with recurrent respiratory symptoms should be evaluated by radiological and endoscopic means earlier to avoid delay in diagnosis of such conditions. Femorofemoral cardiopulmonary bypass is a relatively safe way of managing certain airway obstructions. PMID:15941480

The Difficult Airway Society 'ADEPT' guidance on selecting airway devices: the basis of a strategy for equipment evaluation.

PubMed

Pandit, J J; Popat, M T; Cook, T M; Wilkes, A R; Groom, P; Cooke, H; Kapila, A; O'Sullivan, E

2011-08-01

Faced with the concern that an increasing number of airway management devices were being introduced into clinical practice with little or no prior evidence of their clinical efficacy or safety, the Difficult Airway Society formed a working party (Airway Device Evaluation Project Team) to establish a process by which the airway management community within the profession could itself lead a process of formal device/equipment evaluation. Although there are several national and international regulations governing which products can come on to the market and be legitimately sold, there has hitherto been no formal professional guidance relating to how products should be selected (i.e. purchased). The Airway Device Evaluation Project Team's first task was to formulate such advice, emphasising evidence-based principles. Team discussions led to a definition of the minimum level of evidence needed to make a pragmatic decision about the purchase or selection of an airway device. The Team concluded that this definition should form the basis of a professional standard, guiding those with responsibility for selecting airway devices. We describe how widespread adoption of this professional standard can act as a driver to create an infrastructure in which the required evidence can be obtained. Essential elements are that: (i) the Difficult Airway Society facilitates a coherent national network of research-active units; and (ii) individual anaesthetists in hospital trusts play a more active role in local purchasing decisions, applying the relevant evidence and communicating their purchasing decisions to the Difficult Airway Society. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

Using literature to help physician-learners understand and manage "difficult" patients.

PubMed

Shapiro, J; Lie, D

2000-07-01

Despite significant clinical and research efforts aimed at recognizing and managing "difficult" patients, such patients remain a frustrating experience for many clinicians. This is especially true for primary care residents, who are required to see a significant volume of patients with diverse and complex problems, but who may not have adequate training and life experience to enable them to deal with problematic doctor-patient situations. Literature--short stories, poems, and patient narratives--is a little-explored educational tool to help residents in understanding and working with difficult patients. In this report, the authors examine the mechanics of using literature to teach about difficult patients, including structuring the learning environment, establishing learning objectives, identifying teaching resources and appropriate pedagogic methods, and incorporating creative writing assignments. They also present an illustrative progression of a typical literature-based teaching session about a difficult patient.

A Mirror for Managers: Using Simulation to Develop Management Teams. Technical Report 23.

ERIC Educational Resources Information Center

Kaplan, Robert E.; And Others

Although simulation is among the least common of the many methods consultants employ to stimulate team development, realistic simulation can help in the diagnosis of management teams. Simulations fill a gap in the repertoire of data collection methods for organizational diagnosis and development by affording an opportunity for direct observation…

The Role of the Facilitator on Total Quality Management Teams.

ERIC Educational Resources Information Center

Eakin, William L.

1993-01-01

As Total Quality Management teams work to improve organizational processes, several types of facilitators emerge: the director, the workhorse, and the cheerleader. Experience at the University of Kansas illustrates how different facilitator styles can affect team learning. (MSE)

Team behaviors: working effectively in teams.

PubMed

Wilson, C K

1998-12-01

The work of building and sustaining teams is often underestimated by middle managers. A manager must have the ability to develop and evolve staff toward a new level of competence, required because of radically upgraded expectations. Managers must be clear about what it means to empower teams, to avoid the trappings of giving "lip service" to authority boundaries, which may exist only on paper. Achieving this clarity means understanding the characteristics of effective teams: a high degree of interdependence, strong sense of organizational empowerment, self-determination, competence, commitment, and genuine concern about the quality of work being performed. An important tool for the manager interested in team development is the creation of a performance model, grounded in the foundational relationship competencies necessary for team success. Performance modeling assists not only in identifying of competency gaps that can be addressed by training but also in determining the workplace barriers to team success.

Managed Development Environment Successes for MSFC's VIPA Team

NASA Technical Reports Server (NTRS)

Finckenor, Jeff; Corder, Gary; Owens, James; Meehan, Jim; Tidwell, Paul H.

2005-01-01

This paper outlines the best practices of the Vehicle Design Team for VIPA. The functions of the VIPA Vehicle Design (VVD) discipline team are to maintain the controlled reference geometry and provide linked, simplified geometry for each of the other discipline analyses. The core of the VVD work, and the approach for VVD s first task of controlling the reference geometry, involves systems engineering, top-down, layout-based CAD modeling within a Product Data Manager (PDM) development environment. The top- down approach allows for simple control of very large, integrated assemblies and greatly enhances the ability to generate trade configurations and reuse data. The second VVD task, model simplification for analysis, is handled within the managed environment through application of the master model concept. In this approach, there is a single controlling, or master, product definition dataset. Connected to this master model are reference datasets with live geometric and expression links. The referenced models can be for drawings, manufacturing, visualization, embedded analysis, or analysis simplification. A discussion of web based interaction, including visualization, between the design and other disciplines is included. Demonstrated examples are cited, including the Space Launch Initiative development cycle, the Saturn V systems integration and verification cycle, an Orbital Space Plane study, and NASA Exploration Office studies of Shuttle derived and clean sheet launch vehicles. The VIPA Team has brought an immense amount of detailed data to bear on program issues. A central piece of that success has been the Managed Development Environment and the VVD Team approach to modeling.

Wagging the Dog: Managing Museum Priorities in a Difficult Economy

ERIC Educational Resources Information Center

Bradburne, James M.

2010-01-01

In these difficult financial times, it is more important than ever to manage money carefully. Educators who don't do so are vulnerable, for despite a thirty-year history of increasing authority and status within and without the museum, education departments are still more expendable than curatorial or collections departments in some museums. This…

Managing the culturally diverse medical practice team: twenty-five strategies.

PubMed

Hills, Laura

2014-01-01

A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

Total Quality Management (TQM). Process Action Team Course

DTIC Science & Technology

1990-05-30

SHET SC EXHAUSTE May 30,1990 DEPARTMENT OF DEFENSE Lfl N CI TOTAL QUALITY MANAGEMENT (TQM) Process Action Team Coursef ©990, Booz.Allen & Hamilton Inc...organization’s TQM infrastructure. If you need additional information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar that...Programs. These efforts were identified in Appendix A of Booz, Allen’s training manual Qtl Quality Management Awareness Seminar. Revision 5, November 15

THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pemberton, Wendy; Mena, RaJah; Beal, William

The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phasemore » efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.« less

Management Enhancement Team Approach (META) for the Australian National Training Authority. An Evaluation Report.

ERIC Educational Resources Information Center

Foreman, David J.; Dunn, John G.

The management enhancement team approach (META) is a team-driven management development program designed for managers within Australia's National Vocational Education and Training Sector (NVETS). META, which has been piloted at more than 70 sites across Australia, is designed to identify and address management development needs within the context…

Management of Cleft Lip and Palate: A Team Approach

PubMed Central

Tervo, R. C.; Chudley, A. E.

1981-01-01

Cleft lip and/or palate is a common congenital malformation. The initial management of the affected infant and family begins in the delivery suite in the hands of the family physician. With patient, informed psychosocial counselling, the family should be told the origin of the malformation, practical tips on managing their child, especially feeding and attending to middle ear infections, and the work of the cleft lip and palate team. The family physician is a vital member of this team, as he is able to advocate for the best interests of the child and family. ImagesFig. 1Fig. 2Fig. 3 PMID:20469362

Making Teamwork Work: Team Knowledge for Team Effectiveness.

PubMed

Guchait, Priyanko; Lei, Puiwa; Tews, Michael J

2016-01-01

This study examined the impact of two types of team knowledge on team effectiveness. The study assessed the impact of taskwork knowledge and teamwork knowledge on team satisfaction and performance. A longitudinal study was conducted with 27 service-management teams involving 178 students in a real-life restaurant setting. Teamwork knowledge was found to impact both team outcomes. Furthermore, team learning behavior was found to mediate the relationships between teamwork knowledge and team outcomes. Educators and managers should therefore ensure these types of knowledge are developed in teams along with learning behavior for maximum effectiveness.

Project TEAMS (Techniques and Education for Achieving Management Skills): Independent Business Owner/Managers.

ERIC Educational Resources Information Center

Platte Technical Community Coll., Columbus, NE.

These Project TEAMS (Techniques and Education for Achieving Managerial Skills) instructional materials consist of five units for use in training independent business owner/managers. The first unit contains materials which deal with management skills relating to personal characteristics of successful business people, knowledge of self and chosen…

No More Heroes: Entrepreneurial Learning in the SME Management Team

ERIC Educational Resources Information Center

Mckeown, Ian

2010-01-01

Entrepreneurship is increasingly viewed as a plural rather than singular endeavour. This paper develops a conceptual framework of team-based entrepreneurial learning, challenging the myth of the entrepreneurial "Lone Ranger" and revealing the significance of power structures in the SME management team in mediating what is and is not learnt.…

TeamSTEPPS for health care risk managers: Improving teamwork and communication.

PubMed

Cooke, Marcia

2016-07-01

Ineffective communication among the health care team is a leading cause of errors in the patient care setting. Studies assessing training related to communication and teamwork in the clinical team are prevalent, however, teamwork training at the administrative level is lacking. This includes individuals in leadership positions such as health care risk managers. The purpose was to determine the impact of an educational intervention on the knowledge and attitudes related to communication and teamwork in the health care risk management population. The educational intervention was an adaptation of a national teamwork training program and incorporated didactic content as well as video vignettes and small group activities. Measurement of knowledge and attitudes were used to determine the impact of the education program. Knowledge and attitudes were assessed pre- and postcourse. Findings indicate that teamwork education tailored to the needs of the specific audience resulted in knowledge gained and improved attitudes toward the components of teamwork. The attitudes that most significantly improved were related to team structure and situation monitoring. There was no improvement in participants' attitudes toward leadership, mutual support, and communication. Team training has been shown to improve safety culture, patient satisfaction, and clinical outcomes. Including risk managers in training on teamwork, communication, and collaboration can serve to foster a common language among clinicians and management. In addition, a measurement related to implementation in the health care setting may yield insight into the impact of training. Qualitative measurement may allow the researcher to delve deeper into how these health care facilities are using team training interventions. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France.

PubMed

de Stampa, Matthieu; Vedel, Isabelle; Trouvé, Hélène; Ankri, Joël; Saint Jean, Olivier; Somme, Dominique

2014-04-07

The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.

Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial.

PubMed

Hassell, J T; Games, A D; Shaffer, B; Harkins, L E

1994-09-01

To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P < .001), and complication rate, which was greater in the nonteam group (P < .001). In the nutrition support team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.

Team Conflict in ICT-Rich Environments: Roles of Technologies in Conflict Management

ERIC Educational Resources Information Center

Correia, Ana-Paula

2008-01-01

This study looks at how an information and communication technologies (ICT)-rich environment impacts team conflict and conflict management strategies. A case study research method was used. Three teams, part of a graduate class in instructional design, participated in the study. Data were collected through observations of team meetings, interviews…

Breakdowns in coordinated decision making at and above the incident management team level: an analysis of three large scale Australian wildfires.

PubMed

Bearman, Chris; Grunwald, Jared A; Brooks, Benjamin P; Owen, Christine

2015-03-01

Emergency situations are by their nature difficult to manage and success in such situations is often highly dependent on effective team coordination. Breakdowns in team coordination can lead to significant disruption to an operational response. Breakdowns in coordination were explored in three large-scale bushfires in Australia: the Kilmore East fire, the Wangary fire, and the Canberra Firestorm. Data from these fires were analysed using a top-down and bottom-up qualitative analysis technique. Forty-four breakdowns in coordinated decision making were identified, which yielded 83 disconnects grouped into three main categories: operational, informational and evaluative. Disconnects were specific instances where differences in understanding existed between team members. The reasons why disconnects occurred were largely consistent across the three sets of data. In some cases multiple disconnects occurred in a temporal manner, which suggested some evidence of disconnects creating states that were conducive to the occurrence of further disconnects. In terms of resolution, evaluative disconnects were nearly always resolved however operational and informational disconnects were rarely resolved effectively. The exploratory data analysis and discussion presented here represents the first systematic research to provide information about the reasons why breakdowns occur in emergency management and presents an account of how team processes can act to disrupt coordination and the operational response. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Translational Science Project Team Managers: Qualitative Insights and Implications from Current and Previous Postdoctoral Experiences.

PubMed

Wooten, Kevin C; Dann, Sara M; Finnerty, Celeste C; Kotarba, Joseph A

2014-07-01

The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle.

Building the occupational health team: keys to successful interdisciplinary collaboration.

PubMed

Wachs, Joy E

2005-04-01

Teamwork among occupational health and safety professionals, management, and employees is vital to solving today's complex problems cost-effectively. No single discipline can meet all the needs of workers and the workplace. However, teamwork can be time-consuming and difficult if attention is not given to the role of the team leader, the necessary skills of team members, and the importance of a supportive environment. Bringing team members together regularly to foster positive relationships and infuse them with the philosophy of strength in diversity is essential for teams to be sustained and work to be accomplished. By working in tandem, occupational health and safety professionals can become the model team in business and industry delivering on their promise of a safe and healthy workplace for America's work force.

Team approach to manage difficult-to-treat TB cases: Experiences in Europe and beyond.

PubMed

D'Ambrosio, L; Bothamley, G; Caminero Luna, J A; Duarte, R; Guglielmetti, L; Muñoz Torrico, M; Payen, M C; Saavedra Herrera, N; Salazar Lezama, M A; Skrahina, A; Tadolini, M; Tiberi, S; Veziris, N; Migliori, G B

As recommended by the World Health Organization (WHO), optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as 'TB Consilium'. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others), thus lowering the risk of making mistakes - or managing the patients inappropriately, in order to improve their clinical outcomes. At present, several high MDR-TB burden countries in the different WHO regions (and beyond) have introduced TB Consilium-like bodies at the national or subnational level to reach consensus on the best treatment approach for their patients affected by TB. In addition, in countries/settings where a formal system of consultation does not exist, specialized staff from MDR-TB reference centres or international organizations usually spend a considerable amount of their working time responding to phone or e-mail clinical queries on how to manage M/XDR-TB cases. The aim of this manuscript is to describe the different experiences with the TB Consilia both at the international level (European Respiratory Society - ERS/WHO TB Consilium) and in some of the countries where this experience operates successfully in Europe and beyond. The Consilium experiences are described around the following topics: (1) history, aims and focus; (2) management and funding; (3) technical functioning and structure; (4) results achieved. In addition a comparative analysis of the TB Consilia in the different countries has been performed. Copyright © 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Interprofessional team management in pediatric critical care: some challenges and possible solutions.

PubMed

Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

2016-01-01

Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.

Interprofessional team management in pediatric critical care: some challenges and possible solutions

PubMed Central

Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

2016-01-01

Background Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. Methods We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. Findings The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one’s own unit, engagement of health care professionals occurs and projects become accepted. Conclusion Bottom–up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of

Translational Science Project Team Managers: Qualitative Insights and Implications from Current and Previous Postdoctoral Experiences

PubMed Central

Wooten, Kevin C.; Dann, Sara M.; Finnerty, Celeste C.; Kotarba, Joseph A.

2015-01-01

The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle. PMID:25621288

IMPACT OF GLUCOSE MANAGEMENT TEAM ON OUTCOMES OF HOSPITALIZARON IN PATIENTS WITH TYPE 2 DIABETES ADMITTED TO THE MEDICAL SERVICE.

PubMed

Wang, Yunjiao J; Seggelke, Stacey; Hawkins, R Matthew; Gibbs, Joanna; Lindsay, Mark; Hazlett, Ingrid; Low Wang, Cecilia C; Rasouli, Neda; Young, Kendra A; Draznin, Boris

2016-12-01

To improve glycemic control of hospitalized patients with diabetes and hyperglycemia, many medical centers have established dedicated glucose management teams (GMTs). However, the impact of these specialized teams on clinical outcomes has not been evaluated. We conducted a retrospective study of 440 patients with type 2 diabetes admitted to the medical service for cardiac or infection-related diagnosis. The primary endpoint was a composite outcome of several well-recognized markers of morbidity, consisting of: death during hospitalization, transfer to intensive care unit, initiation of enteral or parenteral nutrition, line infection, new in-hospital infection or infection lasting more than 20 days of hospitalization, deep venous thrombosis or pulmonary embolism, rise in plasma creatinine, and hospital re-admissions. Medical housestaff managed the glycemia in 79% of patients (usual care group), while the GMT managed the glycemia in 21% of patients (GMT group). The primary outcome was similar between cohorts (0.95 events per patient versus 0.99 events per patient in the GMT and usual care cohorts, respectively). For subanalysis, the subjects in both groups were stratified into those with average glycemia of <180 mg/dL versus those with glycemia >180 mg/dL. We found a significant beneficial impact of glycemic management by the GMT on the composite outcome in patients with average glycemia >180 mg/dL during their hospital stay. The number of patients who met primary outcome was significantly higher in the usual care group (40 of 83 patients, 48%) than in the GMT-treated cohort (8 of 33 patients, 25.7%) (P<.02). Our data suggest that GMTs may have an important role in managing difficult-to-control hyperglycemia in the inpatient setting. BG = blood glucose GMT = glucose management team HbA1c = hemoglobin A1c ICU = intensive care unit POC = point of care T2D = type 2 diabetes.

How to manage your negotiating team.

PubMed

Brett, Jeanne M; Friedman, Ray; Behfar, Kristin

2009-09-01

You are leading a negotiating team for your company. When you sit down with the other party, someone on your side of the table blurts out: "Just tell us--what do we need to do to get more of your business?" And in that moment, you know you've lost the upper hand. Gaffes like this are more common than most businesspeople would care to admit, management professors Brett, Friedman, and Behfar have found in their research. Even though team members are all technically on the same side, they often have different priorities and imagine different ideal outcomes: Business development just wants to close the deal. Finance is most concerned about costs. Legal is focused on patents and intellectual property. The authors recommend taking four steps, either singly or in tandem, to align those goals: Map out each person's priorities, work out conflicts directly with departments, employ a mediator if that doesn't work, and use data to resolve differences. Once you are all on the same page, you can take steps to make sure everyone is coordinated during the negotiations themselves. Try simulating the negotiation beforehand, assigning roles to team members that take advantage of their strengths, and establishing the signals you will use to communicate with one another during the session. The payoff from working as a cohesive group is clear. With access to greater expertise and the ability to assign members to specialized roles, teams can implement more-complex strategies than a sole negotiator could ever pull off.

When managers and their teams disagree: a longitudinal look at the consequences of differences in perceptions of organizational support.

PubMed

Bashshur, Michael R; Hernández, Ana; González-Romá, Vicente

2011-05-01

The authors argue that over time the difference between team members' perception of the organizational support received by the team (or team climate for organizational support) and their manager's perception of the organizational support received by the team has an effect on important outcomes and emergent states, such as team performance and team positive and negative affect above and beyond the main effects of climate perceptions themselves. With a longitudinal sample of 179 teams at Time 1 and 154 teams at Time 2, the authors tested their predictions using a combined polynomial regression and response surface analyses approach. The results supported the authors' predictions. When team managers and team members' perceptions of organizational support were high and in agreement, outcomes were maximized. When team managers and team members disagreed, team negative affect increased and team performance and team positive affect decreased. The negative effects of disagreement were most amplified when managers perceived that the team received higher levels of support than did the team itself.

Managing Difficult, Frustrating, and Hostile Conversations: Strategies for Savvy Administrators. Second Edition

ERIC Educational Resources Information Center

Kosmoski, Georgia J.; Pollack, Dennis R.

2005-01-01

The second edition of this best-selling resource provides new and updated content influenced by the feedback of over 250 school administrators. "Managing Difficult, Frustrating, and Hostile Conversations" uncovers safe and effective strategies for dispelling common sensitive situations such as handling legitimate complaints, controlling those…

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi.

PubMed

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; In 't Veen, Johannes C C M

2017-02-09

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories 'the A-I of difficult-to-manage asthma' to resonate with an established Dutch 'A-E acronym for determining asthma control'. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme.

Making Choices: Self-Directed Teams or Total Quality Management?

ERIC Educational Resources Information Center

Holpp, Lawrence

1992-01-01

Describes differences between total quality management and self-directed teams in terms of job design, decision making, flexibility, supervision, labor relations, quality, customers, and training. Offers suggestions for which method to choose when. (SK)

Evaluation on Collaborative Satisfaction for Project Management Team in Integrated Project Delivery Mode

NASA Astrophysics Data System (ADS)

Zhang, L.; Li, Y.; Wu, Q.

2013-05-01

Integrated Project Delivery (IPD) is a newly-developed project delivery approach for construction projects, and the level of collaboration of project management team is crucial to the success of its implementation. Existing research has shown that collaborative satisfaction is one of the key indicators of team collaboration. By reviewing the literature on team collaborative satisfaction and taking into consideration the characteristics of IPD projects, this paper summarizes the factors that influence collaborative satisfaction of IPD project management team. Based on these factors, this research develops a fuzzy linguistic method to effectively evaluate the level of team collaborative satisfaction, in which the authors adopted the 2-tuple linguistic variables and 2-tuple linguistic hybrid average operators to enhance the objectivity and accuracy of the evaluation. The paper demonstrates the practicality and effectiveness of the method through carrying out a case study with the method.

Obstructive sleep apnea as a risk factor associated with difficult airway management - A narrative review.

PubMed

Leong, Siaw May; Tiwari, Akhilesh; Chung, Frances; Wong, David T

2018-03-01

The association between obstructive sleep apnea (OSA) and difficult airway had been studied in various clinical trials but the relationship between the two conditions has not been clearly established. The objective of this narrative review is to determine if OSA is a risk factor associated with difficult airway. The OVID Medline in process, Medline (vis Pub Med), EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS were searched up to April 2016 using specific keywords. Inclusion criteria were: [1] airway management in patients with a diagnosis of OSA, [2] comparison of airway management between OSA and non-OSA patients, [3] publications or abstracts in the English language. The incidence of difficult airway between OSA and non-OSA patients was compared using Chi-square analysis or Fisher's exact test. Ten studies were included in the final review. Overall, the incidence of difficult tracheal intubation was higher in OSA patients versus non-OSA patients [56/386 (14.5%) vs. 69/897 (7.7%); P=0.0002]. OSA patients also have a higher incidence of difficult mask ventilation [115/4626 (2.5%) vs. 471/64,684 (0.7%); P<0.0001]. Compared to non-OSA patients, OSA was not associated with difficulty in the use of a supraglottic airway (SGA) device [10/663 (1.5%) vs. 162/15,171 (1.1%); P=0.38]. No studies compared difficult surgical airway in OSA and non-OSA patients. OSA was found to be a risk factor associated with difficult tracheal intubation and difficult mask ventilation. There was no association between OSA and difficult SGA use. Copyright © 2017 Elsevier Inc. All rights reserved.

A methodology and supply chain management inspired reference ontology for modeling healthcare teams.

PubMed

Kuziemsky, Craig E; Yazdi, Sara

2011-01-01

Numerous studies and strategic plans are advocating more team based healthcare delivery that is facilitated by information and communication technologies (ICTs). However before we can design ICTs to support teams we need a solid conceptual model of team processes and a methodology for using such a model in healthcare settings. This paper draws upon success in the supply chain management domain to develop a reference ontology of healthcare teams and a methodology for modeling teams to instantiate the ontology in specific settings. This research can help us understand how teams function and how we can design ICTs to support teams.

Dr. von Braun With Management Team

NASA Technical Reports Server (NTRS)

1961-01-01

Dr. von Braun is shown in this photograph, which was probably taken in the early 1960s, with members of his management team. Pictured from left to right are, Werner Kuers, Director of the Manufacturing Engineering Division; Dr. Walter Haeussermarn, Director of the Astrionics Division; Dr. William Mrazek, Propulsion and Vehicle Engineering Division; Dr. von Braun; Dieter Grau, Director of the Quality Assurance Division; Dr. Oswald Lange, Director of the Saturn Systems Office; and Erich Neubert , Associate Deputy Director for Research and Development.

Profile of an excellent nurse manager: identifying and developing health care team leaders.

PubMed

Kallas, Kathryn D

2014-01-01

The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi

PubMed Central

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; in ’t Veen, Johannes C C M

2017-01-01

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories ‘the A–I of difficult-to-manage asthma’ to resonate with an established Dutch ‘A–E acronym for determining asthma control’. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme. PMID:28184039

Leading Teams of Higher Education Administrators: Integrating Goal Setting, Team Role, and Team Life Cycle Theories

ERIC Educational Resources Information Center

Posthuma, Richard; Al-Riyami, Said

2012-01-01

Leaders of higher education institutions can create top management teams of academic administrators to guide and improve their organizations. This study illustrates how the leadership of top management teams can be accomplished successfully through a combination of goal setting (Doran, 1981; Locke & Latham, 1990), understanding of team roles…

A multilevel study of the impact of project manager's leadership on extra-role performance of project team members

NASA Astrophysics Data System (ADS)

Shokory, Suzyanty Mohd; Suradi, Nur Riza Mohd

2018-04-01

The current study examines the impact of transformational and transactional leadership of project manager on the extra-role performance of project team members. In addition, this study also identifies factor dominant to extra-role performance of project team members when the transformational and transactional leadership of project managers are analyzed simultaneously. The study involved 175 of project team members from 35 project teams (each project team consists of different contracting companies registered in the Selangor (N = 175 from 35 contractors company). A multilevel analysis with hierarchical linear modeling (HLM) approach was used in this study. The analysis showed that transformational and transactional leadership of the project manager is a positive significant with extra-role performance project team members when analyzed separately. However when the two constructs (transformational leadership and transactional leadership of project manager) were analyzed simultaneously, transformational leadership was found to have more impact on extra-role performance project team members compared to transactional leadership. These findings explained that although transformational and transactional leadership of project managers can improve extra-role performance project team members, but this study has proved that transformational leadership of project managers affect extra-role performance project team members more as compared to transactional leadership.

Effective communication during difficult conversations.

PubMed

Polito, Jacquelyn M

2013-06-01

A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

Lean management: innovative tools for engaging teams in continuous quality improvement.

PubMed

Perreault, Lucille; Vaillancourt, Lise; Filion, Catherine; Hadj, Camélia

2014-01-01

Lean management has proven to be a sustainable method to ensure a high level of patient care through innovation and teamwork. It involves a set of six tools that allow for visual management shared among team members. The team focuses their efforts on the improvement of organizational indicators in a standardized and engaging way, resulting in the sustainability of improvements. This article outlines the program's rollout at Montfort Hospital (l'Hôpital Montfort). In only a few months, two pilot units accomplished close to 50 improvements each. In addition, the organizational employee satisfaction questionnaire showed very positive results. Copyright © 2014 Longwoods Publishing.

76 FR 22923 - Wellpoint, Inc. D/B/A/Anthem Blue Cross & Blue Shield Enterprise Provider Data Management Team...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

.../B/A/Anthem Blue Cross & Blue Shield Enterprise Provider Data Management Team Including On-Site... & Blue Shield, Enterprise Provider Data Management Team, Including On-Site Leased Workers From Kelly... Of Kentucky, Enterprise Provider Data Management Team, Louisville, Kentucky TA-W-74,895B Wellpoint...

Utilizing Virtual Teams in a Management Principles Course

ERIC Educational Resources Information Center

Olson-Buchanan, Julie B.; Rechner, Paula L.; Sanchez, Rudolph J.; Schmidtke, James M.

2007-01-01

Purpose: The purpose of this paper is to describe development of a component in a management principles course to develop university students' virtual team skills. There were several challenges in creating and implementing this new component. The paper aims to describe how these challenges were addressed and discusses outcomes associated with this…

Multi-UAV Collaborative Sensor Management for UAV Team Survivability

DTIC Science & Technology

2006-08-01

Multi-UAV Collaborative Sensor Management for UAV Team Survivability Craig Stoneking, Phil DiBona , and Adria Hughes Lockheed Martin Advanced...Command, Aviation Applied Technology Directorate. REFERENCES [1] DiBona , P., Belov, N., Pawlowski, A. (2006). “Plan-Driven Fusion: Shaping the

Operationalizing Heedful Interrelating: How Attending, Responding, and Feeling Comprise Coordinating and Predict Performance in Self-Managing Teams.

PubMed

Stephens, John Paul; Lyddy, Christopher J

2016-01-01

Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes.

Operationalizing Heedful Interrelating: How Attending, Responding, and Feeling Comprise Coordinating and Predict Performance in Self-Managing Teams

PubMed Central

Stephens, John Paul; Lyddy, Christopher J.

2016-01-01

Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes. PMID:27047407

Difficult airway management practice patterns among anesthesiologists practicing in the United States: have we made any progress?

PubMed

Ezri, Tiberiu; Szmuk, Peter; Warters, R David; Katz, Jeffrey; Hagberg, Carin A

2003-09-01

To determine the extent instruction and practice in the use of airway devices and techniques varies among anesthesiologists practicing in the United States. Survey questionnaire. University medical center. Questionnaires were completed by American-trained anesthesiologists who attended the 1999 American Society of Anesthesiologists (ASA) Annual Meeting. Data collected included demographics, education, skills with airway devices/techniques, management of clinical difficult airway scenarios, and the use of the ASA Difficult Airway Algorithm. 1) DEMOGRAPHICS: 452 questionnaires were correctly completed; 62% attending anesthesiologists, 70% <50 years, 81% males, 44% from academic institutions, 63% >10 years of practice, 81% night duty, 77% board certified. 2) Education: 71% had at least one educational modality: difficult airway rotation, workshops, conferences, books, and simulators. 3) Skills: Miller blade 61%, Bullard laryngoscope 32%, LMA 86%, Combitube 43%, bougie 43%, exchangers 47%, cuffed oropharyngeal airway (COPA) 34%, retrograde 41%, transtracheal needle jet ventilation 34%, cricothyrotomy 21%, fiberoptics 59%, and blind nasal intubation 78%. The average reported use of special airway devices/techniques was 47.5%. 4) Management choices: failed intubation/ventilation: LMA (81%) and for all other situations: fiberoptic intubation. Use of ASA Difficult Airway Algorithm in clinical practice (86%). Fiberoptic intubation and the LMA are most popular in management of the difficult airway.

Two-year outcome of team-based intensive case management for patients with schizophrenia.

PubMed

Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U

1995-12-01

Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.

Case study: Comparison of motivation for achieving higher performance between self-directed and manager-directed aerospace engineering teams

NASA Astrophysics Data System (ADS)

Erlick, Katherine

"The stereotype of engineers is that they are not people oriented; the stereotype implies that engineers would not work well in teams---that their task emphasis is a solo venture and does not encourage social aspects of collaboration" (Miner & Beyerlein, 1999, p. 16). The problem is determining the best method of providing a motivating environment where design engineers may contribute within a team in order to achieve higher performance in the organization. Theoretically, self-directed work teams perform at higher levels. But, allowing a design engineer to contribute to the team while still maintaining his or her anonymity is the key to success. Therefore, a motivating environment must be established to encourage greater self-actualization in design engineers. The purpose of this study is to determine the favorable motivational environment for design engineers and describe the comparison between two aerospace design-engineering teams: one self-directed and the other manager directed. Following the comparison, this study identified whether self-direction or manager-direction provides the favorable motivational environment for operating as a team in pursuit of achieving higher performance. The methodology used in this research was the case study focusing on the team's levels of job satisfaction and potential for higher performance. The collection of data came from three sources, (a) surveys, (b) researcher observer journal and (c) collection of artifacts. The surveys provided information regarding personal behavior characteristics, potentiality for higher performance and motivational attributes. The researcher journal provided information regarding team dynamics, individual interaction, conflict and conflict resolution. The milestone for performance was based on the collection of artifacts from the two teams. The findings from this study illustrated that whether the team was manager-directed or self-directed does not appear to influence the needs and wants of the

Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams.

PubMed

van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

2017-04-01

Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader's verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time.

Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams

PubMed Central

van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

2017-01-01

Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader’s verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time. PMID:28490856

Ares I Integrated Vehicle System Safety Team

NASA Technical Reports Server (NTRS)

Wetherholt, Jon; McNairy, Lisa; Shackelford, Carla

2009-01-01

Complex systems require integrated analysis teams which sometimes are divided into subsystem teams. Proper division of the analysis in to subsystem teams is important. Safety analysis is one of the most difficult aspects of integration.

Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

PubMed

Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

2015-01-01

Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

Panel Management to Improve Smoking and Hypertension Outcomes by VA Primary Care Teams: A Cluster-Randomized Controlled Trial.

PubMed

Schwartz, Mark D; Jensen, Ashley; Wang, Binhuan; Bennett, Katelyn; Dembitzer, Anne; Strauss, Shiela; Schoenthaler, Antoinette; Gillespie, Colleen; Sherman, Scott

2015-07-01

Panel Management can expand prevention and chronic illness management beyond the office visit, but there is limited evidence for its effectiveness or guidance on how best to incorporate it into practice. We aimed to test the effectiveness of incorporating panel management into clinical practice by incorporating Panel Management Assistants (PMAs) into primary care teams with and without panel management education. We conducted an 8-month cluster-randomized controlled trial of panel management for improving hypertension and smoking cessation outcomes among veterans. Twenty primary care teams from the Veterans Affairs New York Harbor were randomized to control, panel management support, or panel management support plus education groups. Teams included 69 clinical staff serving 8,153 hypertensive and/or smoking veterans. Teams assigned to the intervention groups worked with non-clinical Panel Management Assistants (PMAs) who monitored care gaps and conducted proactive patient outreach, including referrals, mail reminders and motivational interviewing by telephone. Measurements included mean systolic and diastolic blood pressure, proportion of patients with controlled blood pressure, self-reported quit attempts, nicotine replacement therapy (NRT) prescriptions, and referrals to disease management services. Change in mean blood pressure, blood pressure control, and smoking quit rates were similar across study groups. Patients on intervention teams were more likely to receive NRT (OR = 1.4; 95% CI 1.2-1.6) and enroll in the disease management services MOVE! (OR = 1.2; 95% CI 1.1-1.6) and Telehealth (OR = 1.7, 95% CI 1.4-2.1) than patients on control teams. Panel Management support for primary care teams improved process, but not outcome variables among veterans with hypertension and smoking. Incorporating PMAs into teams was feasible and highly valued by the clinical staff, but clinical impact may require a longer intervention.

Workplace violence investigations and activation of the threat management teams in a multinational corporation.

PubMed

Peek-Asa, Corinne; Casteel, Carri; Rugala, Eugene; Romano, Steve; Ramirez, Marizen

2013-11-01

We examined threat management investigations conducted by a large multinational company. The company provided a database, removing any identifiers, of investigations by the corporate Threat Management Teams in 2009 and 2010. Rates were calculated using worker population data. During the 2-year study period, the company investigated threat management cases at a rate of 13.9 per 10,000 employees per year. Cases that activated a Threat Management Team were more likely to lead to corrective action (odds ratio = 2.0; 95% confidence interval = 1.08 to 3.87) and referral to the Employee Assistance Program (odds ratio = 4.8; 95% confidence interval = 3.00 to 7.77), but were not related to likelihood of termination. When the multidisciplinary teams were involved, cases were more likely to result in some type of action but were not more likely to lead to termination.

When do business units benefit more from collective citizenship behavior of management teams? An upper echelons perspective.

PubMed

Liu, Wu; Gong, Yaping; Liu, Jun

2014-05-01

Drawing upon the notion of managerial discretion from upper echelons theory, we theorize which external contingencies moderate the relationship between collective organizational citizenship behavior (COCB) and unit performance. Focusing on business unit (BU) management teams, we hypothesize that COCB of BU management teams enhances BU performance and that this impact depends on environmental uncertainty and BU management-team decision latitude, 2 determinants of managerial discretion. In particular, the positive effect of COCB is stronger when environmental uncertainty or the BU management-team decision latitude is greater. Time-lagged data from 109 BUs of a telecommunications company support the hypotheses. Additional exploratory analysis shows that the positive moderating effect of environmental uncertainty is further amplified at higher levels of BU management-team decision latitude. Overall, this study extends the internally focused view in the micro OCB literature by introducing external contingencies for the COCB-unit-performance relationship. (c) 2014 APA, all rights reserved.

Traffic management teams : a description and action plan for Virginia.

DOT National Transportation Integrated Search

1988-01-01

A traffic management team improves the overall traffic operations in an urban area, especially along urban corridors, through the communication, coordination, and cooperation of the transportation-related operational agencies in the area. Since vario...

Crew Resource Management for Obstetric and Neonatal Teams to Improve Communication During Cesarean Births.

PubMed

Mancuso, Mary P; Dziadkowiec, Oliwier; Kleiner, Catherine; Halverson-Carpenter, Katherine; Link, Terri; Barry, James

2016-01-01

To assess the effectiveness of crew resource management training and interventions on the quality and quantity of communication during cesarean births in a tertiary academic hospital's labor and birthing services. A prospective pre-post crew resource management training intervention. Tertiary academic hospital in the Western United States. All members of obstetric and neonatal teams that participated in cesarean births. Over a 5-month time period, all obstetric and neonatal staff were required to participate in team training in crew resource management critical language, communication, and team structure. Trained observers collected baseline data (n = 52) for 3 months on the quantity and quality of communications that occurred during cesarean births. Postintervention data (n = 50) were gathered for 3 months after team training. Analysis approach included use of Fisher's exact test, independent-samples t test, and multilevel generalized linear regression models with Poisson distribution. There was a statistically significant increase in quantity and quality of communication from pre- to postintervention assessment for obstetric and neonatal staff. Although the increase in quality was similarly great between both types of teams, increase in quantity was more substantial in obstetric staff. Principles of team communication training shown to be effective in increasing communication among team members in a variety of clinical areas were also effective in improving communication in the labor and birth setting during cesarean births. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Radiological input during paediatric multidisciplinary team meetings and its influence on clinical patient management.

PubMed

Llewellyn-Jones, Glyn; Pereira, John

2016-04-01

There is little information about the role of the radiologist at multidisciplinary team meetings; in particular their influence on patient management. To evaluate the influence of radiologists on clinical patient management during multidisciplinary meetings. Prospective data were collected over a 5-week period from multidisciplinary team meetings across four paediatric clinical domains. Radiological input was recorded for each case discussion, including the type of influence and its potential effect on clinical patient management. One hundred and forty paediatric cases were reviewed. Radiological advice was requested from the radiologist for 25.7% (N = 36) of cases. In 17.9% (N = 25) this advice was judged to have influenced clinical patient management. There were two cases where new imaging findings were discovered. Radiologists influence clinical patient management during multidisciplinary team meetings primarily by providing differential diagnoses and guidance regarding future imaging, with respect to both the necessity and the modality. Occasionally, when imaging is reviewed at these meetings, new findings are discovered that impact on patient management. © 2016 The Royal Australian and New Zealand College of Radiologists.

Developing high-performance cross-functional teams: Understanding motivations, functional loyalties, and teaming fundamentals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, M.A.

1996-08-01

Teamwork is the key to the future of effective technology management. Today`s technologies and markets have become too complex for individuals to work alone. Global competition, limited resources, cost consciousness, and time pressures have forced organizations and project managers to encourage teamwork. Many of these teams will be cross-functional teams that can draw on a multitude of talents and knowledge. To develop high-performing cross-functional teams, managers must understand motivations, functional loyalties, and the different backgrounds of the individual team members. To develop a better understanding of these issues, managers can learn from experience and from literature on teams and teamingmore » concepts. When studying the literature to learn about cross-functional teaming, managers will find many good theoretical concepts, but when put into practice, these concepts have varying effects. This issue of varying effectiveness is what drives the research for this paper. The teaming concepts were studied to confirm or modify current understanding. The literature was compared with a {open_quotes}ground truth{close_quotes}, a survey of the reality of teaming practices, to examine the teaming concepts that the literature finds to be critical to the success of teams. These results are compared to existing teams to determine if such techniques apply in real-world cases.« less

Project TEAMS (Techniques and Education for Achieving Management Skills): Health Care Administrators.

ERIC Educational Resources Information Center

Platte Technical Community Coll., Columbus, NE.

These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training health care administrators. Unit 1 contains materials designed to help the health care administrators increase their management skills in regard to self-awareness, time management, problem solving,…

Organizational culture, team climate, and quality management in an important patient safety issue: nosocomial pressure ulcers.

PubMed

Bosch, Marije; Halfens, Ruud J G; van der Weijden, Trudy; Wensing, Michel; Akkermans, Reinier; Grol, Richard

2011-03-01

Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score ≤ 18) and preventive quality management at ward level. No associations were found between organizational culture, team climate, or preventive quality management at the ward level and the prevalence of nosocomial pressure ulcers. Institutional quality management was positively correlated with preventive quality management at ward level (adj. β 0.32; p < 0.001). Although the prevalence of nosocomial pressure ulcers varied considerably across wards, it did not relate to organizational culture, team climate, or preventive quality management at the ward level. These results would therefore not subscribe the widely suggested importance of these factors in improving health care. However, different designs and research methods (that go beyond the cross-sectional design) may be more informative in studying relations between such complex factors and outcomes in a more meaningful way

Towards a Methodology for Managing Competencies in Virtual Teams - A Systemic Approach

NASA Astrophysics Data System (ADS)

Schumacher, Marinita; Stal-Le Cardinal, Julie; Bocquet, Jean-Claude

Virtual instruments and tools are future trends in Engineering which are a response to the growing complexity of engineering tasks, the facility of communication and strong collaborations on the international market. Outsourcing, off-shoring, and the globalization of organisations’ activities have resulted in the formation of virtual product development teams. Individuals who are working in virtual teams must be equipped with diversified competencies that provide a basis for virtual team building. Thanks to the systemic approach of the functional analysis our paper responds to the need of a methodology of competence management to build virtual teams that are active in virtual design projects in the area of New Product Development (NPD).

The Academic Administrator Grid. A Guide to Developing Effective Management Teams.

ERIC Educational Resources Information Center

Blake, Robert R.; And Others

The use of the "management grid" method of organizational development in college and university administration is described in this adaptation of the 1964 book by the same authors, "The Management Grid." Five major administrative styles are identified: (1) caretaker, (2) comfortable and pleasant, (3) constituency-centered, (4) team, and (5)…

Model of Team Organization and Behavior and Team Description Method

DTIC Science & Technology

1984-10-01

cumbersome or difficult to use or which did not result in the quality of data desired were revised, or discarded and replaced by alternative procedures. The...observation and study of a variety of real-world teams performing real-world missions. Since time and resources for model development were limited, only...of equipment and supplies , team strength, terrain, weather, and illumination (if’ the mission it performed at night). Any or all of these factors may

Leading Teams of Leaders: What Helps Team Member Learning?

ERIC Educational Resources Information Center

Higgins, Monica; Young, Lissa; Weiner, Jennie; Wlodarczyk, Steven

2010-01-01

School districts are moving toward a new form of management in which superintendents need to form and nurture leadership teams. A study of 25 such teams in Connecticut suggests that a team's effectiveness is maximized when the team members are coached by other team members, not the superintendent, and when they are coached on task-related…

Contingency Management with Human Autonomy Teaming

NASA Technical Reports Server (NTRS)

Shively, Robert J.; Lachter, Joel B.

2018-01-01

Automation is playing an increasingly important role in many operations. It is often cheaper faster and more precise than human operators. However, automation is not perfect. There are many situations in which a human operator must step in. We refer to these instances as contingencies and the act of stepping in contingency management. Here we propose coupling Human Autonomy Teaming (HAT) with contingency management. We describe two aspects to HAT, bi-directional communication, and working agreements (or plays). Bi-directional communication like Crew Resource Management in traditional aviation, allows all parties to contribute to a decision. Working agreements specify roles and responsibilities. Importantly working agreements allow for the possibility of roles and responsibilities changing depending on environmental factors (e.g., situations the automation was not designed for, workload, risk, or trust). This allows for the automation to "automatically" become more autonomous as it becomes more trusted and/or it is updated to deal with a more complete set of possible situations. We present a concrete example using a prototype contingency management station one might find in a future airline operations center. Automation proposes reroutes for aircraft that encounter bad weather or are forced to divert for environmental or systems reasons. If specific conditions are met, these recommendations may be autonomously datalinked to the affected aircraft.

Virtual Team Governance: Addressing the Governance Mechanisms and Virtual Team Performance

NASA Astrophysics Data System (ADS)

Zhan, Yihong; Bai, Yu; Liu, Ziheng

As technology has improved and collaborative software has been developed, virtual teams with geographically dispersed members spread across diverse physical locations have become increasingly prominent. Virtual team is supported by advancing communication technologies, which makes virtual teams able to largely transcend time and space. Virtual teams have changed the corporate landscape, which are more complex and dynamic than traditional teams since the members of virtual teams are spread on diverse geographical locations and their roles in the virtual team are different. Therefore, how to realize good governance of virtual team and arrive at good virtual team performance is becoming critical and challenging. Good virtual team governance is essential for a high-performance virtual team. This paper explores the performance and the governance mechanism of virtual team. It establishes a model to explain the relationship between the performance and the governance mechanisms in virtual teams. This paper is focusing on managing virtual teams. It aims to find the strategies to help business organizations to improve the performance of their virtual teams and arrive at the objectives of good virtual team management.

String Quartets as Self-Managed Teams: An Interdisciplinary Perspective

ERIC Educational Resources Information Center

Gilboa, Avi; Tal-Shmotkin, Malka

2012-01-01

This article examines empirically and systematically whether a string quartet (SQ) ensemble is perceived as a self-managed team (SMT). SMTs, which were initially employed in the industrial world, are groups of employees that have a total responsibility for a defined project. The hypothesis that the SQ would exhibit more typical SMT characteristics…

An integrated risk assessment tool for team-based periodontal disease management.

PubMed

Thyvalikakath, Thankam P; Padman, Rema; Gupta, Sugandh

2013-01-01

Mounting evidence suggests a potential association of periodontal disease with systemic diseases such as diabetes, cardiovascular disease, cancer and stroke. The objective of this study is to develop an integrated risk assessment tool that displays a patients' risk for periodontal disease in the context of their systemic disease, social habits and oral health. Such a tool will be used by not just dental professionals but also by care providers who participate in the team-based care for chronic disease management. Displaying relationships between risk factors and its influence on the patient's general health could be a powerful educational and disease management tool for patients and clinicians. It may also improve the coordination of care provided by the provider-members of a chronic care team.

Using Agile Project Management to Enhance the Performance of Instructional Design Teams

ERIC Educational Resources Information Center

Sweeney, David S.; Cifuentes, Lauren

2010-01-01

Instructional design models describe in detail methodologies for designing effective instruction. Several widely adopted models include suggestions for managing instructional design projects. However, these suggestions focus on how to manage the instructional design steps rather than the instructional design and development team process. The…

Effects of the Educational Leadership of Nursing Unit Managers on Team Effectiveness: Mediating Effects of Organizational Communication.

PubMed

Choi, Eun Ha; Kim, Eun-Kyung; Kim, Pil Bong

2018-03-31

EDUCATIONAL LEADERSHIP OF NURSING UNIT MANAGERS ON TEAM EFFECTIVENESS: Mediating Effects of Organizational Communication Satisfaction. This study identifies the effects of the educational leadership of nursing unit managers on team effectiveness and the mediating effects of organizational communication satisfaction; it highlights the importance of educational leadership and organizational communication and provides the data needed to enhance the education capacity of managers. The participants were 216 nursing unit managers of staff nurses at a tertiary hospital located in C Region, South Korea, and nurses who had worked for more than six months at the same hospital. This study was conducted using questionnaires on educational leadership, team effectiveness, and organizational communication satisfaction. Data analysis was performed with a t-test, ANOVA, Scheffé, Pearson's correlation coefficient, and simple and multiple regression analyses using SPSS version 23.0. Mediation analysis was tested using Baron and Kenny's regression analysis and a Sobel test. The mean score for the educational leadership of nursing unit managers was 3.74(±0.68); for organizational communication satisfaction, 3.14(±0.51); and for team effectiveness, 3.52(±0.49). Educational leadership was significantly positively correlated with team effectiveness and organizational communication satisfaction. Organizational communication satisfaction demonstrated a complete mediating effect on the relationship between educational leadership and team effectiveness (β=.61, p<.001) and was significant (Sobel test; Z=7.40, p<.001). The results indicate that the educational leadership of nursing unit managers increases communication satisfaction among nurses; this supports the idea that educational leadership can contribute to team effectiveness. This suggests that the educational leadership and communication capacity of nursing unit managers must be improved to enhance the performance of nursing

Experience as Knowledge in a New Product Development Team: Implications for Knowledge Management

NASA Technical Reports Server (NTRS)

Cooper, Lynne P.

2009-01-01

This study was conducted to better understand how New Product Development (NPD) team members apply their experiences to meet the task needs of their project. Although "experience" is highly valued in team members, little research has looked specifically at experiences as a type of knowledge, and how this knowledge is used in work settings. This research evaluated nearly 200 instances where team members referenced past experiences during team meetings. During these experience exchanges, team members structured the sharing of their experiences to include three common elements: the source of the experience, the nature of the experience, and the degree of relevance to the current work of the team. The experiences fell into four categories: people (relationships), process, product, and politics. This paper describes how team members structured, applied, and integrated their individual experiences and presents the resulting implications for knowledge management systems that wish to exploit experience knowledge.

Strength in Numbers: A Team-Based Approach to Managing Patients with Hyponatremia.

PubMed

Adams, Kirkwood; Kearney, Michelle; Lee, Kiwon; Rhoney, Denise; Smith, K Melissa

2018-05-24

This virtual patient panel provides learners with real-world application of best practices among various members of the healthcare team in the management of patients with hyponatremia. A patient case is provided, followed by discussion among the team members to provide insight and context to why particular courses of action were chosen. (Online access: https://courses.elseviercme.com/hyponatremia17). Copyright © 2018. Published by Elsevier Inc.

From words to action: visibility of management in supporting interdisciplinary team working in an acute rehabilitative geriatric hospital.

PubMed

Buttigieg, Sandra C; Cassar, Vincent; Scully, Judy W

2013-01-01

The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. The authors draw on solid theoretical frameworks--the complexity theory, team effectiveness model and the social identity theory--to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level.

Understanding medical practice team roles.

PubMed

Hills, Laura

2015-01-01

Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

RESULTS OF THE ENVIRONMENTAL MANAGEMENT (EM) CORPORATE PROJECT TEAM DISPOSING WASTE & REDUCING RISK

DOE Office of Scientific and Technical Information (OSTI.GOV)

SHRADER, T.A.; KNERR, R.

2005-01-31

In 2002, the US Department of Energy's (DOE) Office of Environmental Management (EM) released the Top-To-Bottom Review of cognizant clean-up activities around the DOE Complex. The review contained a number of recommendations for changing the way EM operates in order to reduce environmental risk by significantly accelerating clean-up at the DOE-EM sites. In order to develop and implement these recommendations, a number of corporate project teams were formed to identify, evaluate, and initiate implementation of alternatives for the different aspects of clean-up. In August 2002, a corporate team was formed to review all aspects of the management, treatment, and disposalmore » of low level radioactive waste (LLW), mixed low level radioactive waste (MLLW), transuranic waste (TRU), and hazardous waste (HW). Over the next 21 months, the Corporate Project Team: Disposing Waste, Reducing Risk, developed a number of alternatives for implementing the recommendations of the Top-To-Bottom Review based on information developed during numerous site visits and interviews with complex and industry personnel. With input from over a dozen EM sites at various stages of clean-up, the team identified the barriers to the treatment and disposal of low level waste, mixed low level waste, and transuranic waste. Once identified, preliminary design alternatives were developed and presented to the Acquisition Authority (for this project, the Assistant Secretary for Environmental Management) for review and approval. Once the preliminary design was approved, the team down selected to seven key alternatives which were subsequently fully developed in the Project Execution Plan. The seven most viable alternatives were: (1) creation of an Executive Waste Disposal Board; (2) projectizing the disposal of low level waste and mixed low level waste; (3) creation of a National Consolidation and Acceleration Facility for waste; (4) improvements to the Broad Spectrum contract; (5) improvements to the

Guidelines and algorithms for managing the difficult airway.

PubMed

Gómez-Ríos, M A; Gaitini, L; Matter, I; Somri, M

2018-01-01

The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Project TEAMS (Techniques and Education for Achieving Management Skills): Business and Industrial Supervisors.

ERIC Educational Resources Information Center

Platte Technical Community Coll., Columbus, NE.

These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training business and industrial supervisors. Unit 1 is designed to help managers in business or industry increase management skills in regard to leadership techniques, problem solving and decision making, and…

Online vs live methods for teaching difficult airway management to anesthesiology residents.

PubMed

Bello, Giuseppe; Pennisi, Mariano Alberto; Maviglia, Riccardo; Maggiore, Salvatore Maurizio; Bocci, Maria Grazia; Montini, Luca; Antonelli, Massimo

2005-04-01

To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. Prospective, randomized, controlled trial. University hospital. Two randomly selected groups, each containing 28 physicians enrolled from among residents in Anesthesiology and Intensive Care Medicine in Italy. Residents in Group 1 took a traditional 5-h course on the principles and practice of airway management, which included lectures, slide projection, and dummy demonstrations. The same material was presented to Group 2 in an exclusively online format, which could be individually accessed for a period of 36 h. In the online course, student-instructor interaction was provided through threaded discussion forums during three 30-min real-time question-and-answer sessions. Differences in baseline and post-course scores on written tests and practical skills tests were measured. Knowledge gains in Group 2 were slightly, but not significantly, greater compared with Group 1 both in written (P=0.228) and practical skills (P=0.376) tests. Semi-quantitative ratings of learner satisfaction were significantly higher in the online group (P=0.014). Almost all online students (93%) were logged in for at least 45 of the 90 min of real-time question-and-answer sessions. The four instructors spent an average of 144+/-10 min preparing answers and interacting with online students. Online teaching formats may be a valid alternative for teaching residents the principles and practice of difficult airway management. Interaction with instructors seems to be an important element, but it may require substantial time commitments by instructors.

Using a Multiperspective Design Team to Develop and Manage Multilayered Online Courses

ERIC Educational Resources Information Center

Anderson, Nella Bea; Poole, L. Lori; Quinn, Stephanie; Schlicht, Carrie L.

2014-01-01

The focus of this research-based review is how to best develop and manage online classes. After receiving faculty, student, and industry feedback, Colorado State University-Global Campus integrated multi-perspective design teams to develop and manage multilayered online courses. This article will reveal the instructional design, development…

Peer-based control in self-managing teams: linking rational and normative influence with individual and group performance.

PubMed

Stewart, Greg L; Courtright, Stephen H; Barrick, Murray R

2012-03-01

The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how peer-based rational control, which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and interacts with the more commonly studied normative control force of group cohesion to explain both individual and collective performance in teams. On the basis of data from 587 factory workers in 45 self-managing teams at 3 organizations, peer-based rational control corresponded with higher performance for both individuals and collective teams. Results further demonstrated that the rational and normative mechanism of peer-based control interacted to explain performance at both the individual and team levels. Increased peer-based rational control corresponded with higher individual and collective performance in teams with low cohesion, but the positive effects on performance were attenuated in cohesive teams.

Challenges in interdisciplinary weight management in primary care: lessons learned from the 5As Team study.

PubMed

Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D

2016-04-01

Increasingly, research is directed at advancing methods to address obesity management in primary care. In this paper we describe the role of interdisciplinary collaboration, or lack thereof, in patient weight management within 12 teams in a large primary care network in Alberta, Canada. Qualitative data for the present analysis were derived from the 5As Team (5AsT) trial, a mixed-method randomized control trial of a 6-month participatory, team-based educational intervention aimed at improving the quality and quantity of obesity management encounters in primary care practice. Participants (n = 29) included in this analysis are healthcare providers supporting chronic disease management in 12 family practice clinics randomized to the intervention arm of the 5AsT trial including mental healthcare workers (n = 7), registered dietitians (n = 7), registered nurses or nurse practitioners (n = 15). Participants were part of a 6-month intervention consisting of 12 biweekly learning sessions aimed at increasing provider knowledge and confidence in addressing patient weight management. Qualitative methods included interviews, structured field notes and logs. Four common themes of importance in the ability of healthcare providers to address weight with patients within an interdisciplinary care team emerged, (i) Availability; (ii) Referrals; (iii) Role perception and (iv) Messaging. However, we find that what was key to our participants was not that these issues be uniformly agreed upon by all team members, but rather that communication and clinic relationships support their continued negotiation. Our study shows that firm clinic relationships and deliberate communication strategies are the foundation of interdisciplinary care in weight management. Furthermore, there is a clear need for shared messaging concerning obesity and its treatment between members of interdisciplinary teams. © 2016 World Obesity.

The effectiveness of a nurse practitioner-led pain management team in long-term care: A mixed methods study.

PubMed

Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa

2016-10-01

Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group

[Management of difficult-to-treat asthma using a flow sheet for systematic evaluation and therapeutic intervention].

PubMed

Wakayama, Hisashi; Ogasawara, Tomohiko; Sato, Ai; Honda, Mamiko; Sakurai, Keiko; Uemura, Takehiro; Kasai, Daishi; Kato, Hisaaki; Tomita, Yuka; Park, Jangchul; Mizuno, Akiko; Suzuki, Masayuki

2008-11-01

Although most patients of asthma can be controlled by inhaled corticosteroid (ICS), some patients remain uncontrolled even after the introduction of ICS treatment. In management of such difficult-to-treat asthma, systematic review including additional differential diagnosis and avoidance of exacerbating factors is very important. Here we postulate a flow sheet presenting an algorithm which intends to achieve better asthma control following ATS refractory asthma guidance. For patients with poor controlled asthma even after using ICS more than moderate dose, we used the sheet in our daily outpatient management and investigated whether we could improve the control in such patients. The sheet was constructed by an algorithm which included (1) reevaluation of inhalation technique of ICS; (2) additional differential diagnosis of COPD and other similar diseases; and (3) reevaluation of presence of exacerbating factors. In our outpatient department, seven clinicians managed 22 difficult-to-treat asthma patients using this sheet. Additional factors which might worsen asthma control could be detected in 21 patients (95.5%). Firstly, smoking was disclosed in 8 patients (36.4%). Secondly, keeping pets was identified in 7 patients (31.8%). 5 patients (22.7%) were diagnosed as COPD rather than asthma and 4 patients (18.2%) were diagnosed as having rhinosinusitis. Some improvement of asthma control was achieved in 9 patients (40.9%). Reevaluation of refractory asthma patients using our newly developed flow sheet is essential and it may facilitate understanding of management of difficult-to-treat asthma.

Supporting the Federal Emergency Management Agency Rescuers: a variation of critical incident stress management.

PubMed

Garcia, Evangeline; Horton, Denise A

2003-02-01

The purpose of this article was to document the efforts of two military installations in facilitating Critical Incident Stress Management teams for Federal Emergency Management Agency Rescue and Recovery Units following the attacks on the World Trade Center on September 11, 2001. McGuire Air Force Base accepted the mission to support the rotating task forces with emotional support, and Fort Dix offered temporary lodging while the teams were in-bound and out-bound to the "Ground Zero" site. A team, comprised of staff from both installations due to the configuration of professional and support staffs, does the Critical Incident Stress Management work. Both installations are within commuting distance of New York City and could provide adequate safety, security, and logistics to the teams. The classic crisis management models were not called into play, as that service was not asked for; however, it was clear to the McGuire Air Force Base/Fort Dix Critical Incident Stress Management team members that the rescue and recovery teams needed their physical presence. Many rescue organizations have their own "debriefing teams," yet it is believed that "outside teams" may be helpful as interim measures to demonstrate the universality of the process of coping with traumatic stress and grief management. It is hoped that this article honors the workers who came together to help in a very difficult time for our country. This article documents the interim measures that were taken for a group of people moving through crisis.

Performance of district disaster management teams after undergoing an operational level planners' training in Uganda.

PubMed

Orach, Christopher Garimol; Mayega, Roy William; Woboya, Vincent; William, Bazeyo

2013-06-01

Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team's performance, roles and experiences following the training. The disasters most commonly experienced by the district teams were epidemics of diseases in humans (7 of 12), animals (epizoonotics) (3 of 12) and crops (3 of 12); hailstorms and floods (3 of 12). The capabilities viewed most useful for management of disasters were provision of health care services (9/12) and response management (8 of 12). The capability domains most often consulted during the disasters were general response management (31%), health services (29%) and water and sanitation (17%). The skills areas perceived to be vital following the training were response to epidemics 10/12, disaster management planning 8/12, hazards and vulnerability analysis 7/12 and principles of disaster planning 7/12 respectively. Main challenges mentioned by district teams were inadequacy of finance and logistics, lack of commitment by key partners towards disaster preparedness and response. The most common disaster experienced disasters related to outbreaks of diseases in man, animals and crops. The most frequently applied capabilities were response management and provision of emergency health services. The activities most frequently implemented following disaster management teams training were conducting planning meetings, refinement of plans and dissemination of skills gained. The main challenges were related to limited budget allocations and legal frameworks for disaster management that should be addressed by both central and local governments.

External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team

DTIC Science & Technology

2015-11-02

External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team N O V E M B E R 2 , 2 0 1 5... MANAGEMENT AGENCY SUBJECT: External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team...Report No. DODIG-2016-007) Attached is the External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment

Tightening the Iron Cage: Concertive Control in Self-Managing Teams.

ERIC Educational Resources Information Center

Barker, James R.

1993-01-01

Describes how an (industrial) organization's control system evolved in response to a managerial change from hierarchical, bureaucratic control to concertive control via self-management teams. The organization's members developed a system of value-based normative rules that controlled their actions more powerfully and completely than did the former…

The role of the multidisciplinary health care team in the management of patients with Marfan syndrome

PubMed Central

von Kodolitsch, Yskert; Rybczynski, Meike; Vogler, Marina; Mir, Thomas S; Schüler, Helke; Kutsche, Kerstin; Rosenberger, Georg; Detter, Christian; Bernhardt, Alexander M; Larena-Avellaneda, Axel; Kölbel, Tilo; Debus, E Sebastian; Schroeder, Malte; Linke, Stephan J; Fuisting, Bettina; Napp, Barbara; Kammal, Anna Lena; Püschel, Klaus; Bannas, Peter; Hoffmann, Boris A; Gessler, Nele; Vahle-Hinz, Eva; Kahl-Nieke, Bärbel; Thomalla, Götz; Weiler-Normann, Christina; Ohm, Gunda; Neumann, Stefan; Benninghoven, Dieter; Blankenberg, Stefan; Pyeritz, Reed E

2016-01-01

Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS. First, we show how the initiative and collaboration of patient representatives, scientists, and physicians resulted in the foundation of Marfan centers, initially in the US and later in Germany, and how and why such centers evolved over time. Then, we elucidate the three main structural elements; a team of coordinators, core disciplines, and auxiliary disciplines of health care. Moreover, we explain how a multidisciplinary health care team integrates into many other health care structures of a university medical center, including external quality assurance; quality management system; clinical risk management; center for rare diseases; aorta center; health care teams for pregnancy, for neonates, and for rehabilitation; and in structures for patient centeredness. We provide accounts of medical goals and standards for each core discipline, including pediatricians, pediatric cardiologists, cardiologists, human geneticists, heart surgeons, vascular surgeons, vascular interventionists, orthopedic surgeons, ophthalmologists, and nurses; and of auxiliary disciplines including forensic pathologists, radiologists, rhythmologists, pulmonologists, sleep specialists, orthodontists, dentists, neurologists, obstetric surgeons, psychiatrist/psychologist, and rehabilitation specialists. We conclude that a multidisciplinary health care team is a means

Cognitive Aids for Role Definition (CARD) to improve interprofessional team crisis resource management: An exploratory study.

PubMed

Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain

2016-09-01

This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.

The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

PubMed

Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri

2018-01-01

The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group. Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can

Why do young adults with Type 1 diabetes find it difficult to manage diabetes in the workplace?

PubMed

Balfe, Myles; Brugha, Ruairi; Smith, Diarmuid; Sreenan, Seamus; Doyle, Frank; Conroy, Ronan

2014-03-01

This article explores how and why workplace environments impact diabetes management for adults people with Type 1 diabetes, 23-30 years of age. Interviews were conducted with 35 young adults, 29 women and 6 men. The majority of these interviewees worked in sectors such as banking, technology and administration. Young adults found it difficult to manage diabetes in the workplace for two main reasons: work-related time pressures and the non-routine nature of interviewees' work and working environment. Young adults also found it difficult to get the time to exercise both inside and outside of work. Young adults with Type 1 diabetes need to be provided with the tools and technologies that they need to manage diabetes in modern flexible workplaces. Copyright © 2014 Elsevier Ltd. All rights reserved.

How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol.

PubMed

Goicolea, Isabel; Vives-Cases, Carmen; San Sebastian, Miguel; Marchal, Bruno; Kegels, Guy; Hurtig, Anna-Karin

2013-03-23

Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues-such as IPV management-get integrated into health systems, and that focuses on healthcare teams' learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning

Case management: a randomized controlled study comparing a neighborhood team and a centralized individual model.

PubMed

Eggert, G M; Zimmer, J G; Hall, W J; Friedman, B

1991-10-01

This randomized controlled study compared two types of case management for skilled nursing level patients living at home: the centralized individual model and the neighborhood team model. The team model differed from the individual model in that team case managers performed client assessments, care planning, some direct services, and reassessments; they also had much smaller caseloads and were assigned a specific catchment area. While patients in both groups incurred very high estimated health services costs, the average annual cost during 1983-85 for team cases was 13.6 percent less than that of individual model cases. While the team cases were 18.3 percent less expensive among "old" patients (patients who entered the study from the existing ACCESS caseload), they were only 2.7 percent less costly among "new" cases. The lower costs were due to reductions in hospital days and home care. Team cases averaged 26 percent fewer hospital days per year and 17 percent fewer home health aide hours. Nursing home use was 48 percent higher for the team group than for the individual model group. Mortality was almost exactly the same for both groups during the first year (about 30 percent), but was lower for team patients during the second year (11 percent as compared to 16 percent). Probable mechanisms for the observed results are discussed.

Trust in Culturally Diverse Teams

DTIC Science & Technology

2008-09-01

Humansystems® Incorporated 111 Farquhar St., Guelph, ON N1H 3N4 Project Manager : Barbara D. Adams, Ph.D. (519) 836 5911 PWGSC Contract...on trust in teams and on the management of trust violations within these teams. Reserve force military personnel (n = 106) were recruited to...cultural diversity on trust in teams and on the management of trust violations within these teams. CF reserve force personnel (n = 106) were

The Environmental Assessment and Management (TEAM) Guide: Mississippi Supplement

DTIC Science & Technology

2010-03-01

4 The Environmental Assessment and Management (TEAM) Guide: Mississippi Supplement C on st ru ct io n E n gi...resins manufacturing 10. pulp and paper industry 11. rubber and miscellaneous paper products 12. stone, glass, clay, and concrete products 13...contaminant risk assessment of the material. 4 . The registrant of the by-product must have the certification of a professional engineer licensed in

Hospital in the field: prehospital management of GHB intoxication by medical assistance teams.

PubMed

Dutch, Martin J; Austin, Kristy B

2012-10-01

Recreational use of gamma-hydroxybutyrate (GHB) is increasingly common at mass-gathering dance events in Australia. Overdose often occurs in clusters, and places a significant burden on the surrounding health care infrastructure. To describe the clinical presentation, required interventions and disposition of patrons with GHB intoxication at dance events, when managed by dedicated medical assistance teams. Retrospective analysis of all patrons attending St. John Ambulance medical assistance teams at dance events in the state of Victoria (Australia), from January 2010 through May 2011. Main outcome measures Clinical presentation, medical interventions and discharge destination. Sixty-one patients with GHB intoxication attended medical teams during the study period. The median age was 22 years, and 64% were male. Altered conscious state was present in 89% of attendances, and a GCS <9 in 44%. Hypotension, bradycardia and hypothermia were commonly encountered. Endotracheal intubation was required in three percent of patrons. Median length of stay onsite was 90 minutes. Ambulance transport to hospital was avoided in 65% of presentations. The deployment of medical teams at dance events and music festivals successfully managed the majority of GHB intoxications onsite and avoided acute care ambulance transfer and emergency department attendance.

How To Form a Team: Five Keys to High Performance. For the Practicing Manager. An Ideas into Action Guidebook.

ERIC Educational Resources Information Center

Kanaga, Kim; Kossler, Michael E.

This practical guidebook is designed for managers and leaders who have responsibility for the creation and success of teams. First, a team is described as a workgroup whose members are dependent upon one another for the completion of a given task, and whose members possess different but complementary skill sets. A team manages its own work within…

The impact of team characteristics and context on team communication: An integrative literature review.

PubMed

Tiferes, Judith; Bisantz, Ann M

2018-04-01

Many studies on teams report measures of team communication; however, these studies vary widely in terms of the team characteristics, situations, and tasks studied making it difficult to understand impacts on team communication more generally. The objective of this review is systematically summarize relationships between measures of team communication and team characteristics and situational contexts. A literature review was conducted searching in four electronic databases (PsycINFO, MEDLINE, Ergonomics Abstracts, and SocINDEX). Additional studies were identified by cross-referencing. Articles included for final review had reported at least one team communication measure associated with some team and/or context dimension. Ninety-nine of 727 articles met the inclusion criteria. Data extracted from articles included characteristics of the studies and teams and the nature of each of the reported team and/or context dimensions-team communication properties relationships. Some dimensions (job role, situational stressors, training strategies, cognitive artifacts, and communication media) were found to be consistently linked to changes in team communication. A synthesized diagram that describes the possible associations between eleven team and context dimensions and nine team communication measures is provided along with research needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Building team adaptive capacity: the roles of sensegiving and team composition.

PubMed

Randall, Kenneth R; Resick, Christian J; DeChurch, Leslie A

2011-05-01

The current study draws on motivated information processing in groups theory to propose that leadership functions and composition characteristics provide teams with the epistemic and social motivation needed for collective information processing and strategy adaptation. Three-person teams performed a city management decision-making simulation (N=74 teams; 222 individuals). Teams first managed a simulated city that was newly formed and required growth strategies and were then abruptly switched to a second simulated city that was established and required revitalization strategies. Consistent with hypotheses, external sensegiving and team composition enabled distinct aspects of collective information processing. Sensegiving prompted the emergence of team strategy mental models (i.e., cognitive information processing); psychological collectivism facilitated information sharing (i.e., behavioral information processing); and cognitive ability provided the capacity for both the cognitive and behavioral aspects of collective information processing. In turn, team mental models and information sharing enabled reactive strategy adaptation.

On knowledge transfer management as a learning process for ad hoc teams

NASA Astrophysics Data System (ADS)

Iliescu, D.

2017-08-01

Knowledge management represents an emerging domain becoming more and more important. Concepts like knowledge codification and personalisation, knowledge life-cycle, social and technological dimensions, knowledge transfer and learning management are integral parts. Focus goes here in the process of knowledge transfer for the case of ad hoc teams. The social dimension of knowledge transfer plays an important role. No single individual actors involved in the process, but a collective one, representing the organisation. It is critically important for knowledge to be managed from the life-cycle point of view. A complex communication network needs to be in place to supports the process of knowledge transfer. Two particular concepts, the bridge tie and transactive memory, would eventually enhance the communication. The paper focuses on an informational communication platform supporting the collaborative work on knowledge transfer. The platform facilitates the creation of a topic language to be used in knowledge modelling, storage and reuse, by the ad hoc teams.

Improving supervision: a team approach.

PubMed

1993-01-01

This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.

The Moderating Role of Performance in the Link From Interactional Justice Climate to Mutual Trust Between Managers and Team Members.

PubMed

Martínez-Tur, Vicente; Gracia, Esther; Moliner, Carolina; Molina, Agustín; Kuster, Inés; Vila, Natalia; Ramos, José

2016-06-01

The main goal of this study was to examine the interaction between team members' performance and interactional justice climate in predicting mutual trust between managers and team members. A total of 93 small centers devoted to the attention of people with intellectual disability participated in the study. In each center, the manager (N = 93) and a group of team members (N = 746) were surveyed. On average, team members were 36.2 years old (SD = 9.3), whereas managers were 41.2 years old (SD = 8.8). The interaction between interactional justice climate and performance was statistically significant. Team members' performance strengthened the link from interactional justice climate to mutual trust. © The Author(s) 2016.

Assisting School Management Teams to Construct Their School Improvement Plans: An Action Learning Approach

ERIC Educational Resources Information Center

Van Der Voort, Geoffrey; Wood, Lesley

2014-01-01

This article reports on a first cycle of a larger action research study conducted to determine how Circuit Teams could support School Management Teams of underperforming high schools towards whole-school development. Although it is a mandated requirement by the Department of Education, none of the four schools involved in the study had developed a…

Team Supervision of the Doctorate: Managing Roles, Relationships and Contradictions

ERIC Educational Resources Information Center

Watts, Jacqueline H.

2010-01-01

Working in teams is widely recognised as an important skill across a range of occupations and professions, with the teaching of teamwork now a feature of the higher education curriculum. The success of teamwork, however, depends to a large extent on the mediated management of complex variables such as individual conduct, collective action,…

Conflict in medical teams: opportunity or danger?

PubMed

Greer, Lindred L; Saygi, Ozum; Aaldering, Hillie; de Dreu, Carsten K W

2012-10-01

  Intragroup conflicts often occur when people are called upon to collaborate in the accomplishment of a task. For example, when surgeons and nurses work together during an operation, conflicts may emerge because of differences in functional understanding. Whether these conflicts are beneficial or detrimental to team outcomes has been the source of much debate. From one perspective, a conflict that stems from differences in members' functional understanding may enhance team members' understanding and performance of the task at hand. By contrast, such a conflict may cause hostility, emotionality and distraction from actual task accomplishment.   This study reviews findings on the relationships between intragroup conflict and team outcomes, discusses potential conflict resolution strategies for intragroup conflicts and explores how these link to the field of medical education.   Three primary types of conflict have been distinguished, involving, respectively, task-, process- and relationship-associated conflict. Both process conflict, or conflict about the logistics of task accomplishment, and relationship conflict, or conflict about interpersonal incompatibilities, have been shown to detract from effective team functioning. Task conflict, or conflict about the content of the task itself, is also generally negative for team functioning, but under certain conditions its negative effects may be minimised. For example, when teams can clearly separate task issues from relationship issues, task conflicts are less destructive for team outcomes. However, achieving such a separation in practice, and thereby realising the benefits of task conflict, is quite difficult to achieve.   Intragroup conflicts pose a challenge to effective team functioning. In the education of medical professionals, effective training in conflict management skills and their application to specific team conflict dynamics, such as with reference to how to resolve task as opposed to relationship

Work Teams that Work.

ERIC Educational Resources Information Center

Galagan, Patricia

1986-01-01

Describes a line manager's successful attempt to design an autonomously run plant. The author discusses the assembly of a team of workers to develop the plant, product design, characteristics of the team members, the employee reward system, role of the plant manager, and the manager's evaluation of the plant's success. (CT)

A Survey of Knowledge Management Skills Acquisition in an Online Team-Based Distributed Computing Course

ERIC Educational Resources Information Center

Thomas, Jennifer D. E.

2007-01-01

This paper investigates students' perceptions of their acquisition of knowledge management skills, namely thinking and team-building skills, resulting from the integration of various resources and technologies into an entirely team-based, online upper level distributed computing (DC) information systems (IS) course. Results seem to indicate that…

Management of complicated gallstones: results of an alternative approach to difficult cholecystectomies.

PubMed

Lirici, Marco Maria; Califano, Andrea

2010-10-01

Laparoscopic cholecystectomy (LC) is the gold standard treatment of gallstones. Nevertheless, the incidence of conversion and injuries to the biliary tract is still high in difficult cholecystectomies. In this study we sought to determine how using operative risk predictive scores (PSs) and the Nassar scale to grade the difficulty of LC would optimize the perioperative management of complicated gallstone patients. We also evaluated whether the "fundus-first" approach to LC combined with ultrasonic dissection minimizes the risk of conversion and biliary injury in difficult cholecystectomies, and avoids routine intraoperative cholangiography. A prospective non-randomized study was carried out from 2005 to 2007 including 237 patients referred for gallbladder diseases. All patients were evaluated using an operative risk PS. The LC grade of difficulty was assessed according to Nassar. Diagnostic accuracy, sensitivity, and specificity of PS were calculated. LC in difficult cases was accomplished with a fundus-first approach. Outcome measures included: Conversion rate, bile duct (BD) injury rate, and postoperative complications according to Clavien. In 178 out of 237 patients, a higher risk of conversion and complication was predicted. In 146 out of these 178 cases, intra-operative grading confirmed the difficulty of the procedure. The PS diagnostic accuracy was 0.865, sensitivity was 100%, and specificity 65%. Positive predictive value and negative predictive value were 0.82 and 1, respectively. Conversion rate was 2.7%. Mean operating time and postoperative length of hospital stay were 75 minutes and 3.5 days. Intra-operative cholangiography was necessary in five cases, and one intraoperative biliary complication occurred with an uneventful postoperative course. Overall, postoperative complications were 2.7% with a mortality rate of 0.68% (1 myocardial infarction). Fundus-first LC by ultrasonic dissection is safe and minimizes the risk of conversion and biliary injuries

Trauma teams and time to early management during in situ trauma team training.

PubMed

Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine; Hultin, Magnus

2016-01-29

To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. An emergency room in an urban Scandinavian level one trauma centre. A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Trauma teams and time to early management during in situ trauma team training

PubMed Central

Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine

2016-01-01

Objectives To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. Design In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. Setting An emergency room in an urban Scandinavian level one trauma centre. Participants A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. Primary outcome HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Results Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Conclusions Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. PMID:26826152

Are the resources adoptive for conducting team-based diabetes management clinics? An explorative study at primary health care centers in Muscat, Oman.

PubMed

Al-Alawi, Kamila; Johansson, Helene; Al Mandhari, Ahmed; Norberg, Margareta

2018-05-08

AimThe aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches. The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines. A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FindingsThe study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.

Muddles and Huddles: Facilitating a Multicultural Workforce through Team Management Theory.

ERIC Educational Resources Information Center

Schreiber, Evelyn Jaffe

1996-01-01

Suggests two avenues of guidance for organizations adopting a multicultural approach: (1) businesses can profit from experiences in academia, where researchers have outlined areas of difficulty (for example, sharing power and valuing difference); and (2) industries' own team management theory (which dismantles hierarchical structures in favor of…

Crisis Team Management in a Scarce Resource Setting: Angkor Hospital for Children in Siem Reap, Cambodia.

PubMed

Henker, Richard Alynn; Henker, Hiroko; Eng, Hor; O'Donnell, John; Jirativanont, Tachawan

2017-01-01

A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance. Each of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5). CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course. Of the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve ( p  < 0.05) for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information. Teaching of non-technical skills can be effective in a setting with scarce resources in a Southeastern Asian country.

Globus Online: Climate Data Management for Small Teams

NASA Astrophysics Data System (ADS)

Ananthakrishnan, R.; Foster, I.

2013-12-01

Large and highly distributed climate data demands new approaches to data organization and lifecycle management. We need, in particular, catalogs that can allow researchers to track the location and properties of large numbers of data files, and management tools that can allow researchers to update data properties and organization during their research, move data among different locations, and invoke analysis computations on data--all as easily as if they were working with small numbers of files on their desktop computer. Both catalogs and management tools often need to be able to scale to extremely large quantities of data. When developing solutions to these problems, it is important to distinguish between the needs of (a) large communities, for whom the ability to organize published data is crucial (e.g., by implementing formal data publication processes, assigning DOIs, recording definitive metadata, providing for versioning), and (b) individual researchers and small teams, who are more frequently concerned with tracking the diverse data and computations involved in what highly dynamic and iterative research processes. Key requirements in the latter case include automated data registration and metadata extraction, ease of update, close-to-zero management overheads (e.g., no local software install); and flexible, user-managed sharing support, allowing read and write privileges within small groups. We describe here how new capabilities provided by the Globus Online system address the needs of the latter group of climate scientists, providing for the rapid creation and establishment of lightweight individual- or team-specific catalogs; the definition of logical groupings of data elements, called datasets; the evolution of catalogs, dataset definitions, and associated metadata over time, to track changes in data properties and organization as a result of research processes; and the manipulation of data referenced by catalog entries (e.g., replication of a dataset to

The influence of incident management teams on the deployment of wildfire suppression resources

Treesearch

Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson

2017-01-01

Despite large commitments of personnel and equipment to wildfire suppression, relatively little is known about the factors that affect how many resources are ordered and assigned to wildfire incidents and the variation in resources across incident management teams (IMTs). Using detailed data on suppression resource assignments for IMTs managing the highest complexity...

Nutritional support team vs nonteam management of enteral nutritional support in a Veterans Administration Medical Center teaching hospital.

PubMed

Powers, D A; Brown, R O; Cowan, G S; Luther, R W; Sutherland, D A; Drexler, P G

1986-01-01

One hundred one patients receiving enteral nutritional support (ENS) by tube feeding during a 5-month period were prospectively studied. Fifty patients were managed by a nutritional support team (T) and 51 patients were managed by the nonteam approach (NT). Demographics, primary diagnosis, chronic diseases, medical service, calculated basal energy expenditure (BEE), duration of ENS, and final patient disposition were recorded. Enteral formula, formula modifications, results of laboratory tests and calories delivered were obtained daily. Results of nitrogen balance studies were obtained when available and each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. No significant difference was found between the team and nonteam managed groups in regard to total feeding days, mean feeding days per patient, total laboratory tests, laboratory tests per patient or laboratory tests per day. Significantly more team patients attained 1.2 times BEE (T = 47, NT = 38, p less than 0.05) for a significantly greater period of time (T = 398 days, NT = 281 days, p less than 0.05). Significantly more team patients achieved a measured positive nitrogen balance than nonteam patients (T = 42, NT = 1, p less than 0.05). Formula modifications to correct nutritional or metabolic aberrations were made in 15 (30%) team patients and five (9.8%) nonteam patients (p less than 0.05). The number of individual abnormalities (pulmonary, mechanical, gastrointestinal, and metabolic), as well as total abnormalities occurring in the team-managed group, was significantly lower than in the nonteam managed group (160 vs 695, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Managing Biases in Product Development Teams: A Tale of Two Rocks

ERIC Educational Resources Information Center

Keene, Michael A.

2017-01-01

The management of product development teams is a challenging task, especially when success hinges on the ability to guide technical and nontechnical personnel through an effective decision-making process. The "Tale of Two Rocks" exercise illustrates how differing motivations and beliefs about new technologies can affect the decisions…

What Makes Difficult History Difficult?

ERIC Educational Resources Information Center

Gross, Magdalena H.; Terra, Luke

2018-01-01

All modern nation-states have periods of difficult history that teachers fail to address or address inadequately. The authors present a framework for defining difficult histories and understanding what makes them difficult. These events 1) are central to a nation's history, 2) contradict accepted histories or values, 3) connect with present…

[Certification, on-the-ground experience of a manager and his team].

PubMed

Thibault, Catherine; Guillouët, Sonia; Havin, Marie-Pierre

2018-03-01

The certification assessment is an important stage in the life of a healthcare facility. However, instilling a quality culture within a team to lead it towards performance is a long-term endeavour. This cannot work without the existence of a partnership between the paramedical and medical teams, nor without the support of the hospital led by senior quality managers. The challenge is to not limit the quality culture to the certification assessment, which aims to highlight the areas in which the institution conforms and those in which it is failing, but rather to adopt a continuous improvement approach. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

NASA Technical Reports Server (NTRS)

Kinlaw, Dennis C.; Eads, Jeannette

1992-01-01

It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

Defining Projects to Integrate Evolving Team Fundamentals and Project Management Skills

ERIC Educational Resources Information Center

Smith, Harold, III; Smarkusky, Debra; Corrigall, Elizabeth

2008-01-01

Industry has indicated the desire for academic programs to produce graduates that are well-versed in collaborative problem solving and general project management concepts in addition to technical skills. The primary focus of a curriculum is typically centered on the technical training with minimal attention given to coalescing team and project…

Evaluation and management of the patient with difficult-to-control or resistant hypertension.

PubMed

Viera, Anthony J; Hinderliter, Alan L

2009-05-15

High blood pressure is often difficult to control. Resistant hypertension is blood pressure above goal despite adherence to a combination of at least three antihypertensive medications of different classes, optimally dosed and usually including a diuretic. The approach to blood pressure that is apparently difficult to control begins with an assessment of the patient's adherence to the management plan, including lifestyle modifications and medications. White-coat hypertension may need to be ruled out. Suboptimal therapy is the most common reason for failure to reach the blood pressure goal. Once-daily fixed-dose combination pills may improve control through the synergism of antihypertensive agents from different classes and improved adherence. Truly drug-resistant hypertension is commonly caused by chronic kidney disease, obstructive sleep apnea, or hyperaldosteronism, all of which can lead to fluid retention. Higher doses of diuretics (or a change to a loop diuretic) are usually needed. Other strategies include adding an alpha blocker, alpha-beta blocker, clonidine, or an aldosterone antagonist (e.g., spironolactone). Particularly in patients with diabetes or renal disease, combining a long-acting nondihydropyridine with a dihydropyridine calcium channel . blocker can also be considered. Obesity, heavy alcohol intake, high levels of dietary sodium, and interfering substances (especially nonsteroidal anti-inflammatory drugs) contribute to hypertension that is resistant or difficult to control.

Clinical nursing leaders', team members' and service managers' experiences of implementing evidence at a local level.

PubMed

Kitson, Alison; Silverston, Heidi; Wiechula, Rick; Zeitz, Kathryn; Marcoionni, Danni; Page, Tammy

2011-05-01

To describe the experiences of 14 clinical nursing leaders introducing a knowledge translation (KT) project into one metropolitan acute care hospital in South Australia. The study also explored team members' and service managers' experiences. KT strategies assume that local (nursing) clinical leaders have the capacity and capability to champion innovation combining positional leadership roles (ward leader) with a project lead role. There is limited evidence to support these assumptions. Semi-structured interviews of clinical nursing leaders and managers were undertaken at month 4 and 12 of the project. Data were also collected from the interdisciplinary team members (n = 28). Clinical nursing leaders identified risks and anxieties associated with taking on an additional leadership role, whereas managers acknowledged the multiple pressures on the system and the need for local level innovation. Team members generally reported positive experiences. With support, clinical nursing leaders can effectively embrace KT project leadership roles that complement their positional leadership roles. Clinical nursing leaders' experiences differed from nursing and medical managers' experiences.   Managers need to be more attuned to the personal risks local leaders experience, providing support for leaders to experiment and innovate. Managers need to integrate local priorities with broader system wide agendas. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

The 5As team intervention: bridging the knowledge gap in obesity management among primary care practitioners.

PubMed

Ogunleye, Ayodele; Osunlana, Adedayo; Asselin, Jodie; Cave, Andrew; Sharma, Arya Mitra; Campbell-Scherer, Denise Lynn

2015-12-22

Despite opportunities for didactic education on obesity management, we still observe low rates of weight management visits in our primary care setting. This paper describes the co-creation by front-line interdisciplinary health care providers and researchers of the 5As Team intervention to improve obesity prevention and management in primary care. We describe the theoretical foundations, design, and core elements of the 5AsT intervention, and the process of eliciting practitioners' self-identified knowledge gaps to inform the curricula for the 5AsT intervention. Themes and topics were identified through facilitated group discussion and a curriculum relevant to this group of practitioners was developed and delivered in a series of 12 workshops. The research question and approach were co-created with the clinical leadership of the PCN; the PCN committed internal resources and a practice facilitator to the effort. Practice facilitation and learning collaboratives were used in the intervention For the content, front-line providers identified 43 topics, related to 13 themes around obesity assessment and management for which they felt the need for further education and training. These needs included: cultural identity and body image, emotional and mental health, motivation, setting goals, managing expectations, weight-bias, caregiver fatigue, clinic dynamics and team-based care, greater understanding of physiology and the use of a systematic framework for obesity assessment (the "4Ms" of obesity). The content of the 12 intervention sessions were designed based on these themes. There was a strong innovation values fit with the 5AsT intervention, and providers were more comfortable with obesity management following the intervention. The 5AsT intervention, including videos, resources and tools, has been compiled for use by clinical teams and is available online at http://www.obesitynetwork.ca/5As_Team . Primary care interdisciplinary practitioners perceive important

A Research on the Construction of University R&D Management Team in China

ERIC Educational Resources Information Center

Jia, Ning

2007-01-01

The system of Chinese universities R&D as a branch of the system of the whole country R&D, has a great effect on the development and innovation of the country's science and technique. Consequently, it's important to construct an effective management team with high diathesis for University R&D management. Based on the statistics of the…

An Empirical Study of Hospitality Management Student Attitudes toward Group Projects: Instructional Factors and Team Problems

ERIC Educational Resources Information Center

Choi, Youngsoo; Ro, Heejung

2012-01-01

The development of positive attitudes in team-based work is important in management education. This study investigates hospitality students' attitudes toward group projects by examining instructional factors and team problems. Specifically, we examine how the students' perceptions of project appropriateness, instructors' support, and evaluation…

Role Allocation and Team Structure in Command and Control Teams

DTIC Science & Technology

2014-06-01

organizational psychology and management sciences literature show concepts such as empowered self-management and self-regulating work teams (see Cooney, 2004...tankers (FT), search units (S) and rescue units (R). Each unit is represented on the map by a numbered icon. Each type of unit is colour -coded and...Understanding team adaptation: A conceptual analysis and model. Journal of Applied Psychology , 91, 1189-1207. Cannon-Bowers, J. A., Tannenbaum

STS-121: Discovery Pre-Launch Mission Management Team Press Briefing

NASA Technical Reports Server (NTRS)

2006-01-01

The briefing began with Allard Buetel (NASA Public Affairs) introducing Bill Gerstenmaier (Associate Administrator for Space Operations) who provided an update of the Mission Management team meeting. The 3 criteria reviewed by the team were: a) ascent heating; b) ice formation and c) remaining foam still intact. The ascent heating had a safety factor of 5 and posed no concern. Ice formation was not a concern. In order to insure there was no damage to the remaining foam, an 8ft. pipe with a camera attached was used to provide pictures. The boroscope pictures showed there was no damage to the brackets or foam. The inspection went very well and the foam was acceptable and ready to fly. Then the floor was open to questions from the press.

Does participative leadership reduce the onset of mobbing risk among nurse working teams?

PubMed

Bortoluzzi, Guido; Caporale, Loretta; Palese, Alvisa

2014-07-01

To evaluate the advancement of knowledge on the impact of an empowering leadership style on the risk of mobbing behaviour among nurse working teams. The secondary aim was to evaluate, along with leadership style, the contribution of other organisational- and individual-related mobbing predictors. The style of leadership in reducing the onset of mobbing risk in nurse working teams still remains a matter of discussion. Nurse working teams are particularly affected by mobbing and studies exploring individual and organisational inhibiting/modulating factors are needed. An empirical study involving 175 nurses of various public hospital corporations in northern Italy. Data were collected via structured and anonymous questionnaires and analysed through a logistic regression. Organisational, individual and participative leadership variables explained 33.5% (P < 0.01) of variance in the onset of mobbing. Two predictive factors emerged: a participative leadership enacted by nursing managers and the nursing shortage as perceived by clinical nurses. Results confirmed that the contribution made by a participative leadership style in attenuating the onset of mobbing risk in working teams was significant. A participative leadership style adopted by the nurse manager allows for the reduction of tensions in nurse working teams. However, mobbing remains a multifaceted phenomenon that is difficult to capture in its entirety and the leadership style cannot be considered as a panacea for resolving this problem in nurse working teams. © 2013 John Wiley & Sons Ltd.

Power Parenting for Children with ADD/ADHD: A Practical Parent's Guide for Managing Difficult Behaviors.

ERIC Educational Resources Information Center

Flick, Grad L.

The first step in dealing with an attention deficit disorder (ADD/ADHD) child's difficult behavior is to understand its origins. This book presents behavior management techniques to help parents care for their ADD child while ensuring that the child continues to develop positive, healthy self-esteem. The guide shows how to: (1) ensure an accurate…

[Developing team reflexivity as a learning and working tool for medical teams].

PubMed

Riskin, Arieh; Bamberger, Peter

2014-01-01

Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.

How anaesthesiologists understand difficult airway guidelines-an interview study.

PubMed

Knudsen, Kati; Pöder, Ulrika; Nilsson, Ulrica; Högman, Marieann; Larsson, Anders; Larsson, Jan

2017-11-01

In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. A qualitative phenomenographic design was chosen to explore anaesthesiologists' views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts' consensus, a set of scientifically based guidelines for handling the difficult airway. The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently.

The relationship between senior management team culture and clinical governance: Empirical investigation and managerial implications.

PubMed

Prenestini, Anna; Calciolari, Stefano; Lega, Federico; Grilli, Roberto

2015-01-01

Health care organizations are pressured to improve the cost-effectiveness of service delivery. Clinical governance is an important trigger to improve care quality and safety and rank high in the reform agenda of health systems. The senior management team culture plays a major role in establishing clinical governance practices, because it strongly influences the values, attitudes, and behaviors of the members of an organization. The aim of this study was to investigate the relationship between senior management team culture and clinical governance in the public health care organizations of three Italian regions. The assessment of senior management culture was conducted using the Competing Values Framework and a corresponding instrument adapted for the Italian context. Clinical governance was assessed using an ad hoc instrument focused on the senior management team's perception and attitude toward clinical governance. The survey achieved a 54% response rate. The results of four different models demonstrate that organizations characterized by different dominant cultures are associated with significant differences in attitudes toward clinical governance. In particular, on average, dominant cultures with a prevailing external focus are associated with a more positive attitude toward clinical governance. The selection and appointments of top managers should consider the style of leadership that is most apt to facilitate the growth of rational and developmental cultures. Furthermore, the training of top managers and leading doctors should reinforce leadership aptitude and approaches that are consistent with the desired organizational cultures.

Update on Difficult Polypectomy Techniques.

PubMed

Ngamruengphong, Saowanee; Pohl, Heiko; Haito-Chavez, Yamile; Khashab, Mouen A

2016-01-01

Endoscopists often encounter colon polyps that are technically difficult to resect. These lesions traditionally were managed surgically, with significant potential morbidity and mortality. Recent advances in endoscopic techniques and instruments have allowed endoscopists to safely and effectively remove colorectal lesions with high technical and clinical success and potentially avoid invasive surgery. Endoscopic mucosal resection (EMR) has gained acceptance as the first-line therapy for large colorectal lesions. Endoscopic submucosal dissection (ESD) has been reported to be associated with higher rate of en bloc resection and less risk of short-time recurrence, but with an increased risk of adverse events. Therefore, the role of colorectal ESD should be restricted to lesions with high-risk morphologic features of submucosal invasion. In this article, we review the recent literature on the endoscopic management of difficult colorectal neoplasms.

Managing 'difficult emotions' and family life: exploring insights and social support within online self-management training.

PubMed

Sanders, C; Rogers, A; Gardner, C; Kennedy, A

2011-06-01

Previous research has demonstrated how the Internet can foster emotional support and provide a 'private' space for discussing sensitive issues. Whilst the family has been located as a primary source of support, empirical research on the dynamics of close personal relationships in chronic illness experience remains a challenge. To explore the role of family relationships in supporting self-care and the nature of social support exchanged within an online self-management training course. Qualitative thematic and narrative analysis of online discussion boards. Postings for 218 participants, divided between 11 groups were included for a course section that focused on 'difficult emotions'. Participants exchanged a high degree of emotional support and revealed much about their 'real life' relationships. The latter highlighted the complexities of managing illness within family contexts alongside additional pressures of daily life such as caring commitments and work roles. The private interactive space created within the course allowed insights into the dynamics of family life associated with illness management that are challenging to research. Simultaneously, collective support was developed amongst this group of predominantly working women. The article points to the implications for such interventions and associated evaluative research beyond this selective group.

Encountering unexpected difficult airway: relationship with the intubation difficulty scale

PubMed Central

Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin

2016-01-01

Background An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. Methods We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. Results For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Conclusions Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation. PMID:27274369

The external leadership of self-managing teams: intervening in the context of novel and disruptive events.

PubMed

Morgeson, Frederick P

2005-05-01

Relatively little empirical research has been conducted on external leaders of self-managing teams. The integration of functional leadership theory with research on team routines suggests that leaders can intervene in teams in several different ways, and the effectiveness of this intervention depends on the nature of the events the team encounters. External team leaders from 3 organizations first described a series of events (N=117), and leaders and team members then completed surveys to quantitatively describe the events. Results indicated that leader preparation and supportive coaching were positively related to team perceptions of leader effectiveness, with preparation becoming more strongly related to effectiveness as event novelty increased. More active leader intervention activities (active coaching and sense making) were negatively related to satisfaction with leadership yet were positively related to effectiveness as events became more disruptive.

Impact of the 5As Team study on clinical practice in primary care obesity management: a qualitative study

PubMed Central

Asselin, Jodie; Salami, Eniola; Osunlana, Adedayo M.; Ogunleye, Ayodele A.; Cave, Andrew; Johnson, Jeffrey A.; Sharma, Arya M.; Campbell-Scherer, Denise L.

2017-01-01

Background: The 5As [Ask, Assess, Advise, Agree, Assist] of Obesity Management Team study was a randomized controlled trial of an intervention that was implemented and evaluated to help primary care providers improve clinical practice for obesity management. This paper presents health care provider perspectives of the impacts of the intervention on individual provider and team practices. Methods: This study reports a thematic network analysis of qualitative data collected during the 5As Team study, which involved 24 chronic disease teams affiliated with family practices in a Primary Care Network in Alberta. Qualitative data from 28 primary care providers (registered nurses/nurse practitioners [n = 14], dietitians [n = 7] and mental health workers [n = 7]) in the intervention arm were collected through semistructured interviews, field notes, practice facilitator diaries and 2 evaluation workshop questionnaires. Results: Providers internalized 5As Team intervention concepts, deepening self-evaluation and changing clinical reasoning around obesity. Providers perceived that this internalization changed the provider-patient relationship positively. The intervention changed relations between providers, increasing interdisciplinary understanding, collaboration and discovery of areas for improvement. This personal and interpersonal evolution effected change to the entire Primary Care Network. Interpretation: The 5As Team intervention had multiple impacts on providers and teams to improve obesity management in primary care. Improved provider confidence and capability is a precondition of developing effective patient interventions. Trial registration: ClinicalTrials.gov, no.: NCT01967797. PMID:28450428

How anaesthesiologists understand difficult airway guidelines—an interview study

PubMed Central

Knudsen, Kati; Nilsson, Ulrica; Larsson, Anders; Larsson, Jan

2017-01-01

Background In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. Methods A qualitative phenomenographic design was chosen to explore anaesthesiologists’ views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Results Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts’ consensus, a set of scientifically based guidelines for handling the difficult airway. Conclusions The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently. PMID:29299973

Speeding Up Team Learning.

ERIC Educational Resources Information Center

Edmondson, Amy; Bohmer, Richard; Pisano, Gary

2001-01-01

A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)

Ensuring the safety of surgical teams when managing casualties of a radiological dirty bomb.

PubMed

Williams, Geraint; O'Malley, Michael; Nocera, Antony

2010-09-01

The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team. 2010 Elsevier Ltd. All rights reserved.

Perceived distributed effort in team ball sports.

PubMed

Beniscelli, Violeta; Tenenbaum, Gershon; Schinke, Robert Joel; Torregrosa, Miquel

2014-01-01

In this study, we explored the multifaceted concept of perceived mental and physical effort in team sport contexts where athletes must invest individual and shared efforts to reach a common goal. Semi-structured interviews were conducted with a convenience sample of 15 Catalan professional coaches (3 women and 12 men, 3 each from the following sports: volleyball, basketball, handball, soccer, and water polo) to gain their views of three perceived effort-related dimensions: physical, psychological, and tactical. From a theoretical thematic analysis, it was found that the perception of effort is closely related to how effort is distributed within the team. Moreover, coaches viewed physical effort in relation to the frequency and intensity of the players' involvement in the game. They identified psychological effort in situations where players pay attention to proper cues, and manage emotions under difficult circumstances. Tactical effort addressed the decision-making process of players and how they fulfilled their roles while taking into account the actions of their teammates and opponents. Based on these findings, a model of perceived distributed effort was developed, which delineates the elements that compose each of the aforementioned dimensions. Implications of perceived distributed effort in team coordination and shared mental models are discussed.

An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training.

PubMed

France, Daniel J; Leming-Lee, Susie; Jackson, Tom; Feistritzer, Nancye R; Higgins, Michael S

2008-04-01

Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings. Direct observational analyses were performed on 30 surgical teams (15 neurosurgery cases and 15 cardiac cases) to evaluate surgical team compliance with integrated safety and CRM practices after extensive CRM training. Observed surgical teams were compliant with only 60% of the CRM and perioperative safety practices emphasized in the training program. The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.

The Evolving Manager Stereotype: The Effects of Industry Gender Typing on Performance Expectations for Leaders and Their Teams

ERIC Educational Resources Information Center

Cabrera, Susan F.; Sauer, Stephen J.; Thomas-Hunt, Melissa C.

2009-01-01

This study examined how external evaluators' assessments of a management team and its leader are impacted by congruence between the leader's gender and the gender typing of the industry in which the team works. We experimentally tested our theory using industries that are either male typed or gender neutral, with teams led by male and female…

Managing Resource Teams in the Hellenic Navy

DTIC Science & Technology

2011-12-01

28  Table 2.  Impact of Involvement in Teams on Organizations and Workers. (From: Lawler, Mohrman & Ledford, 1992, p. 450...organizational and worker effectiveness such as productivity, quality and morale (Lawler, Mohrman & Ledford, 1995). 30 Table 2. Impact of Involvement in...Teams on Organizations and Workers. (From: Lawler, Mohrman & Ledford, 1992, p. 450) Impact of Involvement in Teams on Organizations and Workers

A new low-cost method for difficult airway management in non-missile-penetrating cervical spine injury.

PubMed

Rabiu, Taopheeq B; Fadare, Amos E

2012-03-01

Accessing and maintaining the airway in penetrating cervical spine injury is a challenge for anaesthetists globally. This is more so in resource-poor settings, where advanced techniques for intubation in difficult airway situations are unavailable. We describe a new, low-cost, easily adaptable method of managing the airway used in a middle-aged man who sustained screw driver injury to the cervical spine with C4 Brown-Séquard syndrome. The deployment of readily available and cheap materials led to successful anaesthesia management of the patient.

Are characteristics of team members important for quality management of chronic patients at primary care level?

PubMed

Klemenc-Ketis, Zalika; Poplas-Susič, Antonija

2017-12-01

To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients. We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements. © 2017 John Wiley & Sons Ltd.

A crew resource management program tailored to trauma resuscitation improves team behavior and communication.

PubMed

Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher

2014-09-01

Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Using Semantic Components to Represent Dynamics of an Interdisciplinary Healthcare Team in a Multi-Agent Decision Support System.

PubMed

Wilk, Szymon; Kezadri-Hamiaz, Mounira; Rosu, Daniela; Kuziemsky, Craig; Michalowski, Wojtek; Amyot, Daniel; Carrier, Marc

2016-02-01

In healthcare organizations, clinical workflows are executed by interdisciplinary healthcare teams (IHTs) that operate in ways that are difficult to manage. Responding to a need to support such teams, we designed and developed the MET4 multi-agent system that allows IHTs to manage patients according to presentation-specific clinical workflows. In this paper, we describe a significant extension of the MET4 system that allows for supporting rich team dynamics (understood as team formation, management and task-practitioner allocation), including selection and maintenance of the most responsible physician and more complex rules of selecting practitioners for the workflow tasks. In order to develop this extension, we introduced three semantic components: (1) a revised ontology describing concepts and relations pertinent to IHTs, workflows, and managed patients, (2) a set of behavioral rules describing the team dynamics, and (3) an instance base that stores facts corresponding to instances of concepts from the ontology and to relations between these instances. The semantic components are represented in first-order logic and they can be automatically processed using theorem proving and model finding techniques. We employ these techniques to find models that correspond to specific decisions controlling the dynamics of IHT. In the paper, we present the design of extended MET4 with a special focus on the new semantic components. We then describe its proof-of-concept implementation using the WADE multi-agent platform and the Z3 solver (theorem prover/model finder). We illustrate the main ideas discussed in the paper with a clinical scenario of an IHT managing a patient with chronic kidney disease.

The Anonymity Factor in Making Multicultural Teams Work: Virtual and Real Teams

ERIC Educational Resources Information Center

Berg, Roberta Wiig

2012-01-01

A major purpose of courses in intercultural communication is often to improve students' ability to perform well in situations with the potential to be both highly enlightening and highly difficult--in multicultural teams. This article reports the results of exercises in which members of a dysfunctional multicultural class were assigned to teams…

Assessment of the trauma evaluation and management (TEAM) module in Australia.

PubMed

Ali, Jameel; Danne, Peter; McColl, Geoff

2004-08-01

To assess the immediate effect on trauma-related knowledge of the trauma evaluation and management (TEAM) program applied to medical students in Australia. 73 final year medical students from Melbourne were randomly assigned to two experimental groups (E1 and E2 who completed the TEAM program after a 20 item MCQ pre-test on trauma resuscitation and a second MCQ exam after the TEAM program) and two control groups (C1 and C2 who completed the pre- and post-MCQ exams before completing the TEAM module). All 73 students completed an evaluation questionnaire. Paired and unpaired t-tests were used for within and between groups comparisons. Groups C1 and C2 had similar mean scores in pre- and post-tests ranging from 57.2 to 60.5%. Groups E1 and E2 had similar pre-test scores but increased their post-test scores (pre-test range 53.8-57.1% and post-test 68.8-77.4%, P < 0.05). On a scale of 1-5 with five being the highest, a score of four or greater was assigned by over 74% of the students that the objectives were met, over 80% that trauma knowledge was improved, 25-40% that clinical skills were improved with over 74% overall satisfaction. Over 75% assigned a score of four or greater suggesting the module be mandatory. After the TEAM program there was significant improvement in cognitive skills. The students strongly supported its introduction in the undergraduate curriculum.

Treatment of Difficult Asthma

PubMed Central

Bowie, Dennis M.

1991-01-01

The difficult asthmatic patient should first be managed by confirming the diagnosis and eliminating any aggravating environmental or occupational factors, including medication use. Proper treatment requires rational addition of drugs in a logical sequence. It is most important to ensure proper inhaler technique, patient compliance, effective doctor-patient communication, and proper patient monitoring. ImagesFigure 2 PMID:21229079

The interplay of diversity training and diversity beliefs on team creativity in nationality diverse teams.

PubMed

Homan, Astrid C; Buengeler, Claudia; Eckhoff, Robert A; van Ginkel, Wendy P; Voelpel, Sven C

2015-09-01

Attaining value from nationality diversity requires active diversity management, which organizations often employ in the form of diversity training programs. Interestingly, however, the previously reported effects of diversity training are often weak and, sometimes, even negative. This situation calls for research on the conditions under which diversity training helps or harms teams. We propose that diversity training can increase team creativity, but only for teams with less positive pretraining diversity beliefs (i.e., teams with a greater need for such training) and that are sufficiently diverse in nationality. Comparing the creativity of teams that attended nationality diversity training versus control training, we found that for teams with less positive diversity beliefs, diversity training increased creative performance when the team's nationality diversity was high, but undermined creativity when the team's nationality diversity was low. Diversity training had less impact on teams with more positive diversity beliefs, and training effects were not contingent upon these teams' diversity. Speaking to the underlying process, we showed that these interactive effects were driven by the experienced team efficacy of the team members. We discuss theoretical and practical implications for nationality diversity management. (c) 2015 APA, all rights reserved).

Dealing with aggressive behavior within the health care team: a leadership challenge.

PubMed

Hynes, Patricia; Kissoon, Niranjan; Hamielec, Cindy M; Greene, Anne Marie; Simone, Carmine

2006-06-01

During an interdisciplinary Canadian leadership forum [ (click on the Conferences icon)], participants were challenged to develop an approach to a difficult leadership/management situation. In a scenario involving aggressive behavior among health care providers, participants identified that, before responding, an appropriate leader should collect additional information to identify the core problem(s) causing such behavior. Possibilities include stress; lack of clear roles, responsibilities, and standard operating procedures; and, finally, lack of training on important leadership/management skills. As a result of these core problems, several potential solutions are possible, all with potential obstacles to implementation. Additional education around communication and team interaction was felt to be a priority. In summary, clinical leaders probably have a great deal to gain from augmenting their leadership/management skills.

Student Management Teams Increase College Students' Feelings of Autonomy in the Classroom

ERIC Educational Resources Information Center

Troisi, Jordan D.

2015-01-01

The use of Student Management Teams (SMTs) is a relatively new teaching technique designed to increase students' motivation and involvement with the planning and execution of college courses. However, to date, little systematic, empirical research has validated the effectiveness of using SMTs. To test the effectiveness of this technique, the…

Structuring Effective Student Teams.

ERIC Educational Resources Information Center

Dickson, Ellen L.

1997-01-01

Experience with student teams working on policy analysis projects indicates the need for faculty supervision of teams in the process of addressing complex issues. The problem-solving approach adopted in one policy analysis course is described, including assignments and tasks, issues and sponsors, team dynamics, conflict management, and the…

Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence.

PubMed

Pol, Manjunath Maruti; Prasad, K Shiv Krishna; Deo, Vishant; Uniyal, Madhur

2016-09-02

Penetrating cardiac injury (PCI) is gradually increasing in developing countries owing to large-scale manufacturing of illegal country-made weapons. These injuries are associated with significant morbidity and mortality. Logistically it is difficult to have all organ-based specialists arrive together and attend every critically injured patient round-the-clock in developing countries. It is therefore important for doctors (physicians, surgeons and anaesthetists) to be trained for adequate management of critically injured patients following trauma. We report the approach towards 2 cases of haemodynamically unstable PCI managed by a team of trauma doctors. Time lag (duration between injury and arrival at hospital) and quick horizontal resuscitation are important considerations in the treatment. By not referring these patients to different hospitals the team actually reduced the time lag, and a quick life-saving surgery by trauma surgeons (trained in torso surgery) offered these almost dying patients a chance of survival. 2016 BMJ Publishing Group Ltd.

Development and Implementation of Team-Based Panel Management Tools: Filling the Gap between Patient and Population Information Systems.

PubMed

Watts, Brook; Lawrence, Renée H; Drawz, Paul; Carter, Cameron; Shumaker, Amy Hirsch; Kern, Elizabeth F

2016-08-01

Effective team-based models of care, such as the Patient-Centered Medical Home, require electronic tools to support proactive population management strategies that emphasize care coordination and quality improvement. Despite the spread of electronic health records (EHRs) and vendors marketing population health tools, clinical practices still may lack the ability to have: (1) local control over types of data collected/reports generated, (2) timely data (eg, up-to-date data, not several months old), and accordingly (3) the ability to efficiently monitor and improve patient outcomes. This article describes a quality improvement project at the hospital system level to develop and implement a flexible panel management (PM) tool to improve care of subpopulations of patients (eg, panels of patients with diabetes) by clinical teams. An in-depth case analysis approach is used to explore barriers and facilitators in building a PM registry tool for team-based management needs using standard data elements (eg, laboratory values, pharmacy records) found in EHRs. Also described are factors that may contribute to sustainability; to date the tool has been adapted to 6 disease-focused subpopulations encompassing more than 200,000 patients. Two key lessons emerged from this initiative: (1) though challenging, team-based clinical end users and information technology needed to work together consistently to refine the product, and (2) locally developed population management tools can provide efficient data tracking for frontline clinical teams and leadership. The preliminary work identified critical gaps that were successfully addressed by building local PM registry tools from EHR-derived data and offers lessons learned for others engaged in similar work. (Population Health Management 2016;19:232-239).

Self-Assessment of Governance Teams in an Argentine Private University: Adapting to Difficult Times

ERIC Educational Resources Information Center

Durand, Julio; Pujadas, Carlos

2004-01-01

Argentine Universities like similar institutions all around the world are facing a complex and challenging environment that demands a more sophisticated leadership and the development of complex managerial skills. In this paper we propose that enhancing the quality of collective decision making, and building more complex teams as a way to preserve…

Community Disaster and Sustainability Teams for Civil Protection

NASA Astrophysics Data System (ADS)

Kelman, I.; Cordonnier, B.

2009-04-01

Many examples of community-based teams for civil protection and disaster risk reduction exist. Turkey has a Community Disaster Volunteer Training Program while the USA has Community Emergency Response Teams which have been extended into secondary schools as Teen School Emergency Response Training. The principles and practices of these teams further apply directly to other development and sustainability endeavours, all of which are intricately linked to disaster risk reduction and civil protection. An example is keeping local water courses and storm drains clear from rubbish. That improves community health and cleanliness while assisting rainfall drainage to reduce flood risk. The "community teams" concept, as implemented for civil protection and disaster risk reduction, therefore connects with day-to-day living, such as ensuring that all community members have adequate access to water, food, waste management, shelter, health care, education, and energy. Community teams should be based on the best science and pedagogy available to ensure that concepts, training, skills, and implementation are effective and are maintained over the long-term. That entails going beyond the interest that is commonly generated by highlighting high-profile events, such as hurricanes and earthquakes, or high-profile concerns, such as climate change or terrorism. When community teams are focused on high-profile challenges, maintaining interest can be difficult without specific manifestations of the perceived "number one threat". Incorporating day-to-day concerns into civil protection can overcome that. For example, the community teams' talents and energy could be used for picking up rubbish, for educating about health and waste disposal, and for conducting vulnerability assessments in order to inspire action for continual vulnerability reduction. In addition to the examples given above, Japan's Jishu-bosai-soshiki community activities and Asia's "Townwatch" initiative adopt wider and deeper

Team knowledge representation: a network perspective.

PubMed

Espinosa, J Alberto; Clark, Mark A

2014-03-01

We propose a network perspective of team knowledge that offers both conceptual and methodological advantages, expanding explanatory value through representation and measurement of component structure and content. Team knowledge has typically been conceptualized and measured with relatively simple aggregates, without fully accounting for differing knowledge configurations among team members. Teams with similar aggregate values of team knowledge may have very different team dynamics depending on how knowledge isolates, cliques, and densities are distributed across the team; which members are the most knowledgeable; who shares knowledge with whom; and how knowledge clusters are distributed. We illustrate our proposed network approach through a sample of 57 teams, including how to compute, analyze, and visually represent team knowledge. Team knowledge network structures (isolation, centrality) are associated with outcomes of, respectively, task coordination, strategy coordination, and the proportion of team knowledge cliques, all after controlling for shared team knowledge. Network analysis helps to represent, measure, and understand the relationship of team knowledge to outcomes of interest to team researchers, members, and managers. Our approach complements existing team knowledge measures. Researchers and managers can apply network concepts and measures to help understand where team knowledge is held within a team and how this relational structure may influence team coordination, cohesion, and performance.

Peer-Based Control in Self-Managing Teams: Linking Rational and Normative Influence with Individual and Group Performance

ERIC Educational Resources Information Center

Stewart, Greg L.; Courtright, Stephen H.; Barrick, Murray R.

2012-01-01

The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how "peer-based rational control", which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and…

Total Quality Management: Analysis, Evaluation and Implementation Within ACRV Project Teams

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1991-01-01

Total quality management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The Assured Crew Return Vehicle (ACRV) Project Office was identified as an excellent project in which to demonstrate the applications and benefits of TQM processes. As the ACRV Program moves through its various stages of development, it is vital that effectiveness and efficiency be maintained in order to provide the Space Station Freedom (SSF) crew an affordable, on-time assured return to Earth. A critical factor for the success of the ACRV is attaining the maximum benefit from the resources applied to the program. Through a series of four tutorials on various quality improvement techniques, and numerous one-on-one sessions during the SSF's 10-week term in the project office, results were obtained which are aiding the ACRV Office in implementing a disciplined, ongoing process for generating fundamental decisions and actions that shape and guide the organization. Significant advances were made in improving the processes for two particular groups - the correspondence distribution team and the WATER Test team. Numerous people from across JSC were a part of the various team activities including engineering, man systems, and safety. The work also included significant interaction with the support contractor to the ACRV Project. The results of the improvement activities can be used as models for other organizations desiring to operate under a system of continuous improvement. In particular, they have advanced the ACRV Project Teams further down the path of continuous improvement, in support of a working philosophy of TQM.

Retrograde intubation: an alternative way for the management of difficult airway.

PubMed

Lama, P; Shrestha, B R

2008-01-01

Inserting a retrograde wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fiber-optic bronchoscope or an expert user of such a device is not available. Even in cases when fibropric can not be negotiated for the purpose, this method has been claimed to be useful to manage the airway. Some mouth opening is essential for the oral or nasal retrieval of the wire from the pharynx. Here, a case of post mandibular reconstructed wound infection required surgical debridement and plate removal from reconstructed lower mandible under general anesthesia. We retrieved the guide wire passed through a cricothyroid puncture and subsequently accomplished wire-guided oro-tracheal intubation. In the absence of a flexible fiber-optic bronchoscope, this technique is a very useful aid to intubate patients with limited mouth opening.

Oral and dental management for head and neck cancer patients treated by chemotherapy and radiotherapy.

PubMed

McCaul, Lorna K

2012-03-01

The incidence of head and neck cancer is rising. The attendant oral complications of cancer management make oral health maintenance a lifelong challenge for these patients. Holistic management in the context of a core multidisciplinary team is essential in optimizing outcomes. Predicting the risk of adverse oral outcomes is difficult. Effective communication between healthcare professionals in the core and extended teams and with the patient is essential. Primary care dental teams will be involved in the long-term management of oral care for head and cancer patients. A broad understanding of the management of head and neck cancer, consequences of treatment and the need for good communication is key to good quality patient care.

Caseload management methods for use within district nursing teams: a literature review.

PubMed

Roberson, Carole

2016-05-01

Effective and efficient caseload management requires extensive skills to ensure that patients receive the right care by the right person at the right time. District nursing caseloads are continually increasing in size and complexity, which requires specialist district nursing knowledge and skills. This article reviews the literature related to caseload management with the aim of identifying the most effective method for district nursing teams. The findings from this review are that there are different styles and methods of caseload management. The literature review was unable to identify a single validated tool or method, but identified themes for implementing effective caseload management, specifically caseload analysis; workload measurement; work allocation; service and practice development and workforce planning. This review also identified some areas for further research.

[Anaesthetic management in a paediatric patient with a difficult airway due to epidermolysis bullosa dystrophica].

PubMed

Blázquez Gómez, E; Garcés Aletá, A; Monclus Diaz, E; Manen Berga, F; García-Aparicio, L; Ontanilla López, A

2015-05-01

Dystrophic epidermolysis bullosa (DEB) is a rare inherited disorder characterized by blistering after minimal trauma. These blisters tend to form dystrophic scars, leading to limiting and life-threatening sequelae. The anaesthetic management of patients with DEB is a challenge, even for the most experienced anaesthesiologists, but basic principles can help us prepare the plan of care. The main goals are to prevent trauma/infection of skin/mucous, and to establish a secure airway without causing bullae. Patient positioning and the instruments used to monitor vital signs and administering anaesthetic agents can cause new lesions. It is advisable to lubricate the instruments and to avoid adhesive material and shearing forces on the skin. Besides the implications of the comorbidities, there is a potential difficult intubation and difficult vascular access. Acute airway obstruction can occur due to airway instrumentation. We report the case of a patient diagnosed with EBD difficult airway and undergoing correction of syndactylyl and dental extractions. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Airway physical examination tests for detection of difficult airway management in apparently normal adult patients.

PubMed

Roth, Dominik; Pace, Nathan L; Lee, Anna; Hovhannisyan, Karen; Warenits, Alexandra-Maria; Arrich, Jasmin; Herkner, Harald

2018-05-15

The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities. We performed this individually for each of the four descriptors of the difficult airway: difficult face mask ventilation, difficult laryngoscopy, difficult tracheal intubation, and failed intubation. We searched major electronic databases including CENTRAL, MEDLINE, Embase, ISI Web of Science, CINAHL, as well as regional, subject specific, and dissertation and theses databases from inception to 16 December 2016, without language restrictions. In addition, we searched the Science Citation Index and checked the references of all the relevant studies. We also handsearched selected journals, conference proceedings, and relevant guidelines. We updated this search in March 2018, but we have not yet incorporated these results. We considered full-text diagnostic test accuracy studies of any individual index test, or a combination of tests, against a reference standard. Participants were adults without obvious airway abnormalities, who were having laryngoscopy performed with a standard laryngoscope and the trachea intubated with a standard tracheal tube. Index tests included the Mallampati test, modified Mallampati test, Wilson risk score, thyromental distance, sternomental distance, mouth opening test, upper lip bite test, or any combination of these. The target condition was difficult airway, with one of the following reference

The importance of multidisciplinary team management of patients with non-small-cell lung cancer

PubMed Central

Ellis, P.M.

2012-01-01

Historically, a simple approach to the treatment of non-small-cell lung cancer (nsclc) was applicable to nearly all patients. Recently, a more complex treatment algorithm has emerged, driven by both pathologic and molecular phenotype. This increasing complexity underscores the importance of a multidisciplinary team approach to the diagnosis, treatment, and supportive care of patients with nsclc. A team approach to management is important at all points: from diagnosis, through treatment, to end-of-life care. It also needs to be patient-centred and must involve the patient in decision-making concerning treatment. Multidisciplinary case conferencing is becoming an integral part of care. Early integration of palliative care into the team approach appears to contribute significantly to quality of life and potentially extends overall survival for these patients. Supportive approaches, including psychosocial and nutrition support, should be routinely incorporated into the team approach. Challenges to the implementation of multidisciplinary care require institutional commitment and support. PMID:22787414

The Team We Got.

ERIC Educational Resources Information Center

Soos, Frank

1992-01-01

Discusses the importance of high school basketball in rural West Virginia and what it felt like to win and to lose. Reflects on how playing team sports builds character, and suggests that, although life goes on regardless of game outcomes, it is still difficult to think of high school basketball as just a game. (LP)

Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

PubMed

Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

2017-03-01

Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

A change management perspective on the introduction of music therapy to interprofessional teams.

PubMed

Ledger, Alison; Edwards, Jane; Morley, Michael

2013-01-01

The purpose of this paper is to demonstrate how a change management perspective contributes new understandings about music therapy implementation processes. Narrative inquiry, ethnography, and arts-based research methods were used to explore the experiences of 12 music therapists who developed new services in healthcare settings. These experiences were interpreted using insights from the field of change management. A change management perspective helps to explain music therapists' experiences of resistance and struggle when introducing their services to established health care teams. Organisational change theories and models highlight possible strategies for implementing music therapy services successfully, such as organisational assessment, communication and collaboration with other workers, and the appointment of a service development steering group. This paper offers exciting possibilities for developing understanding of music therapists' experiences and for supporting the growth of this burgeoning profession. There is an important need for professional supervision for music therapists in the service development phase, to support them in coping with resistance and setbacks. Healthcare managers and workers are encouraged to consider ways in which they can support the development of a new music therapy service, such as observing music therapy work and sharing organisational priorities and cultures with a new music therapist. Previous accounts of music therapy service development have indicated that music therapists encounter complex interprofessional issues when they join an established health care team. A change management perspective offers a new lens through which music therapists' experiences can be further understood.

Success rates of pre-hospital difficult airway management: a quality control study evaluating an in-hospital training program.

PubMed

Trimmel, Helmut; Beywinkler, Christoph; Hornung, Sonja; Kreutziger, Janett; Voelckel, Wolfgang G

2018-03-16

Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported. This is a subgroup analysis of pre-hospital airway interventions performed by non-anesthesiologist EMS physicians between 2006 and 2016. The dataset is part of a retrospective quality control study performed in the ground EMS system of Wiener Neustadt, Austria. Difficult airway missions recorded in the electronic database were matched with the hospital information system and analyzed. Nine hundred thirty-three of 23060 ground EMS patients (4%) required an airway intervention. In 48 cases, transient bag-mask-valve ventilation was sufficient, and 5 patients needed repositioning of a pre-existing tracheostomy cannula. Eight hundred thirty-six of 877 patients (95.3%) were successfully intubated within two attempts; in 3 patients, a supraglottic airway device was employed first line. Management of 41 patients with failed tracheal intubation comprised laryngeal tubes (n = 21), intubating laryngeal mask (n = 11), ongoing bag-mask-valve ventilation (n = 8), and crico-thyrotomy (n = 1). There was no cannot intubate/cannot ventilate situation. Blood gas analysis at admission revealed hypoxemia in 2 and/or hypercapnia in 11 cases. During the 11-year study period, difficult airways were encountered in 5% but sufficiently managed in all patients. Thus, the training regime presented might be a feasible and beneficial model for training of non-anesthesiologist emergency physicians as well as

The Difficult Gallbladder: A Safe Approach to a Dangerous Problem.

PubMed

Santos, B Fernando; Brunt, L Michael; Pucci, Michael J

2017-06-01

Laparoscopic cholecystectomy is a common surgical procedure, and remains the gold standard for the management of benign gallbladder and biliary disease. While this procedure can be technically straightforward, it can also represent one of the most challenging operations facing surgeons. This dichotomy of a routine operation performed so commonly that poses such a hidden risk of severe complications, such as bile duct injury, must keep surgeons steadfast in the pursuit of safety. The "difficult gallbladder" requires strict adherence to the Culture of Safety in Cholecystectomy, which promotes safety first and assists surgeons in managing or avoiding difficult operative situations. This review will discuss the management of the difficult gallbladder and propose the use of subtotal fenestrating cholecystectomy as a definitive option during this dangerous situation.

Use of a Flexible Intubating Scope in Combination with a Channeled Video Laryngoscope for Managing a Difficult Airway in the Emergency Department.

PubMed

Sowers, Nicholas; Kovacs, George

2016-02-01

Difficulty with intubation is not uncommon in the emergency setting. Video laryngoscopes (VLs) are commonly used to manage the difficult airway in the emergency department (ED). Intubation using a flexible bronchoscope, while considered the gold standard for managing the anticipated difficult airway in the operating room, is not commonly used in the ED. We present a case describing VL-assisted flexible scope intubation performed in the ED as a novel feasible approach to managing the difficult airway. A 65-year-old male, post cardiac arrest, with multiple unsuccessful attempts at prehospital intubation had rapid sequence intubation (RSI) performed and, despite obtaining a view with a King Vision™ VL, the skilled operator was unable to advance the endotracheal tube (ETT). An Ambu™ aScope3 flexible intubating scope (FIS) was placed through the ETT loaded in the channel of the King Vision and advanced through the cords to a position proximal to the carina. The ETT was then advanced easily over the FIS and down the trachea. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although video laryngoscopy is commonly used in the ED, intubation can prove difficult, despite having an adequate view of the glottis. Use of an FIS, however, through a channeled VL makes navigation of the ETT easier and facilitates tube advancement, which can be difficult with VL. Channeled VL-assisted use of an FIS is a viable option for managing the difficult airway. Copyright © 2016 Elsevier Inc. All rights reserved.

Team-based model for non-operating room airway management: validation using a simulation-based study.

PubMed

DeMaria, S; Berman, D J; Goldberg, A; Lin, H-M; Khelemsky, Y; Levine, A I

2016-07-01

Non-operating room (non-OR) airway management has previously been identified as an area of concern because it carries a significant risk for complications. One reason for this could be attributed to the independent practice of residents in these situations. The aim of the present study was to ascertain whether differences in performance exist between residents working alone vs with a resident partner when encountering simulated non-OR airway management scenarios. Thirty-six anaesthesia residents were randomized into two groups. Each group experienced three separate scenarios (two scenarios initially and then a third 6 weeks later). The scenarios consisted of one control scenario and two critical event scenarios [i.e. asystole during laryngoscopy and pulseless electrical activity (PEA) upon post-intubation institution of positive pressure ventilation]. One group experienced the simulated non-OR scenarios alone (Solo group). The other group consisted of resident pairs, participating in the same three scenarios (Team group). Although the time to intubation did not differ between the Solo and Team groups, there were several differences in performance. The Team group received better overall performance ratings for the asystole (8.5 vs 5.5 out of 10; P<0.001) and PEA (8.5 vs 5.8 out of 10; P<0.001) scenarios. The Team group was also able to recognize asystole and PEA conditions faster than the Solo group [10.1 vs 23.5 s (P<0.001) and 13.3 vs 36.0 s (P<0.001), respectively]. Residents who performed a simulated intubation with a second trained provider had better overall performance than those who practised independently. The residents who practised in a group were also faster to diagnose serious complications, including peri-intubation asystole and PEA. Given these data, it is reasonable that training programmes consider performing all non-OR airway management with a team-based method. © The Author 2016. Published by Oxford University Press on behalf of the British

Membership and management: structures of inter-professional working in community mental health teams for older people in England.

PubMed

Wilberforce, Mark; Tucker, Sue; Abendstern, Michele; Brand, Christian; Giebel, Clarissa Marie; Challis, David

2013-09-01

Community mental health services are regarded as the preferred first tier of specialist psychogeriatric support, with integrated multidisciplinary teams believed to offer improved decision-making and greater continuity of care than separate single-profession services. In England over 400 community mental health teams (CMHTs) form the cornerstone of such support, yet research has neither assessed progress toward integrating key professional disciplines nor the nature of their membership and management arrangements. A self-administered questionnaire was sent to all CMHTs for older people in England, seeking a combination of objective and subjective information on team structure and management. Responses from 376 (88%) teams highlighted broader multidisciplinary membership than found in a 2004 survey, with particular growth in the number of support workers and other unqualified practitioners. Only modest progress was found in the integration of psychologists and social workers within CMHTs. The data also revealed a trend toward "core" team membership, and away from "sessional" membership in which staff may have divided loyalties between services. Multidisciplinary working was reported as beneficial by many respondents, but examples of "silo working" were also found, which may have hampered service delivery in a minority of teams. The reported growth in the number of practitioners without professional registration raises issues about the appropriate skill mix and substitution within CMHTs, while local agencies should review barriers to the integration of psychologists and social workers. Further research is required to explore the quality of multidisciplinary team working.

Occupational therapists in the interdisciplinary team setting.

PubMed

Reed, S M

1984-01-01

The interdisciplinary team approach to patient care provides an answer to the fragmentation and confusion patients feel when dealing with our complex healthcare system. Even though the team approach has been in use for the past two decades, implementation of a successful team is very difficult and rarely sustained over a significant period of time. This is especially true in general hospitals and in physical rehabilitation programs that spring from general hospitals where the physician and the nurse are the traditional care group. Occupational therapists, as they establish roles on interdisciplinary teams as staff members and team leaders, will require a knowledge of what makes a team function effectively. They can use this knowledge to evaluate the status of their own team and contribute to changes that will insure its long-term success. Six key issues should be addressed during the planning stage of any new healthcare team to insure its continued viability. These issues are: program philosophy, client focus, role clarification, collaboration and information sharing, policies and procedures, and staff supportiveness.

The AGING Initiative experience: a call for sustained support for team science networks.

PubMed

Garg, Tullika; Anzuoni, Kathryn; Landyn, Valentina; Hajduk, Alexandra; Waring, Stephen; Hanson, Leah R; Whitson, Heather E

2018-05-18

Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the increasing impact on the United States society, MCC research has been identified as a high priority research area by multiple federal agencies. In response to this need, two national research entities, the Healthcare Systems Research Network (HCSRN) and the Claude D. Pepper Older Americans Independence Centers (OAIC), formed the Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative to build nationwide capacity for MCC team science. This article describes the structure, lessons learned and initial outcomes of the AGING Initiative. We call for funding mechanisms to sustain infrastructures that have demonstrated success in fostering team science and innovation in translating findings to policy change necessary to solve complex problems in healthcare.

Improving service user self-management: development and implementation of a strategy for the Richmond Response and Rehabilitation Team.

PubMed

Sanders, Julie; Fitzpatrick, Joanne M

2017-01-01

Community rapid response and rehabilitation teams are used to prevent avoidable hospital admissions for adults living with multiple long-term conditions and to support early hospital discharge by providing short-term intensive multidisciplinary support. Supporting self-management is an important service intervention if desired outcomes are to be achieved. A Care Quality Commission inspection of the Richmond Response and Rehabilitation Team in 2014 identified that self-management plans were not routinely developed with service users and reported this as requiring improvement. This quality improvement project aimed to develop and implement a self-management strategy for service users and for 90% of service users to have a personalised self-management plan within 3 months. The quality improvement intervention used the Plan-Do-Study-Act model comprising: (1) the development of a self-management plan, (2) staff education to support service users to self-manage using motivational interviewing techniques, (3) piloting the self-management plan with service users, (4) implementation of the self-management plan and (5) monthly audit and feedback. Evaluation involved an audit of the number and quality of self-management plans developed with service users and a survey of staff knowledge and confidence to support service users to self-manage. Following implementation of the intervention, the number of self-management plans developed in collaboration with service users increased from 0 to 187 over a 4-week period. Monthly audit data confirmed that this improvement has been sustained. Results indicated that staff knowledge and confidence improved after an education intervention. Quality improvement methods facilitated development and operationalisation of a self-management strategy by a community rapid response and rehabilitation team. The next phase of the project is to evaluate the impact of the self-management strategy on key service outcomes including self-efficacy, unplanned

Managing Difficult Behaviour in Young Children.

ERIC Educational Resources Information Center

Slee, June

2003-01-01

Managing antisocial behavior is a critical issue facing those who work with young children, as the presence of early socialization problems is the single greatest predictor of adolescent and adult antisocial behavior. This booklet highlights the effectiveness of behavior management strategies that introduce and reinforce positive behaviors, rather…

Technical Guidance Manual: Contaminant Flux Reduction Barriers for Managing Difficult-to-Treat Source Zones in Unconsolidated Media

DTIC Science & Technology

2017-06-20

was to evaluate if inexpensive flow reduction agents delivered via permeation grouting technology could help manage difficult-to-treat chlorinated...30  Table 4.  Description of Case Study Site ................................................................................... 30  Table 5...Intentionally Left Blank ES-1 EXECUTIVE SUMMARY Project Objective The overall objective of this project was to evaluate if inexpensive flow reduction

Implementation of critical care response team.

PubMed

Al Shimemeri, Abdullah

2014-04-01

Analyses of hospital deaths have indicated that a significant proportion of the reported deaths might have been prevented had the patients received intensive level care early enough. Over the past few decades the critical care response team has become an important means of preventing these deaths. As the proactive arm of intensive care delivery, the critical care response team places emphasis on early identification of signs of clinical deterioration, which then prompts the mobilization of intensive care brought right to the patient's bedside. However, the setting up of a critical care response team is a difficult undertaking involving different levels of cooperation between all service stakeholders, and a bringing together of professional expertise and experience in its operations. The implementation of a critical care response team often involves a high-level restructuring of a hospital's service orientation. In the present work, the various factors and different models to be considered in implementing a critical care response team are addressed.

[The function of team-meetings for treatment teams on child and adolescent psychiatric wards].

PubMed

Branik, Emil; Meng, Heiner

2006-01-01

In the daily work of multidisciplinary teams on child and adolescent psychiatric wards team-meetings play a central role to coordinate various treatment activities. In medical literature studies on the topic are lacking, and only few articles were found. The authors explore by a descriptive-hermeneutic analysis the numerous functions of meetings for the treatment team. To them belong catharsis, containment, reflection, regulation and integration. Psychodynamic, group dynamical and institutional factors will be described regarding their influence on the therapy management. Issues of power in institutions will be comprised in the discussion. The dialectical tension between professionalism and emotionality in the work with patients especially from the borderline-spectrum as well as between unity and diversity within the treatment team in regard to the different roles of each and everyone team member will be presented. Hints at how to manage these tensions will be given to preserve the therapeutical milieu on the ward.

Development and initial validation of primary care provider mental illness management and team-based care self-efficacy scales.

PubMed

Loeb, Danielle F; Crane, Lori A; Leister, Erin; Bayliss, Elizabeth A; Ludman, Evette; Binswanger, Ingrid A; Kline, Danielle M; Smith, Meredith; deGruy, Frank V; Nease, Donald E; Dickinson, L Miriam

Develop and validate self-efficacy scales for primary care provider (PCP) mental illness management and team-based care participation. We developed three self-efficacy scales: team-based care (TBC), mental illness management (MIM), and chronic medical illness (CMI). We developed the scales using Bandura's Social Cognitive Theory as a guide. The survey instrument included items from previously validated scales on team-based care and mental illness management. We administered a mail survey to 900 randomly selected Colorado physicians. We conducted exploratory principal factor analysis with oblique rotation. We constructed self-efficacy scales and calculated standardized Cronbach's alpha coefficients to test internal consistency. We calculated correlation coefficients between the MIM and TBC scales and previously validated measures related to each scale to evaluate convergent validity. We tested correlations between the TBC and the measures expected to correlate with the MIM scale and vice versa to evaluate discriminant validity. PCPs (n=402, response rate=49%) from diverse practice settings completed surveys. Items grouped into factors as expected. Cronbach's alphas were 0.94, 0.88, and 0.83 for TBC, MIM, and CMI scales respectively. In convergent validity testing, the TBC scale was correlated as predicted with scales assessing communications strategies, attitudes toward teams, and other teamwork indicators (r=0.25 to 0.40, all statistically significant). Likewise, the MIM scale was significantly correlated with several items about knowledge and experience managing mental illness (r=0.24 to 41, all statistically significant). As expected in discriminant validity testing, the TBC scale had only very weak correlations with the mental illness knowledge and experience managing mental illness items (r=0.03 to 0.12). Likewise, the MIM scale was only weakly correlated with measures of team-based care (r=0.09 to.17). This validation study of MIM and TBC self-efficacy scales

Team Projects and Peer Evaluations

ERIC Educational Resources Information Center

Doyle, John Kevin; Meeker, Ralph D.

2008-01-01

The authors assign semester- or quarter-long team-based projects in several Computer Science and Finance courses. This paper reports on our experience in designing, managing, and evaluating such projects. In particular, we discuss the effects of team size and of various peer evaluation schemes on team performance and student learning. We report…

Diagnosis and management practices for gestational diabetes mellitus in Australia: Cross-sectional survey of the multidisciplinary team.

PubMed

Meloncelli, Nina; Barnett, Adrian; Pelly, Fiona; de Jersey, Susan

2018-04-18

Gestational diabetes mellitus (GDM) is one of the most common pregnancy disorders; however, if well managed, women with GDM experience similar pregnancy outcomes to those without. Currently, there is limited evidence on actual management practices across Australia or how multidisciplinary teams interact to optimise care. To examine the current screening, diagnostic, task and role perceptions and management practices, as reported by members of the GDM multidisciplinary team. A 64-item electronic survey containing multiple choice, Likert scale and open-ended questions was developed for this cross-sectional observational study and advertised through health professional organisations and Queensland Health facilities in May and June, 2017. The 183 survey respondents included 45 diabetes educators, 43 dietitians, 21 endocrinologists/diabetes specialists, 14 obstetricians and 21 midwives. Although almost 90% reported using updated diagnostic guidelines, less than two-thirds used GDM management guidelines. While 68% reported using the same blood glucose targets for GDM management, there was variation to what criteria prompted the commencement of medication to control blood glucose levels. There was a good consensus concerning the health professional responsible for tasks such as medical nutrition therapy, gestational weight gain and self-blood glucose monitoring education and ultrasound use. Other tasks appeared to be the role of almost any member of the GDM multidisciplinary team. The survey results indicate there is a need for consistent evidence on how to best manage GDM and that role identity, access to specialist knowledge and best practice need to be clearly defined within GDM models of care. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Developing Expert Teams with a Strong Safety Culture

NASA Technical Reports Server (NTRS)

Rogers, David G.

2010-01-01

Would you like to lead a world renowned team that draws out all the talents and expertise of its members and consistently out performs all others in the industry? Ever wonder why so many organizations fail to truly learn from past mistakes only to repeat the same ones at a later date? Are you a program/project manager or team member in a high-risk organization where the decisions made often carry the highest of consequences? Leadership, communication, team building, critical decision-making and continuous team improvement skills and behaviors are mere talking points without the attitudes, commitment and strategies necessary to make them the very fabric of a team. Developing Expert Teams with a Strong Safety Culture, will provide you with proven knowledge and strategies to take your team soaring to heights you may have not thought possible. A myriad of teams have applied these strategies and techniques within their organization team environments: military and commercial aviation, astronaut flight crews, Shuttle flight controllers, members of the Space Shuttle Program Mission Management Team, air traffic controllers, nuclear power control teams, surgical teams, and the fire service report having spectacular success. Many industry leaders are beginning to realize that although the circumstances and environments of these teams may differ greatly to their own, the core elements, governing principles and dynamics involved in managing and building a stellar safety conscious team remain identical.

Job satisfaction among mental healthcare professionals: The respective contributions of professional characteristics, team attributes, team processes, and team emergent states

PubMed Central

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

2017-01-01

Objectives: The aim of this study was to determine the respective contribution of professional characteristics, team attributes, team processes, and team emergent states on the job satisfaction of 315 mental health professionals from Quebec (Canada). Methods: Job satisfaction was measured with the Job Satisfaction Survey. Independent variables were organized into four categories according to a conceptual framework inspired from the Input-Mediator-Outcomes-Input Model. The contribution of each category of variables was assessed using hierarchical regression analysis. Results: Variations in job satisfaction were mostly explained by team processes, with minimal contribution from the other three categories. Among the six variables significantly associated with job satisfaction in the final model, four were team processes: stronger team support, less team conflict, deeper involvement in the decision-making process, and more team collaboration. Job satisfaction was also associated with nursing and, marginally, male gender (professional characteristics) as well as with a stronger affective commitment toward the team (team emergent states). Discussion and Conclusion: Results confirm the importance for health managers of offering adequate support to mental health professionals, and creating an environment favorable to collaboration and decision-sharing, and likely to reduce conflicts between team members. PMID:29276591

Job satisfaction among mental healthcare professionals: The respective contributions of professional characteristics, team attributes, team processes, and team emergent states.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

2017-01-01

The aim of this study was to determine the respective contribution of professional characteristics, team attributes, team processes, and team emergent states on the job satisfaction of 315 mental health professionals from Quebec (Canada). Job satisfaction was measured with the Job Satisfaction Survey. Independent variables were organized into four categories according to a conceptual framework inspired from the Input-Mediator-Outcomes-Input Model. The contribution of each category of variables was assessed using hierarchical regression analysis. Variations in job satisfaction were mostly explained by team processes, with minimal contribution from the other three categories. Among the six variables significantly associated with job satisfaction in the final model, four were team processes: stronger team support, less team conflict, deeper involvement in the decision-making process, and more team collaboration. Job satisfaction was also associated with nursing and, marginally, male gender (professional characteristics) as well as with a stronger affective commitment toward the team (team emergent states). Results confirm the importance for health managers of offering adequate support to mental health professionals, and creating an environment favorable to collaboration and decision-sharing, and likely to reduce conflicts between team members.

Critical Airway Team: A Retrospective Study of an Airway Response System in a Pediatric Hospital.

PubMed

Sterrett, Emily C; Myer, Charles M; Oehler, Jennifer; Das, Bobby; Kerrey, Benjamin T

2017-12-01

Objective Study the performance of a pediatric critical airway response team. Study Design Case series with chart review. Setting Freestanding academic children's hospital. Subjects and Methods A structured review of the electronic medical record was conducted for all activations of the critical airway team. Characteristics of the activations and patients are reported using descriptive statistics. Activation of the critical airway team occurred 196 times in 46 months (March 2012 to December 2015); complete data were available for 162 activations (83%). For 49 activations (30%), patients had diagnoses associated with difficult intubation; 45 (28%) had a history of difficult laryngoscopy. Results Activation occurred at least 4 times per month on average (vs 3 per month for hospital-wide codes). The most common reasons for team activation were anticipated difficult intubation (45%) or failed intubation attempt (20%). For 79% of activations, the team performed an airway procedure, most commonly direct laryngoscopy and tracheal intubation. Bronchoscopy was performed in 47% of activations. Surgical airway rescue was attempted 4 times. Cardiopulmonary resuscitation occurred in 41 activations (25%). Twenty-nine patients died during or following team activation (18%), including 10 deaths associated with the critical airway event. Conclusion Critical airway team activation occurred at least once per week on average. Direct laryngoscopy, tracheal intubation, and bronchoscopic procedures were performed frequently; surgical airway rescue was rare. Most patients had existing risk factors for difficult intubation. Given our rate of serious morbidity and mortality, primary prevention of critical airway events will be a focus of future efforts.

The Ecological Areawide Management (TEAM) of leafy spurge program of the United States Department of Agriculture-Agricultural Research Service.

PubMed

Anderson, Gerald L; Prosser, Chad W; Wendel, Lloyd E; Delfosse, Ernest S; Faust, Robert M

2003-01-01

The Ecological Areawide Management (TEAM) of Leafy Spurge program was developed to focus research and control efforts on a single weed, leafy spurge, and demonstrate the effectiveness of a coordinated, biologically based, integrated pest management program (IPM). This was accomplished through partnerships and teamwork that clearly demonstrated the advantages of the biologically based IPM approach. However, the success of regional weed control programs horizontally across several states and provinces also requires a vertical integration of several sectors of society. Awareness and education are the essential elements of vertical integration. Therefore, a substantial effort was made to produce a wide variety of information products specifically designed to educate different segments of society. During its tenure, land managers and agency decision makers have seen the potential of using the TEAM approach to accelerate the regional control of leafy spurge. The example set by the TEAM organization and participants is viewed as a model for future weed-control efforts.

A model for the submarine depthkeeping team

NASA Technical Reports Server (NTRS)

Ware, J. R.; Best, J. F.; Bozzi, P. J.; Kleinman, D. W.

1981-01-01

The most difficult task the depthkeeping team must face occurs during periscope-depth operations during which they may be required to maintain a submarine several hundred feet long within a foot of ordered depth and within one-half degree of ordered pitch. The difficulty is compounded by the facts that wave generated forces are extremely high, depth and pitch signals are very noisy and submarine speed is such that overall dynamics are slow. A mathematical simulation of the depthkeeping team based on the optimal control models is described. A solution of the optimal team control problem with an output control restriction (limited display to each controller) is presented.

A Genuine TEAM Player

NASA Technical Reports Server (NTRS)

2001-01-01

Qualtech Systems, Inc. developed a complete software system with capabilities of multisignal modeling, diagnostic analysis, run-time diagnostic operations, and intelligent interactive reasoners. Commercially available as the TEAMS (Testability Engineering and Maintenance System) tool set, the software can be used to reveal unanticipated system failures. The TEAMS software package is broken down into four companion tools: TEAMS-RT, TEAMATE, TEAMS-KB, and TEAMS-RDS. TEAMS-RT identifies good, bad, and suspect components in the system in real-time. It reports system health results from onboard tests, and detects and isolates failures within the system, allowing for rapid fault isolation. TEAMATE takes over from where TEAMS-RT left off by intelligently guiding the maintenance technician through the troubleshooting procedure, repair actions, and operational checkout. TEAMS-KB serves as a model management and collection tool. TEAMS-RDS (TEAMS-Remote Diagnostic Server) has the ability to continuously assess a system and isolate any failure in that system or its components, in real time. RDS incorporates TEAMS-RT, TEAMATE, and TEAMS-KB in a large-scale server architecture capable of providing advanced diagnostic and maintenance functions over a network, such as the Internet, with a web browser user interface.

Team safety and innovation by learning from errors in long-term care settings.

PubMed

Buljac-Samardžić, Martina; van Woerkom, Marianne; Paauwe, Jaap

2012-01-01

Team safety and team innovation are underexplored in the context of long-term care. Understanding the issues requires attention to how teams cope with error. Team managers could have an important role in developing a team's error orientation and managing team membership instabilities. The aim of this study was to examine the impact of team member stability, team coaching, and a team's error orientation on team safety and innovation. A cross-sectional survey method was employed within 2 long-term care organizations. Team members and team managers received a survey that measured safety and innovation. Team members assessed member stability, team coaching, and team error orientation (i.e., problem-solving and blaming approach). The final sample included 933 respondents from 152 teams. Stable teams and teams with managers who take on the role of coach are more likely to adopt a problem-solving approach and less likely to adopt a blaming approach toward errors. Both error orientations are related to team member ratings of safety and innovation, but only the blaming approach is (negatively) related to manager ratings of innovation. Differences between members' and managers' ratings of safety are greater in teams with relatively high scores for the blaming approach and relatively low scores for the problem-solving approach. Team coaching was found to be positively related to innovation, especially in unstable teams. Long-term care organizations that wish to enhance team safety and innovation should encourage a problem-solving approach and discourage a blaming approach. Team managers can play a crucial role in this by coaching team members to see errors as sources of learning and improvement and ensuring that individuals will not be blamed for errors.

Analysis of team types based on collaborative relationships among doctors, home-visiting nurses and care managers for effective support of patients in end-of-life home care.

PubMed

Fujita, Junko; Fukui, Sakiko; Ikezaki, Sumie; Otoguro, Chizuru; Tsujimura, Mayuko

2017-11-01

To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis. Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice. It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; 17: 1943-1950. © 2017 Japan Geriatrics Society.

Bed management team with Kanban web-based application.

PubMed

Rocha, Hermano Alexandre Lima; Santos, Ana Kelly Lima da Cruz; Alcântara, Antônia Celia de Castro; Lima, Carmen Sulinete Suliano da Costa; Rocha, Sabrina Gabriele Maia Oliveira; Cardoso, Roberto Melo; Cremonin, Jair Rodrigues

2018-05-15

To measure the effectiveness of the bed management process that uses a web-based application with Kanban methodology to reduce hospitalization time of hospitalized patients. Before-after study was performed. The study was conducted between July 2013 and July 2017, at the Unimed Regional Hospital of Fortaleza, which has 300 beds, of which 60 are in the intensive care unit (ICU). It is accredited by International Society for Quality in Healthcare. Patients hospitalized in the referred period. Bed management with an application that uses color logic to signal at which stage of high flow the patients meet, in which each patient is interpreted as a card of the classical Kanban theory. It has an automatic user signaling system for process movement, and a system for monitoring and analyzing discharge forecasts. Length of hospital stay, number of customer complaints related to bed availability. After the intervention, the hospital's overall hospital stay time was reduced from 5.6 days to 4.9 days (P = 0.001). The units with the greatest reduction were the ICUs, with reduction from 6.0 days to 2.0 (P = 0.001). The relative percentage of complaints regarding bed availability in the hospital fell from 27% to 0%. We conclude that the use of an electronic tool based on Kanban methodology and accessed via the web by a bed management team is effective in reducing patients' hospital stay time.

Insights of health district managers on the implementation of primary health care outreach teams in Johannesburg, South Africa: a descriptive study with focus group discussions.

PubMed

Moosa, Shabir; Derese, Anselme; Peersman, Wim

2017-01-21

Primary health care (PHC) outreach teams are part of a policy of PHC re-engineering in South Africa. It attempts to move the deployment of community health workers (CHWs) from vertical programmes into an integrated generalised team-based approach to care for defined populations in municipal wards. There has little evaluation of PHC outreach teams. Managers' insights are anecdotal. This is descriptive qualitative study with focus group discussions with health district managers of Johannesburg, the largest city in South Africa. This was conducted in a sequence of three meetings with questions around implementation, human resources, and integrated PHC teamwork. There was a thematic content analysis of validated transcripts using the framework method. There were two major themes: leadership-management challenges and human resource challenges. Whilst there was some positive sentiment, leadership-management challenges loomed large: poor leadership and planning with an under-resourced centralised approach, poor communications both within the service and with community, concerns with its impact on current services and resistance to change, and poor integration, both with other streams of PHC re-engineering and current district programmes. Discussion by managers on human resources was mostly on the plight of CHWs and calls for formalisation of CHWs functioning and training and nurse challenges with inappropriate planning and deployment of the team structure, with brief mention of the extended team. Whilst there is positive sentiment towards intent of the PHC outreach team, programme managers in Johannesburg were critical of management of the programme in their health district. Whilst the objective of PHC reform is people-centred health care, its implementation struggles with a centralising tendency amongst managers in the health service in South Africa. Managers in Johannesburg advocated for decentralisation. The implementation of PHC outreach teams is also limited by

[Community health in primary health care teams: a management objective].

PubMed

Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

2016-12-01

To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Leading team learning: what makes interprofessional teams learn to work well?

PubMed

Chatalalsingh, Carole; Reeves, Scott

2014-11-01

This article describes an ethnographic study focused on exploring leaders of team learning in well-established nephrology teams in an academic healthcare organization in Canada. Employing situational theory of leadership, the article provides details on how well established team members advance as "learning leaders". Data were gathered by ethnographic methods over a 9-month period with the members of two nephrology teams. These learning to care for the sick teams involved over 30 regulated health professionals, such as physicians, nurses, social workers, pharmacists, dietitians and other healthcare practitioners, staff, students and trainees, all of whom were collectively managing obstacles and coordinating efforts. Analysis involved an inductive thematic analysis of observations, reflections, and interview transcripts. The study indicated how well established members progress as team-learning leaders, and how they adapt to an interprofessional culture through the activities they employ to enable day-to-day learning. The article uses situational theory of leadership to generate a detailed illumination of the nature of leaders' interactions within an interprofessional context.

44 CFR 206.43 - Emergency support teams.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...

44 CFR 206.43 - Emergency support teams.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...

44 CFR 206.43 - Emergency support teams.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...

44 CFR 206.43 - Emergency support teams.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...

44 CFR 206.43 - Emergency support teams.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...

[Difficult Ventilation Requiring Emergency Endotracheal Intubation during Awake Craniotomy Managed by Laryngeal Mask Airway].

PubMed

Matsuda, Asako; Mizota, Toshiyuki; Tanaka, Tomoharu; Segawa, Hajime; Fukuda, Kazuhiko

2016-04-01

We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased. We immediately started manual ventilation, but the airway resistance was extremely high and we could not adequately ventilate the patient. We administered muscle relaxant for suspected laryngospasm, but ventilatory status did not improve; so we decided to conduct emergency endotracheal intubation. We tried to intubate using Airwayscope or LMA-Fastrach, but they were not effective in our case. Finally trachea was intubated using transnasal fiberoptic bronchoscopy. We discuss airway management during awake craniotomy, focusing on emergency endotracheal intubation during surgery.

Undergoing an immunization is effortlessly, manageable or difficult according to five-year-old children.

PubMed

Harder, Maria; Christensson, Kyllike; Söderbäck, Maja

2015-06-01

To prevent diseases among children they regularly undergo immunizations. Previous research show different approaches available to facilitate immunization-procedures for children to protect them from harm. To complement this research and provide care suited for children, research recognizing their perceptions of undergoing such a procedure is needed. The aim of this study was to describe 5-year-old children's perceptions of undergoing an immunization. A phenomenographic approach and analysis was used to describe the children's (n = 21) various perceptions. The data-collection was accomplished directly after the immunization to grasp the children's immediate perceptions. Drawings and reflective talks were used as they are considered as suitable methods when involving young children in research. The right to conduct research with children was approved by the appropriate research ethics committee and also by each child and the parents. The findings show that children's perceptions of an immunization-procedure may vary from effortlessly, to manageable or difficult. Regardless of how the child perceive the immunization-procedure each perception embrace the children's descriptions of actors and articles in the situation, their feelings in the situation and also their actions to deal with the immunization. Nevertheless, these descriptions vary according to how the children perceive the immunization as effortlessly, manageable or difficult. Children's and adults' perceptions of medical procedures may differ and children need guidance, time and space to deal with them. Recognizing children's perceptions of undergoing an immunization contributes to the promotion of their right to be involved in their own health care and towards the development of child-centred care. © 2014 Nordic College of Caring Science.

MOBILE EMISSIONS CHARACTERIZATION TEAM (HANDOUT)

EPA Science Inventory

The handout describes the Mobile Emissions Characterization Team of EPA's Office of Research and Development, National Risk Management Research Laboratory, Air Pollution Prevention and Control Division. The team conducts research to characterize and evaluate emissions of volatile...

Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.

PubMed

Taylor, Erin Fries; Machta, Rachel M; Meyers, David S; Genevro, Janice; Peikes, Deborah N

2013-01-01

Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care.

Being Right Isn't Always Enough: NFL Culture and Team Physicians' Conflict of Interest.

PubMed

McKinney, Ross

2016-11-01

The job of being a sports team physician is difficult, regardless of the level, from high school to the National Football League. When a sports league receives the intensity of attention leveled at the NFL, though, a difficult occupation becomes even more challenging. Even for the NFL players themselves, players' best interests regarding health issues are often unclear. Football players are, as a lot, highly competitive individuals. They want to win, and they want to help the team win. It's a warrior culture, and respect is earned by playing hurt. Should the team physician respect a player's autonomy when this means allowing him to make choices that might lead to further personal harm, especially if the player's choices align with the preference of the coach and management? Or should the doctor set limits and balance the player's choices with a paternalistic set of constraints, perhaps in opposition to both the player's and the team's desires? Simplification of this web of conflicts of interest is the goal of the model proposed by Glenn Cohen, Holly Lynch, and Christopher Deubert. In my view, their proposal is very clever. As an idea, it meets the expectations its authors set, namely, to minimize the problem of conflict of interest in the delivery of health care services to NFL football players. The ethics of the proposal align well with certain moral goals, like treating the player's interests more fairly and treating the player's health as an end instead of as the means to an end. But will such a proposal ever make headway in the pressurized environment of the NFL? © 2016 The Hastings Center.

Educational program in crisis management for cardiac surgery teams including high realism simulation.

PubMed

Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K

2012-07-01

Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

[Clinical interview in psychiatric difficult situations].

PubMed

Lorettu, Liliana; Nivoli, Gian Carlo; Milia, Paolo; Depalmas, Cristiano; Clerici, Massimo; Nivoli, Alessandra M A

2017-01-01

There are here described a number of basic principles underlying an effective clinical interview in psychiatric difficult situations (violent or suicidal patients, victims of serious physical and psychological damages, authors of inadequate or anti-social requests to the therapist). The aim of the present study is to provide the psychiatric operator with useful skills for the optimal management of the interview in difficult situations both at diagnostically and therapeutically level. The methodology was based on examination of the literature and personal experience of the authors. The authors highlighted 18 working hypothesis that may represent beneficial instruments in situations of difficult psychiatric interview. Further studies will deepen under the clinical, actuarial and statistical validity the principles covered in various clinical and crisis situations with difficulty to the interview, in relation also to specific types of patients for a more updated training of the operators in the field of mental health.

EPA’s Role in Emergency Response - Special Teams

EPA Pesticide Factsheets

The Environmental Response Team; Radiological Response Team; Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division; and National Criminal Enforcement Response Team provide specialized support.

Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: monitoring and management strategies to enhance teamwork.

PubMed

Kossaify, A; Hleihel, W; Lahoud, J-C

2017-12-01

Highlight the importance of teamwork in health care institutions by performing a review and discussion of the relevant literature. Review paper. A MEDLINE/Pubmed search was performed starting from 1990, and the terms 'team, teamwork, managers, healthcare, and cooperation' were searched in titles, abstracts, keywords, and conclusions; other terms 'patient safety, ethics, audits and quality of care' were specifically searched in abstracts and were used as additional filters criteria to select relevant articles. Thirty-three papers were found relevant; factors affecting the quality of care in health care institutions are multiple and varied, including issues related to individual profile, to administrative structure and to team-based effort. Issues affecting teamwork include mainly self-awareness, work environment, leadership, ethics, cooperation, communication, and competition. Moreover, quality improvement plans aiming to enhance and expand teams are essential in this context. Team monitoring and management are vital to achieve efficient teamwork with all the required qualities for a safer health system. In all cases, health managers' responsibility plays a fundamental role in creating and sustaining a teamwork atmosphere. Teamwork is known to improve outcomes in medicine, whether at the clinical, organizational, or scientific level. Teamwork in health care institutions must increasingly be encouraged, given that individual effort is often insufficient for optimal clinical outcome. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Activation of a medical emergency team using an electronic medical recording-based screening system*.

PubMed

Huh, Jin Won; Lim, Chae-Man; Koh, Younsuck; Lee, Jury; Jung, Youn-Kyung; Seo, Hyun-Suk; Hong, Sang-Bum

2014-04-01

To evaluate the efficacy of a medical emergency team activated using 24-hour monitoring by electronic medical record-based screening criteria followed by immediate intervention by a skilled team. Retrospective cohort study. Academic tertiary care hospital with approximately 2,700 beds. A total of 3,030 events activated by a medical emergency team from March 1, 2008, to February 28, 2010. None. We collected data for all medical emergency team activations: patient characteristics, trigger type for medical emergency team (electronic medical record-based screening vs calling criteria), interventions during each event, outcomes of the medical emergency team intervention, and 28-day mortality after medical emergency team activation. We analyzed data for 2009, when the medical emergency team functioned 24 hours a day, 7 days a week (period 2), compared with that for 2008, when the medical emergency team functioned 12 hours a day, 7 days a week (period 1). The commonest cause of medical emergency team activation was respiratory distress (43.6%), and the medical emergency team performed early goal-directed therapy (21.3%), respiratory care (19.9%), and difficult airway management (12.3%). For patients on general wards, 51.3% (period 1) and 38.4% (period 2) of medical emergency team activations were triggered by the electronic medical record-based screening system (electronic medical record-triggered group). In 23.4%, activation occurred because of an abnormality in laboratory screening criteria. The commonest activation criterion from electronic medical record-based screening was respiratory rate (39.4%). Over half the patients were treated in the general ward, and one third of the patients were transferred to the ICU. The electronic medical record-triggered group had lower ICU admission with an odds ratio of 0.35 (95% CI, 0.22-0.55). In surgical patients, the electronic medical record-triggered group showed the lower 28-day mortality (10.5%) compared with the call

Team RoboSimian

NASA Image and Video Library

2015-06-09

Many members of Team RoboSimian and a few guests gather with competition hardware at a "Meet the Robots" event during the DARPA Robotics Challenge Finals in Pomona, California, on June 6, 2015. The RoboSimian team at JPL is collaborating with partners at the University of California, Santa Barbara, and the California Institute of Technology in Pasadena. Caltech manages JPL for NASA. http://photojournal.jpl.nasa.gov/catalog/PIA19329

Extra-team connections for knowledge transfer between staff teams

PubMed Central

Ramanadhan, Shoba; Wiecha, Jean L.; Emmons, Karen M.; Gortmaker, Steven L.; Viswanath, Kasisomayajula

2009-01-01

As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties between staff members based in different site teams) as potential channels for knowledge sharing. Data come from a cross-sectional study of afterschool childcare staff implementing a health promotion program at 20 urban sites of the Young Men's Christian Association of Greater Boston. We conducted a sociometric social network analysis and attempted a census of 91 program staff members. We surveyed 80 individuals, and included 73 coordinators and general staff, who lead and support implementation, respectively, in this study. A multiple linear regression model demonstrated a positive relationship between extra-team connections (β = 3.41, P < 0.0001) and skill receipt, a measure of knowledge transfer. We also found that intra-team connections (within-team ties between staff members) were also positively related to skill receipt. Connections between teams appear to support knowledge transfer in this network, but likely require greater active facilitation, perhaps via organizational changes. Further research on extra-team connections and knowledge transfer in low-resource, high turnover environments is needed. PMID:19528313

Managing Global Virtual Teams across Classrooms, Students and Faculty

ERIC Educational Resources Information Center

Shea, Timothy P.; Sherer, Pamela D.; Quilling, Rosemary D.; Blewett, Craig N.

2011-01-01

Virtual teams are becoming commonplace in business today so our business school students should have experience in effectively working in virtual teams. Based on a month-long virtual team project conducted by the authors between classes in South Africa and the United States, this paper discusses the opportunities and challenges of using global…

The Team to Address Bariatric Care in Canadian Children (Team ABC3): Team Grant Research Proposal.

PubMed

2017-10-05

Severe obesity (SO) in Canadian children remains poorly understood. However, based on international data, the prevalence of SO appears to be increasing and is associated with a number of psychosocial, bio-mechanical, and cardiometabolic health risks. The purpose of our national Team to Address Bariatric Care in Canadian Children (Team ABC3) is to develop and lead a series of inter-related studies to enhance the understanding and management of SO in Canadian children and adolescents (0-18 years). From 2015 to 2019, Team ABC3 will conduct a series of projects at the regional, provincial, and national levels using multiple methods and study designs to respond to key knowledge gaps by (i) generating evidence on the prevalence of SO and its impact on health services utilization in children using existing Canadian data sources from primary care settings, (ii) exploring contemporary definitions of SO that link with health outcomes, (iii) comparing and contrasting health risks across the continuum of SO, (iv) understanding potential barriers to and facilitators of treatment success in children with SO, and (v) examining innovative lifestyle and behavioral interventions designed to successfully manage SO in children and their families. Furthermore, to examine the impact of innovative interventions on the management SO, we will (vi) evaluate whether adding a health coach, who provides support via text, email, and/or phone, improves children's ability to adhere to a web-based weight management program and (vii) test the feasibility and impact of a community-based weight management program for pre-school children with SO and their parents that combines group-based parenting sessions with in-home visits. Our research aligns with national priorities in obesity research, brings together leading scientists, clinicians, and stakeholders from across Canada, and will inform health services delivery throughout the country to provide the best care possible for children with SO and

Team Research at the Biology-Mathematics Interface: Project Management Perspectives

ERIC Educational Resources Information Center

Milton, John G.; Radunskaya, Ami E.; Lee, Arthur H.; de Pillis, Lisette G.; Bartlett, Diana F.

2010-01-01

The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics…

Cost implications of organizing nursing home workforce in teams.

PubMed

Mukamel, Dana B; Cai, Shubing; Temkin-Greener, Helena

2009-08-01

To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs.

Child Protection and Case Management Team Performance Evaluation Tool (CPCMT P.E.T.).

DTIC Science & Technology

1982-05-01

audit): ( 1 ) Structural measures - the environment, physical facilities, personnel capability, and organizational characteristics of the program (e.g...Need objective criteria for the measurement - define terms . Examples: Under organization, what is ( 1 ) "complete interdisciplinary composition" and (5...VATALOG NUMBER Health Care Studies Div Rpt #82-00 1 4. TITLE (and SubtUo) S. TYPE OF REPORT & PERIOD COVERED Child Protection and Case Management Team

Teams in Education: Creating an Integrated Approach.

ERIC Educational Resources Information Center

Arcaro, Jerome S.

This handbook is designed to help educational professionals develop cross-functional or departmental quality teams. Nine chapters focus on: (1) the concept of Total Quality Management (TQM) and 14 points for quality in education; (2) team goals and formation; (3) stages of successful team building; (4) the development of quality task teams; (5)…

Effective healthcare teams require effective team members: defining teamwork competencies

PubMed Central

Leggat, Sandra G

2007-01-01

Background Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. Methods Members of a state branch of the professional association of Australian health service managers participated in a teamwork survey. Results The 37% response rate enabled identification of a management teamwork competency set comprising leadership, knowledge of organizational goals and strategies and organizational commitment, respect for others, commitment to working collaboratively and to achieving a quality outcome. Conclusion Although not part of the research question the data suggested that the competencies for effective teamwork are perceived to be different for management and clinical teams, and there are differences in the perceptions of effective teamwork competencies between male and female health service managers. This study adds to the growing evidence that the focus on individual skill development and individual accountability and achievement that results from existing models of health professional training, and which is continually reinforced by human resource management practices within healthcare systems, is not consistent with the competencies required for effective teamwork. PMID:17284324

Enhancing Deep Learning: Lessons from the Introduction of Learning Teams in Management Education in France

ERIC Educational Resources Information Center

Borredon, Liz; Deffayet, Sylvie; Baker, Ann C.; Kolb, David

2011-01-01

Drawing from the reflective teaching and learning practices recommended in influential publications on learning styles, experiential learning, deep learning, and dialogue, the authors tested the concept of "learning teams" in the framework of a leadership program implemented for the first time in a top French management school…

Team-Building Success: It's in the Cards

ERIC Educational Resources Information Center

Scarfino, Deborah; Roever, Carol

2009-01-01

Successful team outcomes frequently--if not always--rely upon proven techniques for managing diverse styles and strengths. In this article, the authors describe the Diversity Card Game and the benefits it offers for students and instructors. Building teams using Diversity gives students the knowledge to manage clashes that might otherwise create…

Enhance your team-based qualitative research.

PubMed

Fernald, Douglas H; Duclos, Christine W

2005-01-01

Qualitative research projects often involve the collaborative efforts of a research team. Challenges inherent in teamwork include changes in membership and differences in analytical style, philosophy, training, experience, and skill. This article discusses teamwork issues and tools and techniques used to improve team-based qualitative research. We drew on our experiences in working on numerous projects of varying, size, duration, and purpose. Through trials of different tools and techniques, expert consultation, and review of the literature, we learned to improve how we build teams, manage information, and disseminate results. Attention given to team members and team processes is as important as choosing appropriate analytical tools and techniques. Attentive team leadership, commitment to early and regular team meetings, and discussion of roles, responsibilities, and expectations all help build more effective teams and establish clear norms. As data are collected and analyzed, it is important to anticipate potential problems from differing skills and styles, and how information and files are managed. Discuss analytical preferences and biases and set clear guidelines and practices for how data will be analyzed and handled. As emerging ideas and findings disperse across team members, common tools (such as summary forms and data grids), coding conventions, intermediate goals or products, and regular documentation help capture essential ideas and insights. In a team setting, little should be left to chance. This article identifies ways to improve team-based qualitative research with more a considered and systematic approach. Qualitative researchers will benefit from further examination and discussion of effective, field-tested, team-based strategies.

Workload of Team Leaders and Team Members During a Simulated Sepsis Scenario.

PubMed

Tofil, Nancy M; Lin, Yiqun; Zhong, John; Peterson, Dawn Taylor; White, Marjorie Lee; Grant, Vincent; Grant, David J; Gottesman, Ronald; Sudikoff, Stephanie N; Adler, Mark; Marohn, Kimberly; Davidson, Jennifer; Cheng, Adam

2017-09-01

Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40-60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members. Multicenter observational study. Nine pediatric simulation centers (five United States, three Canada, and one United Kingdom). Team leaders and team members during a 12-minute pediatric sepsis scenario. National Aeronautics and Space Administration-Task Load Index. One hundred twenty-seven teams were recruited from nine sites. One hundred twenty-seven team leaders and 253 team members completed the National Aeronautics and Space Administration-Task Load Index. Team leader had significantly higher overall workload than team member (51 ± 11 vs 44 ± 13; p < 0.01). Team leader had higher workloads in all subcategories except in performance where the values were equal and in physical demand where team members were higher than team leaders (29 ± 22 vs 18 ± 16; p < 0.01). The highest category for each group was mental 73 ± 13 for team leader and 60 ± 20 for team member. For team leader, two categories, mental (73 ± 17) and effort (66 ± 16), were high workload, most domains for team member were moderate workload levels. Team leader and team member are under moderate workloads during a pediatric sepsis scenario with team leader under high workloads (> 60) in the mental demand and effort subscales. Team leader average significantly higher workloads. Consideration of decreasing

From Quick Start Teams to Home Teams: The Duke TQM Experience.

ERIC Educational Resources Information Center

Lubans, John; Gordon, Heather

This paper describes the Duke University Libraries' transition in early 1994 from its traditional hierarchical model to an organization emphasizing Total Quality Management (TQM) concepts such as self-managing teams and continuous improvement. Existing conditions at the libraries that played a role in the decision to switch included: (1) rising…

Managing and mitigating conflict in healthcare teams: an integrative review.

PubMed

Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine

2016-07-01

To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Integrative literature review. CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. © 2016 John Wiley & Sons Ltd.

The critical role of conflict resolution in teams: a close look at the links between conflict type, conflict management strategies, and team outcomes.

PubMed

Behfar, Kristin J; Peterson, Randall S; Mannix, Elizabeth A; Trochim, William M K

2008-01-01

This article explores the linkages between strategies for managing different types of conflict and group performance and satisfaction. Results from a qualitative study of 57 autonomous teams suggest that groups that improve or maintain top performance over time share 3 conflict resolution tendencies: (a) focusing on the content of interpersonal interactions rather than delivery style, (b) explicitly discussing reasons behind any decisions reached in accepting and distributing work assignments, and (c) assigning work to members who have the relevant task expertise rather than assigning by other common means such as volunteering, default, or convenience. The authors' results also suggest that teams that are successful over time are likely to be both proactive in anticipating the need for conflict resolution and pluralistic in developing conflict resolution strategies that apply to all group members. 2008 APA

Interpersonal team leadership skills.

PubMed

Nelson, M

1995-05-01

To say that a team leader's job is a tough one is certainly not saying enough. It is up to the team leader to manage a group of people to be individuals but yet work as a team. The team leader must keep the peace and yet create a revolution with this group all at the same time. The good leader will require a lot of education, training, and tons of practical application to be a success. The good news, however, is that the team leader's job is a rewarding one, one that they'll always feel good about if they do it right. How many of us get the opportunity to take a group of wonderful, thinking individual minds and pull from them ideas that a whole team can take to success? Yes, the job is indeed tough, but the paybacks are many.

Integrated Safety Analysis Teams

NASA Technical Reports Server (NTRS)

Wetherholt, Jonathan C.

2008-01-01

Today's complex systems require understanding beyond one person s capability to comprehend. Each system requires a team to divide the system into understandable subsystems which can then be analyzed with an Integrated Hazard Analysis. The team must have both specific experiences and diversity of experience. Safety experience and system understanding are not always manifested in one individual. Group dynamics make the difference between success and failure as well as the difference between a difficult task and a rewarding experience. There are examples in the news which demonstrate the need to connect the pieces of a system into a complete picture. The Columbia disaster is now a standard example of a low consequence hazard in one part of the system; the External Tank is a catastrophic hazard cause for a companion subsystem, the Space Shuttle Orbiter. The interaction between the hardware, the manufacturing process, the handling, and the operations contributed to the problem. Each of these had analysis performed, but who constituted the team which integrated this analysis together? This paper will explore some of the methods used for dividing up a complex system; and how one integration team has analyzed the parts. How this analysis has been documented in one particular launch space vehicle case will also be discussed.

Does Virtual Team Composition Matter? Trait and Problem-Solving Configuration Effects on Team Performance

ERIC Educational Resources Information Center

Turel, Ofir; Zhang, Yi

2010-01-01

Due to the increased importance and usage of self-managed virtual teams, many recent studies have examined factors that affect their success. One such factor that merits examination is the configuration or composition of virtual teams. This article tackles this point by (1) empirically testing trait-configuration effects on virtual team…

Student-Led Project Teams: Significance of Regulation Strategies in High- and Low-Performing Teams

ERIC Educational Resources Information Center

Ainsworth, Judith

2016-01-01

We studied group and individual co-regulatory and self-regulatory strategies of self-managed student project teams using data from intragroup peer evaluations and a postproject survey. We found that high team performers shared their research and knowledge with others, collaborated to advise and give constructive criticism, and demonstrated moral…

Design and Validation of a Web-Based System for Assigning Members to Teams Using Instructor-Specified Criteria

ERIC Educational Resources Information Center

Layton, Richard A.; Loughry, Misty L.; Ohland, Matthew W.; Ricco, George D.

2010-01-01

A significant body of research identifies a large number of team composition characteristics that affect the success of individuals and teams in cooperative learning and project-based team environments. Controlling these factors when assigning students to teams should result in improved learning experiences. However, it is very difficult for…

Negative affect reduces team awareness: the effects of mood and stress on computer-mediated team communication.

PubMed

Pfaff, Mark S

2012-08-01

This article presents research on the effects of varying mood and stress states on within-team communication in a simulated crisis management environment, with a focus on the relationship between communication behaviors and team awareness. Communication plays a critical role in team cognition along with cognitive factors such as attention, memory, and decision-making speed. Mood and stress are known to have interrelated effects on cognition at the individual level, but there is relatively little joint exploration of these factors in team communication in technologically complex environments. Dyadic communication behaviors in a distributed six-person crisis management simulation were analyzed in a factorial design for effects of two levels of mood (happy, sad) and the presence or absence of a time pressure stressor. Time pressure and mood showed several specific impacts on communication behaviors. Communication quantity and efficiency increased under time pressure, though frequent requests for information were associated with poor performance. Teams in happy moods showed enhanced team awareness, as revealed by more anticipatory communication patterns and more detailed verbal responses to teammates than those in sad moods. Results show that the attention-narrowing effects of mood and stress associated with individual cognitive functions demonstrate analogous impacts on team awareness and information-sharing behaviors and reveal a richer understanding of how team dynamics change under adverse conditions. Disentangling stress from mood affords the opportunity to target more specific interventions that better support team awareness and task performance.

Optimal management of phenylketonuria: a centralized expert team is more successful than a decentralized model of care.

PubMed

Camfield, Carol S; Joseph, Marissa; Hurley, Teresa; Campbell, Karen; Sanderson, Susan; Camfield, Peter R

2004-07-01

To compare phenylketonuria (PKU) management by a centralized, expert team in the Province of Nova Scotia (NS) with the decentralized approach in New Brunswick (NB). Retrospective chart review documented frequency of outpatient visits, phenylalanine (Phe) concentration, and medical formula use. Structured telephone interviews with the 8 regional NB dietitians (NB-D) documented their knowledge and support in PKU management. Patients with PKU (n=108; age, birth to 42 years) reside in NB (n=69) and NS (n=39). More were lost to contact in NB than in NS (9/69 vs 1/39) and more were completely off diet in NB than in NS (24/60 vs 1/38, P=.05). All 15 children <2 years old followed by a PKU team in either NS or Saint John, NB had optimal Phe levels. Children 2 to 12 years of age in NS had better Phe control and more medical visits than in NB (P <.01). Older patients had more episodes of elevated Phe levels (P=.01). Formula was dispensed in appropriate yearly amounts to 52% in NB and >95% in NS. Mental handicap or borderline intelligence was common in both NB (44%) and NS (42%). All NB-D wished additional specialized medical, nursing, or social work assistance. PKU management appears to be more effective with an expert, coordinated team approach.

Overcoming the ten most common barriers to effective team communication.

PubMed

Hills, Laura

2013-01-01

Communication is at the heart of medical practice management. Yet there are many barriers to effective communication that can interfere with the smooth running of the practice. This article describes the 10 most common barriers to effective medical practice team communication and offers six steps the practice manager can take to break them down. This article also suggests that the practice develop a team communication strategy. It suggests 10 communication principles readers can share directly with their teams and describes three hallmarks of effective team communication. Finally, this article provides a list of 25 practical questions practice managers can use to improve their team's communication.

Interference of psychological factors in difficult-to-control asthma.

PubMed

Halimi, Laurence; Vachier, Isabelle; Varrin, Muriel; Godard, Philippe; Pithon, Gérard; Chanez, Pascal

2007-01-01

Most patients with asthma can be controlled with suitable medication, but 5-10% of them remain difficult to control despite optimal management. We investigated whether patients with difficult-to-control asthma (DCA) or controlled asthma (CA) differ with respect to psychological factors, such as general control beliefs on life events. DCA was defined as an absence of control despite optimal management. Recent control was measured using the Asthma Control Questionnaire. General control beliefs were investigated using a Locus of Control scale (LOC). Patients with DCA had a significantly higher external LOC as compared to patients with CA (P=0.01). In the DCA group, the hospital admission rate was highly significant in association with the external LOC (P=0.004) as compared to the internal LOC trend. This study showed that patients with DCA had different general control beliefs which might have hampered their management and interfered with their therapeutic adherence. The present findings could enhance management of DCA in a clinical setting.

Imagery Integration Team

NASA Technical Reports Server (NTRS)

Calhoun, Tracy; Melendrez, Dave

2014-01-01

The Human Exploration Science Office (KX) provides leadership for NASA's Imagery Integration (Integration 2) Team, an affiliation of experts in the use of engineering-class imagery intended to monitor the performance of launch vehicles and crewed spacecraft in flight. Typical engineering imagery assessments include studying and characterizing the liftoff and ascent debris environments; launch vehicle and propulsion element performance; in-flight activities; and entry, landing, and recovery operations. Integration 2 support has been provided not only for U.S. Government spaceflight (e.g., Space Shuttle, Ares I-X) but also for commercial launch providers, such as Space Exploration Technologies Corporation (SpaceX) and Orbital Sciences Corporation, servicing the International Space Station. The NASA Integration 2 Team is composed of imagery integration specialists from JSC, the Marshall Space Flight Center (MSFC), and the Kennedy Space Center (KSC), who have access to a vast pool of experience and capabilities related to program integration, deployment and management of imagery assets, imagery data management, and photogrammetric analysis. The Integration 2 team is currently providing integration services to commercial demonstration flights, Exploration Flight Test-1 (EFT-1), and the Space Launch System (SLS)-based Exploration Missions (EM)-1 and EM-2. EM-2 will be the first attempt to fly a piloted mission with the Orion spacecraft. The Integration 2 Team provides the customer (both commercial and Government) with access to a wide array of imagery options - ground-based, airborne, seaborne, or vehicle-based - that are available through the Government and commercial vendors. The team guides the customer in assembling the appropriate complement of imagery acquisition assets at the customer's facilities, minimizing costs associated with market research and the risk of purchasing inadequate assets. The NASA Integration 2 capability simplifies the process of securing one

Reduction of duration and cost of mechanical ventilation in an intensive care unit by use of a ventilatory management team.

PubMed

Cohen, I L; Bari, N; Strosberg, M A; Weinberg, P F; Wacksman, R M; Millstein, B H; Fein, I A

1991-10-01

To test the hypothesis that a formal interdisciplinary team approach to managing ICU patients requiring mechanical ventilation enhances ICU efficiency. Retrospective review with cost-effectiveness analysis. A 20-bed medical-surgical ICU in a 450-bed community referral teaching hospital with a critical care fellowship training program. All patients requiring mechanical ventilation in the ICU were included, comparing patients admitted 1 yr before the inception of the ventilatory management team (group 1) with those patients admitted for 1 yr after the inception of the team (group 2). Group 1 included 198 patients with 206 episodes of mechanical ventilation and group 2 included 165 patients with 183 episodes of mechanical ventilation. A team consisting of an ICU attending physician, nurse, and respiratory therapist was formed to conduct rounds regularly and supervise the ventilatory management of ICU patients who were referred to the critical care service. The two study groups were demographically comparable. However, there were significant reductions in resource use in group 2. The number of days on mechanical ventilation decreased (3.9 days per episode of mechanical ventilation [95% confidence interval 0.3 to 7.5 days]), as did days in the ICU (3.3 days per episode of mechanical ventilation [90% confidence interval 0.3 to 6.3 days]), numbers of arterial blood gases (23.2 per episode of mechanical ventilation; p less than .001), and number of indwelling arterial catheters (1 per episode of mechanical ventilation; p less than .001). The estimated cost savings from these reductions was $1,303 per episode of mechanical ventilation. We conclude that a ventilatory management team, or some component thereof, can significantly and safely expedite the process of "weaning" patients from mechanical ventilatory support in the ICU.

Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures.

PubMed

Heinrich, Sebastian; Birkholz, Torsten; Ihmsen, Harald; Irouschek, Andrea; Ackermann, Andreas; Schmidt, Joachim

2012-08-01

Difficult laryngoscopy in pediatric patients undergoing anesthesia. This retrospective analysis was conducted to investigate incidence and predictors of difficult laryngoscopy in a large cohort of pediatric patients receiving general anesthesia with endotracheal intubation. Young age and craniofacial dysmorphy are predictors for the difficult pediatric airway and difficult laryngoscopy. For difficult laryngoscopy, other general predictors are not yet described. Retrospectively, from a 5-year period, data from 11.219 general anesthesia procedures in pediatric patients with endotracheal intubation using age-adapted Macintosh blades in a single center (university hospital) were analyzed statistically. The overall incidence of difficult laryngoscopy [Cormack and Lehane (CML) grade III and IV] was 1.35%. In patients younger than 1 year, the incidence of CML III or IV was significantly higher than in the older patients (4.7% vs 0.7%). ASA Physical Status III and IV, a higher Mallampati Score (III and IV) and a low BMI were all associated (P < 0.05) with difficult laryngoscopy. Patients undergoing oromaxillofacial surgery and cardiac surgery showed a significantly higher rate of CML III/IV findings. The general incidence of difficult laryngoscopy in pediatric anesthesia is lower than in adults. Our results show that the risk of difficult laryngoscopy is much higher in patients below 1 year of age, in underweight patients and in ASA III and IV patients. The underlying disease might also contribute to the risk. If the Mallampati score could be obtained, prediction of difficult laryngoscopy seems to be reliable. Our data support the existing recommendations for a specialized anesthesiological team to provide safe anesthesia for infants and neonates. © 2012 Blackwell Publishing Ltd.

Cost Implications of Organizing Nursing Home Workforce in Teams

PubMed Central

Mukamel, Dana B; Cai, Shubing; Temkin-Greener, Helena

2009-01-01

Objective To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. Data Sources/Study Setting Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. Study Design A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. Data Collection Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. Principal Findings Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. Conclusions Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs. PMID:19486181

[Management of open access gastrointestinal endoscopy and quality of care: collaboration between an improvement team and primary care].

PubMed

Sebastián Domingo, Juan José; Sánchez Sánchez, Clara; Galve Royo, Eugenio; Mendi Metola, Carolina; Valdepérez Torrubia, Javier

2012-02-01

To create an improvement team within a healthcare quality improvement project of the Government of Aragon (Spain), aimed at increasing the quality of care and suitability of the indications of gastrointestinal endoscopy in the open access endoscopy system of a secondary hospital in Aragon. The team developed a consensus document indicating how to use oral endoscopy and colonoscopy correctly, and held information and training sessions with all the primary care physicians involved in this area. Sector I health centers and Royo Villanova Hospital, in Zaragoza. The team consisted of a gastroenterologist and three primary care physicians and, from the outset received the support of the primary care administration and management in the health area. Inappropriate use of endoscopy, particularly colonoscopy, was reduced from 20% to 11.6%. Significant savings were achieved in health costs. The endoscopy waiting list was reduced. The quality of care and the safety of patients undergoing these examinations improved. Training of primary care physicians in these procedures was enhanced, and coordination between primary and specialized was implemented. To ensure efficient running of an open access gastrointestinal endoscopy system, an interdisciplinary improvement team and the full involvement of the primary care staff managing this resource are required. Copyright © 2011 Elsevier España, S.L. All rights reserved.

The Making of a Skull Base Team and the Value of Multidisciplinary Approach in the Management of Sinonasal and Ventral Skull Base Malignancies.

PubMed

Snyderman, Carl H; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A

2017-04-01

The management of sinonasal and ventral skull base malignancies is best performed by a team. Although the composition of the team may vary, it is important to have multidisciplinary representation. There are multiple obstacles, both individual and institutional, that must be overcome to develop a highly functioning team. Adequate training is an important part of team-building and can be fostered with surgical telementoring. A quality improvement program should be incorporated into the activities of a skull base team. Copyright © 2016 Elsevier Inc. All rights reserved.

Team approach concept in management of oro-facial clefts: a survey of Nigerian practitioners

PubMed Central

Akinmoladun, Victor I; Obimakinde, Obitade S

2009-01-01

Background Cleft palate craniofacial teams have evolved across the globe in the last 20 years in compliance with the interdisciplinary concept of management of oro-facial clefts. An interdisciplinary care allows a coordinated treatment protocol for the patient. The objective of this study was to evaluate oro-facial cleft care in Nigeria with particular emphasis on the compliance of the practitioners to the team approach concept. Methods A snapshot survey was conducted among specialists that attended the Pan African Congress on Cleft Lip and Palate, at the International Institute of Tropical Agriculture, Nigeria in February 2007. Result Sixty three respondents successfully completed and returned the questionnaire for analysis. Mean age of respondents was 43.5 years and the range was 38–62 years. Male to female ratio was 2.7:1. Oral and Maxillofacial Surgeons and Plastic Surgeons constituted the majority of respondents (38.1% and 22.2%) respectively. Only 47.6% (n = 30) of the specialists belonged to cleft teams. Majority of Oral and Maxillofacial Surgeons and Plastic Surgeons belonged to cleft teams (70% and 63.3% respectively) while speech pathologists and orthodontists were less represented (20% and 36.7% respectively) in teams. Conclusion Findings from this study suggests that interdisciplinary care for the cleft patient does not appear to have been fully embraced in Nigeria. This may be a result of several reasons ranging from non availability of the requisite specialists, the relatively young age of cleft care practice in this part of the world to the poor state of infrastructure. PMID:19426559

Team approach concept in management of oro-facial clefts: a survey of Nigerian practitioners.

PubMed

Akinmoladun, Victor I; Obimakinde, Obitade S

2009-05-10

Cleft palate craniofacial teams have evolved across the globe in the last 20 years in compliance with the interdisciplinary concept of management of oro-facial clefts. An interdisciplinary care allows a coordinated treatment protocol for the patient. The objective of this study was to evaluate oro-facial cleft care in Nigeria with particular emphasis on the compliance of the practitioners to the team approach concept. A snapshot survey was conducted among specialists that attended the Pan African Congress on Cleft Lip and Palate, at the International Institute of Tropical Agriculture, Nigeria in February 2007. Sixty three respondents successfully completed and returned the questionnaire for analysis. Mean age of respondents was 43.5 years and the range was 38-62 years.Male to female ratio was 2.7:1. Oral and Maxillofacial Surgeons and Plastic Surgeons constituted the majority of respondents (38.1% and 22.2%) respectively. Only 47.6% (n = 30) of the specialists belonged to cleft teams. Majority of Oral and Maxillofacial Surgeons and Plastic Surgeons belonged to cleft teams (70% and 63.3% respectively) while speech pathologists and orthodontists were less represented (20% and 36.7% respectively) in teams. Findings from this study suggests that interdisciplinary care for the cleft patient does not appear to have been fully embraced in Nigeria. This may be a result of several reasons ranging from non availability of the requisite specialists, the relatively young age of cleft care practice in this part of the world to the poor state of infrastructure.

Quality charters or quality members? A control theory perspective on team charters and team performance.

PubMed

Courtright, Stephen H; McCormick, Brian W; Mistry, Sal; Wang, Jiexin

2017-10-01

Though prevalent in practice, team charters have only recently received scholarly attention. However, most of this work has been relatively devoid of theory, and consequently, key questions about why and under what conditions team charter quality affects team performance remain unanswered. To address these gaps, we draw on macro organizational control theory to propose that team charter quality serves as a team-level "behavior" control mechanism that builds task cohesion through a structured exercise. We then juxtapose team charter quality with an "input" team control mechanism that influences the emergence of task cohesion more organically: team conscientiousness. Given their redundant effects on task cohesion, we propose that the effects of team charter quality and team conscientiousness on team performance (through task cohesion) are substitutive such that team charter quality primarily impacts team performance for teams that are low (vs. high) on conscientiousness. We test and find support for our hypotheses in a sample of 239 undergraduate self-managing project teams. Our study contributes to the groups and teams literature in the following ways: first, relative to previous studies, we take a more theory-driven approach toward understanding team charters, and in doing so, uncover when and why team charter quality impacts team performance; second, we integrate two normally disparate perspectives on team effectiveness (team development and team selection) to offer a broader perspective on how teams are "built"; and third, we introduce team charter quality as a performance-enhancing mechanism for teams lower on conscientiousness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Intelligent Virtual Assistant's Impact on Technical Proficiency within Virtual Teams

ERIC Educational Resources Information Center

Graham, Christian; Jones, Nory B.

2016-01-01

Information-systems development continues to be a difficult process, particularly for virtual teams that do not have the luxury of meeting face-to-face. The research literature on this topic reinforces this point: the greater part of database systems development projects ends in failure. The use of virtual teams to complete projects further…

Still a difficult business? Negotiating alcohol-related problems in general practice consultations.

PubMed

Rapley, Tim; May, Carl; Frances Kaner, Eileen

2006-11-01

This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.

Impact of a comprehensive supportive care team on management of hopelessly ill patients with multiple organ failure.

PubMed

Field, B E; Devich, L E; Carlson, R W

1989-08-01

We developed a supportive care team for hopelessly ill patients in an urban emergency/trauma hospital. The team includes a clinical nurse specialist and a faculty physician as well as a chaplain and social worker. The supportive care team provides an alternative to intensive care or conventional ward management of hopelessly ill patients and concentrates on the physical and psychosocial comfort needs of patients and their families. We describe our experience with 20 hopelessly ill patients with multiple organ failure vs a similar group treated before the development of the supportive care team. Although there was no difference in mortality (100 percent), the length of stay in the medical ICU for patients with multiple organ failure decreased by 12 days to 6 days. Additionally, there were 50 percent fewer therapeutic interventions provided by the supportive care team vs intensive care or conventional ward treatment of multiple organ failure patients. We describe the methods that the supportive care team uses in an attempt to meet the physical and psychosocial comfort needs of hopelessly ill multiple organ failure patients and their families. This multidisciplinary approach to the care of the hopelessly ill may have applications in other institutions facing the ethical, medical, and administrative challenges raised by these patients.

Roles and Responsibilities in Feature Teams

NASA Astrophysics Data System (ADS)

Eckstein, Jutta

Agile development requires self-organizing teams. The set-up of a (feature) team has to enable self-organization. Special care has to be taken if the project is not only distributed, but also large and more than one feature team is involved. Every feature team needs in such a setting a product owner who ensures the continuous focus on business delivery. The product owners collaborate by working together in a virtual team. Each feature team is supported by a coach who ensures not only the agile process of the individual feature team but also across all feature teams. An architect (or if necessary a team of architects) takes care that the system is technically sound. Contrariwise to small co-located projects, large global projects require a project manager who deals with—among other things—internal and especially external politics.

Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial.

PubMed

Kearns, Patrick

2017-10-01

PURPOSE: Health services research evaluates redesign models for primary care. Care management is one alternative. Evaluation includes resource utilization as a criterion. Compare the impact of care-manager teams on resource utilization. The comparison includes entire panes of patients and the subset of patients with diabetes. DESIGN: Randomized, prospective, cohort study comparing change in utilization rates between groups, pre- and post-intervention. METHODOLOGY: Ten primary care physician panels in a safety-net setting. Ten physicians were randomized to either a care-management approach (Group 1) or a traditional approach (Group 2). Care managers focused on diabetes and the cardiovascular cluster of diseases. Analysis compared rates of hospitalization, 30-day readmission, emergency room visits, and urgent care visits. Analysis compared baseline rates to annual rates after a yearlong run-in for entire panels and the subset of patients with diabetes. RESULTS: Resource utilization showed no statistically significant change between baseline and Year 3 (P=.79). Emergency room visits and hospital readmission increased for both groups (P=.90), while hospital admissions and urgent care visits decreased (P=.73). Similarly, utilization was not significantly different for patients with diabetes (P=.69). CONCLUSIONS: A care-management team approach failed to improve resource utilization rates by entire panels and the subset of diabetic patients compared to traditional care. This reinforces the need for further evidentiary support for the care-management model's hypothesis in the safety net.

Members' sensemaking in a multi-professional team.

PubMed

Rovio-Johansson, Airi; Liff, Roy

2012-01-01

The aim of this study is to investigate sensemaking as interaction among team members in a multi-professional team setting in a new public management context at a Swedish Child and Youth Psychiatric Unit. A discursive pragmatic approach grounded in ethonomethodology is taken in the analysis of a treatment conference (TC). In order to interpret and understand the multi-voiced complexity of discourse and of talk-in-interaction, the authors use dialogism in the analysis of the members' sensemaking processes. The analysis is based on the theoretical assumption that language and texts are the primary tools actors use to comprehend the social reality and to make sense of their multi-professional discussions. Health care managers are offered insights, derived from theory and empirical evidence, into how professionals' communications influence multi-professional cooperation. The team leader and members are interviewed before and after the observed TC. Team members create their identities and positions in the group by interpreting and "misinterpreting" talk-in-interaction. The analyses reveal the ways the team members relate to their treatment methods in the discussion of a patient; advocating a treatment method means that the team member and the method are intertwined. The findings may be valuable to health care professionals and managers working in teams by showing them how to achieve greater cooperation through the use of verbal abilities. The findings and methods contribute to the international research on cooperation problems in multi-professional teams and to the empirical research on institutional discourse through text and talk.

Nurse Scientists Overcoming Challenges to Lead Transdisciplinary Research Teams

PubMed Central

Kneipp, Shawn M.; Gilleskie, Donna; Sheely, Amanda; Schwartz, Todd; Gilmore, Robert M.; Atkinson, Daryl

2017-01-01

Increasingly, scientific funding agencies are requiring that researchers move toward an integrated, transdisciplinary team science paradigm. While the barriers to and rewards of conducting this type of research have been discussed in the literature, examples of how nurse investigators have led these teams to reconcile the differences in theoretical, methodological, and/or analytic perspectives that inevitably exist are lacking. In this article, we describe these developmental trajectory challenges through a case study of one transdisciplinary team, focusing on team member characteristics and the leadership tasks associated with successful transdisciplinary science teams in the literature. Specifically, we describe how overcoming these challenges has been essential to examining the complex, and potentially cumulative effects that key intersections between legal, social welfare, and labor market systems may have on the health of disadvantaged women. Finally, we discuss this difficult, but rewarding work within the context of lessons learned and transdisciplinary team research in relation to the future of nursing science. PMID:25015404

Leading multiple teams: average and relative external leadership influences on team empowerment and effectiveness.

PubMed

Luciano, Margaret M; Mathieu, John E; Ruddy, Thomas M

2014-03-01

External leaders continue to be an important source of influence even when teams are empowered, but it is not always clear how they do so. Extending research on structurally empowered teams, we recognize that teams' external leaders are often responsible for multiple teams. We adopt a multilevel approach to model external leader influences at both the team level and the external leader level of analysis. In doing so, we distinguish the influence of general external leader behaviors (i.e., average external leadership) from those that are directed differently toward the teams that they lead (i.e., relative external leadership). Analysis of data collected from 451 individuals, in 101 teams, reporting to 25 external leaders, revealed that both relative and average external leadership related positively to team empowerment. In turn, team empowerment related positively to team performance and member job satisfaction. However, while the indirect effects were all positive, we found that relative external leadership was not directly related to team performance, and average external leadership evidenced a significant negative direct influence. Additionally, relative external leadership exhibited a significant direct positive influence on member job satisfaction as anticipated, whereas average external leadership did not. These findings attest to the value in distinguishing external leaders' behaviors that are exhibited consistently versus differentially across empowered teams. Implications and future directions for the study and management of external leaders overseeing multiple teams are discussed.

Primary care team working in Ireland: a qualitative exploration of team members' experiences in a new primary care service.

PubMed

Kennedy, Norelee; Armstrong, Claire; Woodward, Oonagh; Cullen, Walter

2015-07-01

Team working is an integral aspect of primary care, but barriers to effective team working can limit the effectiveness of a primary care team (PCT). The establishment of new PCTs in Ireland provides an excellent opportunity to explore team working in action. The aim of this qualitative study was to explore the experiences of team members working in a PCT. Team members (n = 19) from two PCTs were interviewed from May to June 2010 using a semi-structured interview guide. All interviews were audio-recorded and transcribed. Data were analysed using NVivo (version 8). Thematic analysis was used to explore the data. We identified five main themes that described the experiences of the team members. The themes were support for primary care, managing change, communication, evolution of roles and benefits of team working. Team members were generally supportive of primary care and had experienced benefits to their practice and to the care of their patients from participation in the team. Regular team meetings enabled communication and discussion of complex cases. Despite the significant scope for role conflict due to the varied employment arrangements of the team members, neither role nor interpersonal conflict was evident in the teams studied. In addition, despite the unusual team structure in Irish PCTs - where there is no formally appointed team leader or manager - general issues around team working and its benefits and challenges were very similar to those found in other international studies. This suggests, in contrast to some studies, that some aspects of the leadership role may not be as important in successful PCT functioning as previously thought. Nonetheless, team leadership was identified as an important issue in the further development of the teams. © 2014 John Wiley & Sons Ltd.

Team talk and team activity in simulated medical emergencies: a discourse analytical approach.

PubMed

Gundrosen, Stine; Andenæs, Ellen; Aadahl, Petter; Thomassen, Gøril

2016-11-14

Communication errors can reduce patient safety, especially in emergency situations that require rapid responses by experts in a number of medical specialties. Talking to each other is crucial for utilizing the collective expertise of the team. Here we explored the functions of "team talk" (talking between team members) with an emphasis on the talk-work relationship in interdisciplinary emergency teams. Five interdisciplinary medical emergency teams were observed and videotaped during in situ simulations at an emergency department at a university hospital in Norway. Team talk and simultaneous actions were transcribed and analysed. We used qualitative discourse analysis to perform structural mapping of the team talk and to analyse the function of online commentaries (real-time observations and assessments of observations based on relevant cues in the clinical situation). Structural mapping revealed recurring and diverse patterns. Team expansion stood out as a critical phase in the teamwork. Online commentaries that occurred during the critical phase served several functions and demonstrated the inextricable interconnections between team talk and actions. Discourse analysis allowed us to capture the dynamics and complexity of team talk during a simulated emergency situation. Even though the team talk did not follow a predefined structure, the team members managed to manoeuvre safely within the complex situation. Our results support that online commentaries contributes to shared team situation awareness. Discourse analysis reveals naturally occurring communication strategies that trigger actions relevant for safe practice and thus provides supplemental insights into what comprises "good" team communication in medical emergencies.

Two case reports of unexpected tracheal agenesis in the neonate: 3 C's beyond algorithms for difficult airway management.

PubMed

Grass, Beate; Simma, Leopold; Reinehr, Michael; Zimmermann, Urs; Gysin, Claudine; Henze, Georg; Cannizzaro, Vincenzo

2017-02-08

Handling neonates with postnatal respiratory failure due to congenital airway malformations implies knowledge about emergency management of unexpected difficult airway. In these stressful situations both technical and communication skills of the caretakers are essential. Two cases with prenatally unknown tracheal agenesis are reported. In the presented cases, airway malformation and subsequent difficulties upon endotracheal intubation were not adequately communicated between caretakers. We discuss the aspects of culture, communication, and capnography.

Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

PubMed

Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

2015-12-01

Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. © The Author(s) 2015.

[Organizational climate in management teams and its relationship with health care outcomes].

PubMed

Peña-Viveros, Raúl; Hernández-Hernández, Dulce María; Vélez-Moreno, Ana María Luz; García-Sandoval, Martha Gabriela; Reyes-Tellez, María Araceli; Ureña-Bogarin, Enrique L

2015-01-01

To identify the relationship between organizational climate of management teams and the performance of health services. A transversal and analytical study was designed. The Organizational Climate Scale (OCS) was utilized and performance was assessed by the achievement indicators through correlation analysis and multiple regression. Thirty four medical benefits services headquarters (JSPM) were measured of the Mexican Social Security Institute. Of 862 participating, 238 (27.6%) evaluated the climate of their organizations with a high level; the maximal score was 56%. Average performance value was 0.79 ± 0.07 (minimal: 0.65; maximal: 0.92). A positive correlation was demonstrated between organizational climate level and performance (r=0.4; p=0.008). The organizational climate of the health services managers (JSPM) is directly related with performance in health care.

Population Care Management and Team-Based Approach to Reduce Racial Disparities among African Americans/Blacks with Hypertension

PubMed Central

Bartolome, Rowena E; Chen, Agnes; Handler, Joel; Platt, Sharon Takeda; Gould, Bernice

2016-01-01

Objectives: At Kaiser Permanente, national Equitable Care Health Outcomes (ECHO) Reports with a baseline measurement of 16 Healthcare Effectiveness Data and Information Set measures stratified by race and ethnicity showed a disparity of 8.1 percentage points in blood pressure (BP) control rates between African- American/black (black) and white members. The aims of this study were to describe a population care management team-based approach to improve BP control for large populations and to explain how a culturally tailored, patient-centered approach can address this racial disparity. Methods: These strategies were implemented through: 1) physician-led educational programs on treatment intensification, medication adherence, and consistent use of clinical practice guidelines; 2) building strong care teams by defining individual roles and responsibilities in hypertension management; 3) redesign of the care delivery system to expand access; and 4) programs on culturally tailored communication tools and self-management. Results: At a physician practice level where 65% of patients with hypertension were black, BP control rates (< 140/90 mmHg) for blacks improved from 76.6% to 81.4%, and control rates for whites increased from 82.9% to 84.2%. The racial gap narrowed from 6.3% to 2.8%. As these successful practices continue to spread throughout the program, the health disparity gap in BP control has decreased by 50%, from 8.1% to 3.9%. Conclusion: A sustainable program to collect self-reported race, ethnicity, and language preference data integrated with successful population care management programs provided the foundation for addressing health disparities. Cultural tailoring of a multilevel team-based approach closed the gap for blacks with hypertension. PMID:26824963

Managing in the interprofessional environment: a theory of action perspective.

PubMed

Rogers, Tim

2004-08-01

Managers of multidisciplinary teams face difficult dilemmas in managing competing interests, diverse perspectives and interpersonal conflicts. This paper illustrates the potential of the theory of action methodology of Argyris and Schön (1974, 1996) to illuminate these problems and contribute to their resolution. An empirical example of a depth-investigation with one multidisciplinary community health care team leader in Australia demonstrates that the theory of action offers a more accurate account of the causal dimensions of her dilemmas and provides more scope for effective intervention than her lay explanation will allow. It also provides a more satisfactory analysis of her difficulties with two common problems identified in the literature: defining the appropriate level of autonomy for team members and developing constructive dialogue across perceived discipline-based differences of opinion. Consequently the theory of action appears to offer enormous promise to managers of multidisciplinary teams wanting to understand and resolve their problems and develop a rigorous reflective practice. Further research on the viability of the theory to facilitate a self-correcting system that can promote learning even under conditions of stress and conflict is suggested and implications for learning and teaching for the multidisciplinary environment are briefly discussed.

Team Learning in SMES: Learning the Lessons

ERIC Educational Resources Information Center

McKeown, Ian

2012-01-01

This research identifies and explores the factors that influence team learning in the context of an SME management team. It examines the difficulties the team members face in attempting to share and combine their experiences to co-construct knowledge and understanding of their environment and future opportunities. The paper reveals a connection…

A Theoretical Model and New Test of Managerial Legitimacy in Work Teams

ERIC Educational Resources Information Center

Yoon, Jeongkoo; Thye, Shane

2011-01-01

This study examines endorsement and authorization as two social mechanisms that can induce perceptions of legitimacy for individuals who manage work teams. "Endorsement" is the support of a manager by one's own team members, whereas "authorization" is the support of a team manager stemming from a higher bureaucratic level.…

Accelerating and Braking in Times of Economic Crisis: Organisational Learning in a Top Management Team

ERIC Educational Resources Information Center

Wallo, Andreas; Kock, Henrik; Nilsson, Peter

2012-01-01

Purpose: The purpose of this article is to present the results of a study of an industrial company's top management team (TMT) that fought to survive an economic crisis. Specifically, the article seeks to focus on describing the TMT's composition, group processes, and work during a period of high external pressure; analysing the TMT's work in…

The Perceptions of Senior Management Teams' (SMTs) Dominant Leadership Styles in Selected Botswana Primary Schools

ERIC Educational Resources Information Center

Mhozya, C. M.

2010-01-01

This study, which was funded by the office of research and development (ORD) in the University of Botswana, surveyed 65 primary schools in South Central region in Botswana, which aimed at establishing the perceptions of senior management teams dominant leadership style. The study was done in three phases; the first phase started in June 2008 to…

Faculty Teaching Diversity through Difficult Dialogues: Stories of Challenges and Success

ERIC Educational Resources Information Center

Gayles, Joy Gaston; Kelly, Bridget Turner; Grays, Shaefny; Zhang, Jing Jing; Porter, Kamaria P.

2015-01-01

Teaching diversity courses in graduate preparation programs is likely to trigger difficult dialogues that evoke a range of emotional responses. Difficult dialogues on diversity topics must be managed effectively in order to enhance multicultural competence. This interpretive study examined the experiences of faculty who teach diversity courses in…

[Multidisciplinary team meetings settings on the management of women at high risk of inherited breast cancer. A French study].

PubMed

Gillmann, Fanchon; Cordier, Christophe; Taris, Nicolas; Mathelin, Carole; Maugard, Christine M

2016-06-01

In France, 126 centers for cancer genetics coordinate genetic testing and high-risk cancer surveillance for individuals and their families with hereditary cancer syndromes. Since 2012, the French National Cancer Institute (INCa) supports 17 projects to promote and manage the monitoring of individuals genetically predisposed to cancer. They were assigned 4 missions by INCa including expertise for difficult cases. We initiated a national survey to assess how the oncogenetic clinics responded to the 4th mission for women at high risk of developing breast cancers. We sent the survey to all the French oncogeneticists. We aimed at evaluating the modalities and the extent of implementation of the Multidisciplinary team (MDT) meetings regarding the management of women who have genetically higher risks to develop breast cancer. Fourteen people from 12 administrative regions, who represent 10 of the 17 projects, answered the form. Eleven participants reported the submission of medical cases in Oncogenetics MDT meetings (79 %), 5 in senology MDT meetings (36 %), 5 in MDT meetings dedicated to patients at high risk for breast cancer (36 %) and 2 in network meetings (14 %). Some structures discuss medical cases through different MDT meetings. Although MDT meetings are valuable practices to optimize treatment or management options for patients, its settings might be subject to difficulties to federate the appropriate-number of participants as well as cost-effectiveness issues. This survey thus suggests the need of a standardized process of MDT meetings while taking account specificities of oncogenetics. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Implementing critical pathways and a multidisciplinary team approach to cardiovascular disease management.

PubMed

Peterson, Eric D; Albert, Nancy M; Amin, Alpesh; Patterson, J Herbert; Fonarow, Gregg C

2008-09-08

According to several medical registries, there is a need to improve the care of post-myocardial infarction (MI) patients, especially those with left ventricular dysfunction (LVD) and heart failure. This can potentially be achieved by implementing disease management programs, which include critical pathways, patient education, and multidisciplinary hospital teams. Currently, algorithms for critical pathways, including discharge processes, are lacking for post-MI LVD patients. Such schemes can increase the use of evidence-based medicines proved to reduce mortality. Educational programs are aimed at increasing patients' awareness of their condition, promoting medication compliance, and encouraging the adoption of healthy behaviors; such programs have been shown to be effective in improving outcomes of post-MI LVD patients. Reductions in all-cause hospitalizations and medical costs as well as improved survival rates have been observed when a multidisciplinary team (a nurse, a pharmacist, and a hospitalist) is engaged in patient care. In addition, the use of the "pay for performance" method, which can be advantageous for patients, physicians, and hospitals, may potentially improve the care of post-MI patients with LVD.

Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crises.

PubMed

Weller, Jennifer M; Janssen, Anna L; Merry, Alan F; Robinson, Brian

2008-04-01

We placed anaesthesia teams into a stressful environment in order to explore interactions between members of different professional groups and to investigate their perspectives on the impact of these interactions on team performance. Ten anaesthetists, 5 nurses and 5 trained anaesthetic assistants each participated in 2 full-immersion simulations of critical events using a high-fidelity computerised patient simulator. Their perceptions of team interactions were explored through questionnaires and semi-structured interviews. Written questionnaire data and interview transcriptions were entered into N6 qualitative software. Data were analysed by 2 investigators for emerging themes and coded to produce reports on each theme. We found evidence of limited understanding of the roles and capabilities of team members across professional boundaries, different perceptions of appropriate roles and responsibilities for different members of the team, limited sharing of information between team members and limited team input into decision making. There was a perceived impact on task distribution and the optimal utilisation of resources within the team. Effective management of medical emergencies depends on optimal team function. We have identified important factors affecting interactions between different health professionals in the anaesthesia team, and their perceived influences on team function. This provides evidence on which to build appropriate and specific strategies for interdisciplinary team training in operating theatre staff.

Using Simulation as an Investigational Methodology to Explore the Impact of Technology on Team Communication and Patient Management: A Pilot Evaluation of the Effect of an Automated Compression Device.

PubMed

Gittinger, Matthew; Brolliar, Sarah M; Grand, James A; Nichol, Graham; Fernandez, Rosemarie

2017-06-01

This pilot study used a simulation-based platform to evaluate the effect of an automated mechanical chest compression device on team communication and patient management. Four-member emergency department interprofessional teams were randomly assigned to perform manual chest compressions (control, n = 6) or automated chest compressions (intervention, n = 6) during a simulated cardiac arrest with 2 phases: phase 1 baseline (ventricular tachycardia), followed by phase 2 (ventricular fibrillation). Patient management was coded using an Advanced Cardiovascular Life Support-based checklist. Team communication was categorized in the following 4 areas: (1) teamwork focus; (2) huddle events, defined as statements focused on re-establishing situation awareness, reinforcing existing plans, and assessing the need to adjust the plan; (3) clinical focus; and (4) profession of team member. Statements were aggregated for each team. At baseline, groups were similar with respect to total communication statements and patient management. During cardiac arrest, the total number of communication statements was greater in teams performing manual compressions (median, 152.3; interquartile range [IQR], 127.6-181.0) as compared with teams using an automated compression device (median, 105; IQR, 99.5-123.9). Huddle events were more frequent in teams performing automated chest compressions (median, 4.0; IQR, 3.1-4.3 vs. 2.0; IQR, 1.4-2.6). Teams randomized to the automated compression intervention had a delay to initial defibrillation (median, 208.3 seconds; IQR, 153.3-222.1 seconds) as compared with control teams (median, 63.2 seconds; IQR, 30.1-397.2 seconds). Use of an automated compression device may impact both team communication and patient management. Simulation-based assessments offer important insights into the effect of technology on healthcare teams.

Multidisciplinary team approach to improved chronic care management for diabetic patients in an urban safety net ambulatory care clinic.

PubMed

Tapp, Hazel; Phillips, Shay E; Waxman, Dael; Alexander, Matthew; Brown, Rhett; Hall, Mary

2012-01-01

Since the care of patients with multiple chronic diseases such as diabetes and depression accounts for the majority of health care costs, effective team approaches to managing such complex care in primary care are needed, particularly since psychosocial and physical disorders coexist. Uncontrolled diabetes is a leading health risk for morbidity, disability and premature mortality with between 18-31% of patients also having undiagnosed or undertreated depression. Here we describe a team driven approach that initially focused on patients with poorly controlled diabetes (A1c > 9) that took place at a family medicare office. The team included: resident and faculty physicians, a pharmacist, social worker, nurses, behavioral medicine interns, office scheduler, and an information technologist. The team developed immediate integrative care for diabetic patients during routine office visits.

Difficult Discharge in Pediatric Rehabilitation Medicine Causing Moral Distress.

PubMed

Green, Michael; Carter, Brian; Lasky, Andrew

2016-01-01

An ethical dimension exists in nearly all decisions made. Yet, there are clinical decisions in which the ethical dilemma is so difficult for the clinician that it results in moral distress. We present one example of a morally distressing situation in which care was provided for a child who had altered physical abilities after a trauma and was being discharged to a suboptimal family environment. Caring for a child with an acquired spinal cord injury requires significant resources. When a family is able to physically care for the child, but has demonstrated incomplete follow-through, the team is at risk for experiencing significant moral distress.

Using Rituals to Strengthen Your Medical Practice Team.

PubMed

Hills, Laura

2015-01-01

Rituals can cement the identity of and strengthen the bonds between any people, including the members of the medical practice team. This article presents the idea that the medical practice manager is in the ideal position to create and use rituals for team building. It defines the term ritual, and explores how rituals differ from customs or traditions. As well, it describes six benefits of rituals and the hallmarks of the most effective team rituals; describes seven creative and interesting corporate rituals that medical practice managers can study for inspiration; suggests 20 excellent opportunities within the medical practice calendar year for medical practice team rituals; and identifies six kinds of rituals that are used in organizations. Finally, this article provides a four-step action plan for ritualizing your medical practice team's morning huddles.

Lead us not into tanktation: a simulation modelling approach to gain insights into incentives for sporting teams to tank.

PubMed

Tuck, Geoffrey N; Whitten, Athol R

2013-01-01

Annual draft systems are the principal method used by teams in major sporting leagues to recruit amateur players. These draft systems frequently take one of three forms: a lottery style draft, a weighted draft, or a reverse-order draft. Reverse-order drafts can create incentives for teams to deliberately under-perform, or tank, due to the perceived gain from obtaining quality players at higher draft picks. This paper uses a dynamic simulation model that captures the key components of a win-maximising sporting league, including the amateur player draft, draft choice error, player productivity, and between-team competition, to explore how competitive balance and incentives to under-perform vary according to league characteristics. We find reverse-order drafts can lead to some teams cycling between success and failure and to other teams being stuck in mid-ranking positions for extended periods of time. We also find that an incentive for teams to tank exists, but that this incentive decreases (i) as uncertainty in the ability to determine quality players in the draft increases, (ii) as the number of teams in the league reduces, (iii) as team size decreases, and (iv) as the number of teams adopting a tanking strategy increases. Simulation models can be used to explore complex stochastic dynamic systems such as sports leagues, where managers face difficult decisions regarding the structure of their league and the desire to maintain competitive balance.

Lead Us Not into Tanktation: A Simulation Modelling Approach to Gain Insights into Incentives for Sporting Teams to Tank

PubMed Central

Tuck, Geoffrey N.; Whitten, Athol R.

2013-01-01

Annual draft systems are the principal method used by teams in major sporting leagues to recruit amateur players. These draft systems frequently take one of three forms: a lottery style draft, a weighted draft, or a reverse-order draft. Reverse-order drafts can create incentives for teams to deliberately under-perform, or tank, due to the perceived gain from obtaining quality players at higher draft picks. This paper uses a dynamic simulation model that captures the key components of a win-maximising sporting league, including the amateur player draft, draft choice error, player productivity, and between-team competition, to explore how competitive balance and incentives to under-perform vary according to league characteristics. We find reverse-order drafts can lead to some teams cycling between success and failure and to other teams being stuck in mid-ranking positions for extended periods of time. We also find that an incentive for teams to tank exists, but that this incentive decreases (i) as uncertainty in the ability to determine quality players in the draft increases, (ii) as the number of teams in the league reduces, (iii) as team size decreases, and (iv) as the number of teams adopting a tanking strategy increases. Simulation models can be used to explore complex stochastic dynamic systems such as sports leagues, where managers face difficult decisions regarding the structure of their league and the desire to maintain competitive balance. PMID:24312243

Team Building

ERIC Educational Resources Information Center

Begg, Roddy

2005-01-01

A personal reminiscence of the events surrounding the establishment of Tertiary Education and Management (TEAM), the journal of the European Association for Institutional Research EAIR, the European Higher Education Society--and its development over its first decade, by the founding Editor, at the time of his retirement from the post.

Managing System of Systems Requirements with a Requirements Screening Group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald R. Barden

2012-07-01

Figuring out an effective and efficient way to manage not only your Requirement’s Baseline, but also the development of all your individual requirements during a Program’s/Project’s Conceptual and Development Life Cycle Stages can be both daunting and difficult. This is especially so when you are dealing with a complex and large System of Systems (SoS) Program with potentially thousands and thousands of Top Level Requirements as well as an equal number of lower level System, Subsystem and Configuration Item requirements that need to be managed. This task is made even more overwhelming when you have to add in integration withmore » multiple requirements’ development teams (e.g., Integrated Product Development Teams (IPTs)) and/or numerous System/Subsystem Design Teams. One solution for tackling this difficult activity on a recent large System of Systems Program was to develop and make use of a Requirements Screening Group (RSG). This group is essentially a Team made up of co-chairs from the various Stakeholders with an interest in the Program of record that are enabled and accountable for Requirements Development on the Program/Project. The RSG co-chairs, often with the help of individual support team, work together as a Program Board to monitor, make decisions on, and provide guidance on all Requirements Development activities during the Conceptual and Development Life Cycle Stages of a Program/Project. In addition, the RSG can establish and maintain the Requirements Baseline, monitor and enforce requirements traceability across the entire Program, and work with other elements of the Program/Project to ensure integration and coordination.« less

Creating a safer operating room: Groups, team dynamics and crew resource management principles.

PubMed

Wakeman, Derek; Langham, Max R

2018-04-01

The operating room (OR) is a special place wherein groups of highly skilled individuals must work in a coordinated and harmonious fashion to deliver optimal patient care. Team dynamics and human factors principles were initially studied by the aviation industry to better understand and prevent airline accidents. As a result, crew resource management (CRM) training was designed for all flight personnel to create a highly reliable industry with a commitment to a culture of safety. CRM has since been adapted to health care, resulting in care improvement and harm reduction across a wide variety of medical specialties. When implemented in the OR, CRM has been shown not only to improve communication and morale for OR staff, but also reduce morbidity and mortality for patients. As increasing focus is placed on quality, safety, and high-reliability, surgeons will be expected to participate and lead efforts to facilitate a team approach in this new era of patient care. Copyright © 2018 Elsevier Inc. All rights reserved.

Advice for running a successful research team.

PubMed

Stanley, David; Anderson, Judith

2015-11-01

To explore what is meant by a 'research team' and offer practical suggestions for supporting an effective and productive, collaborative research team. Collaborative research has become one of the main objectives of most higher education institutions and running effective research teams is central to achieving this aim. However, there is limited guidance in the literature about how to run or steer a research team. Search engines/databases used: CINAHL, Nursing and Allied Health Source, Primo search, Google search and Health Collection to access research articles and publications to support this topic. Literature search was extended to the end of 2014. Publications were reviewed for relevance to the topic via standard literature search. Research teams vary in size and composition, however they all require effective collaboration if they are to establish successful and flexible working relationships and produce useful and trustworthy research outputs. This article offers guidance for establishing and managing successful collaborative research relationships, building trust and a positive research team culture, clarifying team member roles, setting the teams' research agenda and managing the teams' functions so that team members feel able to contribute fully to the research goals and build a culture of support and apply 'emotional intelligence' throughout the process of building and running a successful research team. Collaboration is a central component of establishing successful research teams and enabling productive research outputs. This article offers guidance for research teams to help them to function more effectively and allow all members to contribute fully to each team's goals. Research teams that have established trust and a positive team culture will result in more efficient working relationships and potentially greater productivity. The advice offered reinforces the value of having research teams with diverse members from different disciplines

Managing diversity and enhancing team outcomes: the promise of transformational leadership.

PubMed

Kearney, Eric; Gebert, Diether

2009-01-01

In a sample of 62 research and development (R&D) teams, the authors examined transformational leadership as a moderator of the relationship of age, nationality, and educational background diversity with team outcomes. When levels of transformational leadership were high, nationality and educational diversity were positively related to team leaders' longitudinal ratings of team performance. These relationships were nonsignificant when transformational leadership was low. Age diversity was not related to team performance when transformational leadership was high, and it was negatively related to team performance when transformational leadership was low. Two mediated moderation effects help explain these findings. Transformational leadership moderated the relationship of the 3 examined diversity dimensions with the elaboration of task-relevant information, which in turn was positively associated with team performance. Moreover, transformational leadership moderated the relationship of the 3 diversity types with collective team identification, which in turn was positively related to the elaboration of task-relevant information. The authors discuss the theoretical and practical implications of these results. Overall, this study suggests that transformational leadership can foster the utilization of the potential, but frequently untapped, benefits entailed by both demographic and informational/cognitive team diversity. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Making the Grade and Staying Engaged: The Influence of Student Management Teams on Student Classroom Outcomes

ERIC Educational Resources Information Center

Troisi, Jordan D.

2014-01-01

The use of student management teams (SMTs) is a relatively new teaching technique designed to increase the quality of college courses and student performance and engagement within those courses. However, to date, little systematic, empirical research has validated the effectiveness of using SMTs. To test the effectiveness of this technique, the…

The impact of the multidisciplinary team in the management of individuals with diabetic foot ulcers: a systematic review.

PubMed

Buggy, A; Moore, Z

2017-06-02

To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team. Data were extracted using a bespoke data extraction tool and quality appraisal of the studies was undertaken using the EBL Critical Appraisal checklist. Data analysis was undertaken using RevMan with results presented as odds ratio for dichotomous data, or mean difference for continuous data, all with the associated 95% confidence intervals. The search identified 19 eligible studies. Severity of amputation, death rates and length of hospital stay of clients receiving multidisciplinary team care were improved when compared with those who did not receive multidisciplinary team care. Ulcer healing and quality of life showed an improvement but not all studies explored these outcomes. Only 7 of the 19 articles appraised were found to be of acceptable quality, questioning the generalisability of the results. From the currently available evidence a positive impact of the multidisciplinary team on diabetic foot outcomes can be seen, but due to the lack of high-quality evidence and substantial heterogeneity in the studies, these results should be interpreted with caution.

Updates from the AmeriFlux Management Project Tech Team

NASA Astrophysics Data System (ADS)

Biraud, S.; Chan, S.; Dengel, S.; Polonik, P.; Hanson, C. V.; Billesbach, D. P.; Torn, M. S.

2017-12-01

The goal of AmeriFlux is to develop a network of long-term flux sites for quantifying and understanding the role of the terrestrial biosphere in global climate and environmental change. The AmeriFlux Management Program (AMP) Tech Team at LBNL strengthens the AmeriFlux Network by (1) standardizing operational practices, (2) developing calibration and maintenance routines, and (3) setting clear data quality goals. In this poster we will present results and recent progress in three areas: IRGA intercomparison experiment in cooperation with UC Davis, and main manufacturers of sensors used in the AmeriFlux network (LI-COR, Picarro, and Campbell Scientific). Gill sonic anemometers characterization in collaboration with John Frank and Bill Massman (US Forest Service) following the discovery of a significant firmware problem in commonly used Gill Sonic anemometer, Unmanned aerial systems (UAS), and sensors systematically used at AmeriFlux sites to improve site characterization.

Extra-team Connections for Knowledge Transfer between Staff Teams

ERIC Educational Resources Information Center

Ramanadhan, Shoba; Wiecha, Jean L.; Emmons, Karen M.; Gortmaker, Steven L.; Viswanath, Kasisomayajula

2009-01-01

As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties…

Interdiscplinary team processes within an in-home service delivery organization.

PubMed

Gantert, Thomas W; McWilliam, Carol L

2004-01-01

Interdisciplinary teamwork is particularly difficult to achieve in the community context where geographical separateness and solo practices impede face to face contact and collaborative practice. Understanding the processes that occur within interdisciplinary teams is imperative, since client outcomes are influenced by interdisciplinary teamwork. The purpose of this exploratory study was to describe the processes that occur within interdisciplinary teams that deliver in-home care. Applying grounded theory methodology, the researcher conducted unstructured in-depth interviews with a purposeful sample of healthcare providers and used constant comparative analysis to elicit the findings. Findings revealed three key team processes: networking, navigating, and aligning. The descriptions afford several insights that are applicable to in-home healthcare agencies attempting to achieve effective interdisciplinary team functioning.

Neuroergonomics: Quantitative Modeling of Individual, Shared, and Team Neurodynamic Information.

PubMed

Stevens, Ronald H; Galloway, Trysha L; Willemsen-Dunlap, Ann

2018-06-01

The aim of this study was to use the same quantitative measure and scale to directly compare the neurodynamic information/organizations of individual team members with those of the team. Team processes are difficult to separate from those of individual team members due to the lack of quantitative measures that can be applied to both process sets. Second-by-second symbolic representations were created of each team member's electroencephalographic power, and quantitative estimates of their neurodynamic organizations were calculated from the Shannon entropy of the symbolic data streams. The information in the neurodynamic data streams of health care ( n = 24), submarine navigation ( n = 12), and high school problem-solving ( n = 13) dyads was separated into the information of each team member, the information shared by team members, and the overall team information. Most of the team information was the sum of each individual's neurodynamic information. The remaining team information was shared among the team members. This shared information averaged ~15% of the individual information, with momentary levels of 1% to 80%. Continuous quantitative estimates can be made from the shared, individual, and team neurodynamic information about the contributions of different team members to the overall neurodynamic organization of a team and the neurodynamic interdependencies among the team members. Information models provide a generalizable quantitative method for separating a team's neurodynamic organization into that of individual team members and that shared among team members.

Effectiveness of multidisciplinary team case management: difference-in-differences analysis

PubMed Central

Kristensen, Søren Rud; Checkland, Kath; Bower, Peter

2016-01-01

Objectives To evaluate a multidisciplinary team (MDT) case management intervention, at the individual (direct effects of intervention) and practice levels (potential spillover effects). Design Difference-in-differences design with multiple intervention start dates, analysing hospital admissions data. In secondary analyses, we stratified individual-level results by risk score. Setting Single clinical commissioning group (CCG) in the UK's National Health Service (NHS). Participants At the individual level, we matched 2049 intervention patients using propensity scoring one-to-one with control patients. At the practice level, 30 practices were compared using a natural experiment through staged implementation. Intervention Practice Integrated Care Teams (PICTs), using MDT case management of high-risk patients together with a summary record of care versus usual care. Direct and indirect outcome measures Primary measures of intervention effects were accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays; outpatient visits; and admissions for ambulatory care sensitive conditions. Secondary measures included inpatient length of stay; total cost of secondary care services; and patient satisfaction (at the practice level only). Results At the individual level, we found slight, clinically trivial increases in inpatient non-elective admissions (+0.01 admissions per patient per month; 95% CI 0.00 to 0.01. Effect size (ES): 0.02) and 30-day re-admissions (+0.00; 0.00 to 0.01. ES: 0.03). We found no indication that highest risk patients benefitted more from the intervention. At the practice level, we found a small decrease in inpatient non-elective admissions (−0.63 admissions per 1000 patients per month; −1.17 to −0.09. ES: −0.24). However, this result did not withstand a robustness check; the estimate may have absorbed some differences in underlying practice trends. Conclusions The intervention does not meet its

Building a leadership team that works.

PubMed

Blomenberg, Emily M

2005-01-01

Radiology administrators often are challenged to do more with less. In today's fast-paced work environment, leaders must be creative. They must surround themselves with good people in order to successfully achieve their organizations' goals. Once a radiology administrator is satisfied and comfortable that he or she has, the right staff involved, a leadership team can be formally establislished. Howard Regional Health System established an Imaging Services Leadership Team with a vision to provide leaders for the staff to "follow," just as team members learn from the radiology administrator. In addition, team members are vital in assisting the radiology administrator in managing the department The process of building the team consisted of 3 steps: selecting team members (the most challenging and time-consuming component), formalizing a functional team, and putting the team into action. Finding the right people, holding regular meetings, and making those team meetings meaningful are keys to a successful leadership team. The implementation of the team has had a positive effect on imaging services: the number of procedures has increased, the team is used as a communication tool for front-line staff, front-line staff are becoming more comfortable with making decisions.

Managing Student Behavior with Class-Wide Function-Related Intervention Teams: An Observational Study in Early Elementary Classrooms

ERIC Educational Resources Information Center

Caldarella, Paul; Williams, Leslie; Hansen, Blake D.; Wills, Howard

2015-01-01

Comprehensive evidence-based interventions are needed to help early childhood educators manage challenging student behaviors. One such intervention, class-wide function-related intervention teams (CW-FIT), is a multi-tiered behavioral intervention program based on positive behavior support principles, including four main elements: (a) teaching…

Terrible Twos: Why Are 2-Year-Olds So Difficult?

MedlinePlus

... about the terrible twos. Why are 2-year-olds so difficult? Answers from Jay L. Hoecker, M. ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

Team-based learning for midwifery education.

PubMed

Moore-Davis, Tonia L; Schorn, Mavis N; Collins, Michelle R; Phillippi, Julia; Holley, Sharon

2015-01-01

Many US health care and education stakeholder groups, recognizing the need to prepare learners for collaborative practice in complex care environments, have called for innovative approaches in health care education. Team-based learning is an educational method that relies on in-depth student preparation prior to class, individual and team knowledge assessment, and use of small-group learning to apply knowledge to complex scenarios. Although team-based learning has been studied as an approach to health care education, its application to midwifery education is not well described. A master's-level, nurse-midwifery, didactic antepartum course was revised to a team-based learning format. Student grades, course evaluations, and aggregate American Midwifery Certification Board examination pass rates for 3 student cohorts participating in the team-based course were compared with 3 student cohorts receiving traditional, lecture-based instruction. Students had mixed responses to the team-based learning format. Student evaluations improved when faculty added recorded lectures as part of student preclass preparation. Statistical comparisons were limited by variations across cohorts; however, student grades and certification examination pass rates did not change substantially after the course revision. Although initial course revision was time-consuming for faculty, subsequent iterations of the course required less effort. Team-based learning provides students with more opportunity to interact during on-site classes and may spur application of knowledge into practice. However, it is difficult to assess the effect of the team-based learning approach with current measures. Further research is needed to determine the effects of team-based learning on communication and collaboration skills, as well as long-term performance in clinical practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional

Simulated Trauma and Resuscitation Team Training course-evolution of a multidisciplinary trauma crisis resource management simulation course.

PubMed

Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy

2016-07-01

We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating scale and an Advanced Trauma Life Support primary survey checklist. Eleven "trauma teams," consisting of physicians, nurses, and respiratory therapists, each completed 4 crisis simulations over 3 courses. Satisfaction remained high among participants with overall mean satisfaction being 4.39 on a 5-point Likert scale. As participants progressed through scenarios, improvements in global rating scale scores were seen between the 1st and 4th (29.8 vs 36.1 of 42, P = .022), 2nd and 3rd (28.2 vs 34.6, P = .017), and 2nd and 4th (28.2 vs 36.1, P = .003) scenarios. There were no differences in Advanced Trauma Life Support checklist with mean scores for each scenario ranging 11.3 to 13.2 of 17. The evolved Simulated Trauma and Resuscitative Team Training curriculum has maintained high participant satisfaction and is associated with improvement in team crisis resource management skills over the duration of the course. Copyright © 2015 Elsevier Inc. All rights reserved.

Building a comprehensive team for the longitudinal care of single ventricle heart defects: Building blocks and initial results.

PubMed

Texter, Karen; Davis, Jo Ann M; Phelps, Christina; Cheatham, Sharon; Cheatham, John; Galantowicz, Mark; Feltes, Timothy F

2017-07-01

With increasing survival of children with HLHS and other single ventricle lesions, the complexity of medical care for these patients is substantial. Establishing and adhering to best practice models may improve outcome, but requires careful coordination and monitoring. In 2013 our Heart Center began a process to build a comprehensive Single Ventricle Team designed to target these difficult issues. Comprehensive Single Ventricle Team in 2014 was begun, to standardize care for children with single ventricle heart defects from diagnosis to adulthood within our institution. The team is a multidisciplinary group of providers committed to improving outcomes and quality of life for children with single ventricle heart defects, all functioning within the medical home of our heart center. Standards of care were developed and implemented in five target areas to standardize medical management and patient and family support. Under the team 100 patients have been cared for. Since 2014 a decrease in interstage mortality for HLHS were seen. Using a team approach and the tools of Quality Improvement they have been successful in reaching high protocol compliance for each of these areas. This article describes the process of building a successful Single Ventricle team, our initial results, and lessons learned. Additional study is ongoing to demonstrate the effects of these interventions on patient outcomes. © 2017 Wiley Periodicals, Inc.

Endoscopic management of bile duct stones: residual bile duct stones after surgery, cholangitis, and "difficult stones".

PubMed

Karsenti, D

2013-06-01

Endoscopic treatment has become, according to the latest recommendations, the standard treatment for common bile duct stones (CBDS), although in certain situations, surgical clearance of the common duct at the time of laparoscopic cholecystectomy is still considered a possible alternative. The purpose of this article is not to compare endoscopic with surgical treatment of CBDS, but to describe the various techniques of endoscopic treatment, detailing their preferential indications and the various treatment options that must sometimes be considered when faced with "difficult calculi" of the CBD. The different techniques of lithotripsy and the role of biliary drainage with plastic or metallic stents will be detailed as well as papillary balloon dilatation and particularly the technique of sphincterotomy with macrodilatation of the sphincter of Oddi (SMSO), a recently described approach that has changed the strategy for endoscopic management of CBDS. Finally, the overall strategy for endoscopic management of CBDS, with description of different techniques, will be exposed. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Parameters for Successful Management of Cross Cultural Virtual Teams

ERIC Educational Resources Information Center

Gullett, Evelyn; Sixl-Daniell, Karin

2008-01-01

Virtual teams are a common phenomenon in organizations today. Universities are no exception to this trend and, in response, are offering class rooms without boundaries by introducing online programs which allow individuals from all walks of life and diverse geographical locations to come together. Cross-cultural virtual teams, collaborating with…

A quantitative perspective on ethics in large team science.

PubMed

Petersen, Alexander M; Pavlidis, Ioannis; Semendeferi, Ioanna

2014-12-01

The gradual crowding out of singleton and small team science by large team endeavors is challenging key features of research culture. It is therefore important for the future of scientific practice to reflect upon the individual scientist's ethical responsibilities within teams. To facilitate this reflection we show labor force trends in the US revealing a skewed growth in academic ranks and increased levels of competition for promotion within the system; we analyze teaming trends across disciplines and national borders demonstrating why it is becoming difficult to distribute credit and to avoid conflicts of interest; and we use more than a century of Nobel prize data to show how science is outgrowing its old institutions of singleton awards. Of particular concern within the large team environment is the weakening of the mentor-mentee relation, which undermines the cultivation of virtue ethics across scientific generations. These trends and emerging organizational complexities call for a universal set of behavioral norms that transcend team heterogeneity and hierarchy. To this end, our expository analysis provides a survey of ethical issues in team settings to inform science ethics education and science policy.

How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

PubMed

Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J

2008-07-01

In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new