Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare.

PubMed

Weller, Jennifer; Boyd, Matt; Cumin, David

2014-03-01

Modern healthcare is delivered by multidisciplinary, distributed healthcare teams who rely on effective teamwork and communication to ensure effective and safe patient care. However, we know that there is an unacceptable rate of unintended patient harm, and much of this is attributed to failures in communication between health professionals. The extensive literature on teams has identified shared mental models, mutual respect and trust and closed-loop communication as the underpinning conditions required for effective teams. However, a number of challenges exist in the healthcare environment. We explore these in a framework of educational, psychological and organisational challenges to the development of effective healthcare teams. Educational interventions can promote a better understanding of the principles of teamwork, help staff understand each other's roles and perspectives, and help develop specific communication strategies, but may not be sufficient on their own. Psychological barriers, such as professional silos and hierarchies, and organisational barriers such as geographically distributed teams, can increase the chance of communication failures with the potential for patient harm. We propose a seven-step plan to overcome the barriers to effective team communication that incorporates education, psychological and organisational strategies. Recent evidence suggests that improvement in teamwork in healthcare can lead to significant gains in patient safety, measured against efficiency of care, complication rate and mortality. Interventions to improve teamwork in healthcare may be the next major advance in patient outcomes.

Towards a Better Distributed Framework for Learning Big Data

DTIC Science & Technology

2017-06-14

UNLIMITED: PB Public Release 13. SUPPLEMENTARY NOTES 14. ABSTRACT This work aimed at solving issues in distributed machine learning. The PI’s team proposed...communication load. Finally, the team proposed the parallel least-squares policy iteration (parallel LSPI) to parallelize a reinforcement policy learning. 15

KEYNOTE 2 : Rebuilding the Tower of Babel - Better Communication with Standards

DTIC Science & Technology

2013-02-01

and a member of the Object Management Group (OMG) SysML specification team. He has been developing multi-national complex systems for almost 35 years...critical systems development, virtual team management, systems development, and software development with UML, SysML and Architectural Frameworks

Interprofessional communication training: benefits to practicing pharmacists.

PubMed

Luetsch, Karen; Rowett, Debra

2015-10-01

Interprofessional communication skills are important for pharmacists to build collaborative relationships with other health professionals, integrate into healthcare teams, maximise their effectiveness in patient care in addressing complex care needs and meet the demands of health care reforms. This qualitative study explores clinical pharmacists' experiences and reflections after completing a learning and practice module which introduced them to a framework for successful interprofessional communication. The postgraduate clinical pharmacy program at The University of Queensland and the clinical pharmacy practice environments of forty-eight hospital and seven community based pharmacists. A learning and practice module outlining a framework for successful interprofessional communication was designed and integrated into a postgraduate clinical pharmacy program. Enrolled pharmacists applied newly learnt communication skills in pro-actively initiated, clinical discussions with a health professional in their practice environment. They provided written reflections on their experiences which were analysed using thematic analysis. Pharmacists' perceptions of the impact of applying the communication framework during their interaction with a health professional in their practice setting. Themes which emerged from reflections described pharmacists' confidence and capabilities to successfully conduct a clinical discussion with a health professional after initial apprehension and nervousness about the scheduled interaction. The application of the communication framework enhanced their perception of their professional identity, credibility and ability to build a collaborative working relationship with other health professionals. Pharmacists perceived that a learning and practice module for successful interprofessional practice integrated into a postgraduate clinical pharmacy program enhanced their interprofessional communication skills. The development of pro-active, interprofessional communication skills has the potential to increase interprofessional collaboration and pharmacists' personal role satisfaction. Pharmacists also observed it added value to their professional contribution in health care teams when addressing the demands of increasingly complex health care needs and reforms.

Development of an Interdisciplinary Team Communication Framework and Quality Metrics for Home-Based Medical Care Practices.

PubMed

Fathi, Roya; Sheehan, Orla C; Garrigues, Sarah K; Saliba, Debra; Leff, Bruce; Ritchie, Christine S

2016-08-01

The unique needs of homebound adults receiving home-based medical care (HBMC) (ie, home-based primary care and home-based palliative care services) are ideally provided by interdisciplinary care teams (IDTs) that provide coordinated care. The composition of team members from an array of organizations and the unique dimension of providing care in the home present specific challenges to timely access and communication of patient care information. The objective of this work was to develop a conceptual framework and corresponding quality indicators (QIs) that assess how IDT members for HBMC practices access and communicate key patient information with each other. A systematic review of peer-reviewed and gray literature was performed to inform a framework for care coordination in the home and the development of candidate QIs to assess processes by which all IDT members optimally access and use patient information. A technical expert panel (TEP) participated in a modified Delphi process to assess the validity and feasibility of each QI and to identify which would be most suitable for testing in the field. Thematic analysis of literature revealed 4 process themes for how HBMC practices might engage in high-quality care coordination: using electronic medical records, conducting interdisciplinary team meetings, sharing standardized patient assessments, and communicating via secure e-messaging. Based on these themes, 9 candidate QIs were developed to reflect these processes. Three candidate QIs were assessed by the TEP as valid and feasible to measure in an HBMC practice setting. These indicators focused on use of IDT meetings, standardized patient assessments, and secure e-messaging. Translating the complex issue of care coordination into QIs will improve care delivered to vulnerable home-limited adults who receive HBMC. Guided by the literature, we developed a framework to reflect optimal care coordination in the home setting and identified 3 candidate QIs to field-test in HBMC practices. Published by Elsevier Inc.

A Collaborative, Ongoing University Strategic Planning Framework: Process, Landmines, and Lessons

ERIC Educational Resources Information Center

Hill, Susan E. Kogler; Thomas, Edward G.; Keller, Lawrence F.

2009-01-01

This article examines the strategic planning process at Cleveland State University, a large metropolitan state university in Ohio. A faculty-administrative team used a communicative planning approach to develop a collaborative, ongoing, bottom-up, transparent strategic planning process. This team then spearheaded the process through plan…

Decision Accuracy in Computer-Mediated versus Face-to-Face Decision-Making Teams.

PubMed

Hedlund; Ilgen; Hollenbeck

1998-10-01

Changes in the way organizations are structured and advances in communication technologies are two factors that have altered the conditions under which group decisions are made. Decisions are increasingly made by teams that have a hierarchical structure and whose members have different areas of expertise. In addition, many decisions are no longer made via strictly face-to-face interaction. The present study examines the effects of two modes of communication (face-to-face or computer-mediated) on the accuracy of teams' decisions. The teams are characterized by a hierarchical structure and their members differ in expertise consistent with the framework outlined in the Multilevel Theory of team decision making presented by Hollenbeck, Ilgen, Sego, Hedlund, Major, and Phillips (1995). Sixty-four four-person teams worked for 3 h on a computer simulation interacting either face-to-face (FtF) or over a computer network. The communication mode had mixed effects on team processes in that members of FtF teams were better informed and made recommendations that were more predictive of the correct team decision, but leaders of CM teams were better able to differentiate staff members on the quality of their decisions. Controlling for the negative impact of FtF communication on staff member differentiation increased the beneficial effect of the FtF mode on overall decision making accuracy. Copyright 1998 Academic Press.

Center for Plasma Edge Simulation (CPES) -- Rutgers University Final Report

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

Parashar, Manish

2014-03-06

The CPES scientific simulations run at scale on leadership class machines, collaborate at runtime and produce and exchange large data sizes, which present multiple I/O and data management challenges. During the CPES project, the Rutgers team worked with the rest of the CPES team to address these challenges at different levels, and specifically (1) at the data transport and communication level through the DART (Decoupled and Asynchronous Remote Data Transfers) framework, and (2) at the data management and services level through the DataSpaces and ActiveSpaces frameworks. These frameworks and their impact are briefly described.

Auditing Staff-Management Communication in Schools: A Framework for Evaluating Performance.

ERIC Educational Resources Information Center

Tourish, Dennis; Hargie, Owen

1998-01-01

Outlines the principles and procedures of an organizational communication audit as a measure of the effectiveness of personnel management in elementary and secondary schools, examining the principal tools used and the benefits that this approach offers to school management teams. (Author/MSE)

Online Collaborative Learning and Communication Media

ERIC Educational Resources Information Center

Havard, Byron; Du, Jianxia; Xu, Jianzhong

2008-01-01

The purpose of this study is to examine the dynamics of online collaborative learning and communication media regarding team projects. Media richness and social presence theories are well-accepted rational theories that explain media choices and media behaviors, and serve as the theoretical framework. Quantitative and qualitative data collection…

PACs: A Framework for Determining Appropriate Service Delivery Options.

ERIC Educational Resources Information Center

Blosser, Jean L.; Kratcoski, Annette

1997-01-01

Offers speech-language clinicians a framework for team decision making and service delivery by encouraging speech-language pathologists and their colleagues to consider the unique combination of providers, activities, and contexts (PACs) necessary to meet the specific needs of each individual with a communication disorder. Sample cases involving…

Better team management--better team care?

PubMed

Shelley, P; Powney, B

1994-01-01

Team building should not be a 'bolt-on' extra, it should be a well planned, integrated part of developing teams and assisting their leaders. When asked to facilitate team building by a group of NHS managers we developed a framework which enabled individual members of staff to become more effective in the way they communicated with each other, their teams and in turn within the organization. Facing the challenge posed by complex organizational changes, staff were able to use 3 training days to increase and develop their awareness of the principles of teamwork, better team management, and how a process of leadership and team building could help yield better patient care.

A review of instruments to measure interprofessional team-based primary care.

PubMed

Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard

2016-07-01

Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings.

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.

Physician communication in the operating room.

PubMed

Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

2015-01-01

In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education.

Before the Emergency: A Framework for Evaluating Emergency Preparedness Alternatives at Higher Education Institutions

DTIC Science & Technology

2010-09-01

Operations and Procedures • Logistics and Facilities • Training • Exercises, Evaluation and Corrective Actions • Crisis Communications ...Assessment Team BCA Benefit-cost analysis CEO Chief Executive Officer CERT Community Emergency Response Team CFR Code of Federal Regulations...CHDS Center for Homeland Defense and Security CPG 101 Comprehensive Preparedness Guidelines 101 CPP Community Preparedness and Participation CPW

Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care.

PubMed

Boscart, Veronique M; Heckman, George A; Huson, Kelsey; Brohman, Lisa; Harkness, Karen I; Hirdes, John; McKelvie, Robert S; Stolee, Paul

2017-09-01

Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.

Tactical assessment in a squad of intelligent bots

NASA Astrophysics Data System (ADS)

Gołuński, Marcel; Wasiewicz, Piotr

2010-09-01

In this paper we explore the problem of communication and coordination in a team of intelligent game bots (aka embodied agents). It presents a tactical decision making system controlling the behavior of an autonomous bot followed by the concept of a team tactical decision making system controlling the team of intelligent bots. The algorithms to be introduced have been implemented in the Java language by means of Pogamut 2 framework, interfacing the bot logic with Unreal Tournament 2004 virtual environment.

Using an interprofessional competency framework to examine collaborative practice.

PubMed

Hepp, Shelanne L; Suter, Esther; Jackson, Karen; Deutschlander, Siegrid; Makwarimba, Edward; Jennings, Jake; Birmingham, Lisa

2015-03-01

Healthcare organisations are starting to implement collaborative practice to increase the quality of patient care. However, operationalising and measuring progress towards collaborative practice has proven to be difficult. Various interprofessional competency frameworks have been developed that outline essential collaborative practice competencies for healthcare providers. If these competencies were enacted to their fullest, collaborative practice would be at its best. This article examines collaborative practice in six acute care units across Alberta using the Canadian Interprofessional Health Collaborative (CIHC) competency framework (CIHC, 2010 ). The framework entails the six competencies of patient-centred care, communication, role clarification, conflict resolution, team functioning and collaborative leadership (CIHC, 2010 ). We conducted a secondary analysis of interviews with 113 healthcare providers from different professions, which were conducted as part of a quality improvement study. We found positive examples of communication and patient-centred care supported by unit structures and processes (e.g. rapid rounds and collaborative plan of care). Some gaps in collaborative practice were found for role clarification and collaborative leadership. Conflict resolution and team functioning were not well operationalised on these units. Strategies are presented to enhance each competency domain in order to fully enact collaborative practice. Using the CIHC competency framework to examine collaborative practice was useful for identifying strength and areas needing improvement.

Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings.

PubMed

Koenig, Christopher J; Maguen, Shira; Daley, Aaron; Cohen, Greg; Seal, Karen H

2013-01-01

Handoffs are communication processes that enact the transfer of responsibility between providers across clinical settings. Prior research on handoff communication has focused on inpatient settings between provider teams and has emphasized patient safety. This study examines handoff communication within multidisciplinary provider teams in two outpatient settings. To conduct an exploratory study that describes handoff communication among multidisciplinary providers, to develop a theory-driven descriptive framework for outpatient handoffs, and to evaluate the strengths and weaknesses of different handoff types. Qualitative, in-depth, semi-structured interviews with 31 primary care, mental health, and social work providers in two Department of Veterans Affairs (VA) Medical Center outpatient clinics. Audio-recorded interviews were transcribed and analyzed using Grounded Practical Theory to develop a theoretical model of and a descriptive framework for handoff communication among multidisciplinary providers. Multidisciplinary providers reported that handoff decisions across settings were made spontaneously and without clear guidelines. Two situated values, clinic efficiency and patient-centeredness, shaped multidisciplinary providers' handoff decisions. Providers reported three handoff techniques along a continuum: the electronic handoff, which was the most clinically efficient; the provider-to-provider handoff, which balanced clinic efficiency and patient-centeredness; and the collaborative handoff, which was the most patient-centered. Providers described handoff choice as a practical response to manage constituent features of clinic efficiency (time, space, medium of communication) and patient-centeredness (information continuity, management continuity, relational continuity, and social interaction). We present a theoretical and descriptive framework to help providers evaluate differential handoff use, reflect on situated values guiding clinic communication, and guide future research. Handoff communication reflected multidisciplinary providers' efforts to balance clinic efficiency with patient-centeredness within the constraints of day-to-day clinical practice. Evaluating the strengths and weaknesses among alternative handoff options may enhance multidisciplinary provider handoff decision-making and may contribute to increased coordination and continuity of care across outpatient settings.

Interdisciplinary Research: Performance and Policy Issues.

ERIC Educational Resources Information Center

Rossini, Frederick A.; Porter, Alan L.

1981-01-01

Successful interdisciplinary research performance, it is suggested, depends on such structural and process factors as leadership, team characteristics, study bounding, iteration, communication patterns, and epistemological factors. Appropriate frameworks for socially organizing the development of knowledge such as common group learning, modeling,…

Devising a consensus definition and framework for non-technical skills in healthcare to support educational design: A modified Delphi study.

PubMed

Gordon, Morris; Baker, Paul; Catchpole, Ken; Darbyshire, Daniel; Schocken, Dawn

2015-01-01

Non-technical skills are a subset of human factors that focus on the individual and promote safety through teamwork and awareness. There is no widely adopted competency- or outcome-based framework for non-technical skills training in healthcare. The authors set out to devise such a framework using a modified Delphi approach. An exhaustive list of published and team suggested items was presented to the expert panel for ranking and to propose a definition. In the second round, a focused list was presented, as well as the proposed definition elements. The finalised framework was sent to the panel for review. Sixteen experts participated. The final framework consists of 16 competencies for all and eight specific competencies for team leaders. The consensus definition describes non-technical skills as "a set of social (communication and team work) and cognitive (analytical and personal behaviour) skills that support high quality, safe, effective and efficient inter-professional care within the complex healthcare system". The authors have produced a new competency framework, through the works of an International expert panel, which is not discipline specific that can be used by curriculum developers, educational innovators and clinical teachers to support developments in the field.

Interprofessional experiences of recent healthcare graduates: A social psychology perspective on the barriers to effective communication, teamwork, and patient-centred care.

PubMed

Thomson, Krist; Outram, Sue; Gilligan, Conor; Levett-Jones, Tracy

2015-01-01

Achieving safe, quality health care is highly dependent on effective communication between all members of the healthcare team. This study explored the attitudes and experiences of recent healthcare graduates regarding interprofessional teamwork and communication within a clinical setting. A total of 68 pharmacy, nursing, and medicine graduates participated in 12 semi-structured focus group discussions in clinical workplaces across three Australian states. Discussion focussed on graduates' experiences of interprofessional education and its impact on their capacity for interprofessional teamwork and communication. The Social Identity and Realistic Conflict theories were used as a framework for qualitative data analysis. A consistent pattern of profession-focussed, rather than patient- or team-focussed goals was revealed along with reports of negative stereotyping, hierarchical communication, and competition for time with the patient. Graduates acknowledged the importance of communication, teamwork, and patient-centred care and felt a better understanding of the roles of other health professionals would assist them to work together for patients' wellbeing. Identifying workplace identities and differential goals has uncovered possible motivations underlying health professionals' behaviour. These insights may help improve interprofessional collaboration by focusing attention on common team goals, increasing feelings of worth and being valued among different professionals, and decreasing the need for competition.

Shared communication processes within healthcare teams for rare diseases and their influence on healthcare professionals' innovative behavior and patient satisfaction

PubMed Central

2011-01-01

Background A rare disease is a pattern of symptoms that afflicts less than five in 10,000 patients. However, as about 6,000 different rare disease patterns exist, they still have significant epidemiological relevance. We focus on rare diseases that affect multiple organs and thus demand that multidisciplinary healthcare professionals (HCPs) work together. In this context, standardized healthcare processes and concepts are mainly lacking, and a deficit of knowledge induces uncertainty and ambiguity. As such, individualized solutions for each patient are needed. This necessitates an intensive level of innovative individual behavior and thus, adequate idea generation. The final implementation of new healthcare concepts requires the integration of the expertise of all healthcare team members, including that of the patients. Therefore, knowledge sharing between HCPs and shared decision making between HCPs and patients are important. The objective of this study is to assess the contribution of shared communication and decision-making processes in patient-centered healthcare teams to the generation of innovative concepts and consequently to improvements in patient satisfaction. Methods A theoretical framework covering interaction processes and explorative outcomes, and using patient satisfaction as a measure for operational performance, was developed based on healthcare management, innovation, and social science literature. This theoretical framework forms the basis for a three-phase, mixed-method study. Exploratory phase I will first involve collecting qualitative data to detect central interaction barriers within healthcare teams. The results are related back to theory, and testable hypotheses will be derived. Phase II then comprises the testing of hypotheses through a quantitative survey of patients and their HCPs in six different rare disease patterns. For each of the six diseases, the sample should comprise an average of 30 patients with six HCP per patient-centered healthcare team. Finally, in phase III, qualitative data will be generated via semi-structured telephone interviews with patients to gain a deeper understanding of the communication processes and initiatives that generate innovative solutions. Discussion The findings of this proposed study will help to elucidate the necessity of individualized innovative solutions for patients with rare diseases. Therefore, this study will pinpoint the primary interaction and communication processes in multidisciplinary teams, as well as the required interplay between exploratory outcomes and operational performance. Hence, this study will provide healthcare institutions and HCPs with results and information essential for elaborating and implementing individual care solutions through the establishment of appropriate interaction and communication structures and processes within patient-centered healthcare teams. PMID:21510848

Shared communication processes within healthcare teams for rare diseases and their influence on healthcare professionals' innovative behavior and patient satisfaction.

PubMed

Hannemann-Weber, Henrike; Kessel, Maura; Budych, Karolina; Schultz, Carsten

2011-04-21

A rare disease is a pattern of symptoms that afflicts less than five in 10,000 patients. However, as about 6,000 different rare disease patterns exist, they still have significant epidemiological relevance. We focus on rare diseases that affect multiple organs and thus demand that multidisciplinary healthcare professionals (HCPs) work together. In this context, standardized healthcare processes and concepts are mainly lacking, and a deficit of knowledge induces uncertainty and ambiguity. As such, individualized solutions for each patient are needed. This necessitates an intensive level of innovative individual behavior and thus, adequate idea generation. The final implementation of new healthcare concepts requires the integration of the expertise of all healthcare team members, including that of the patients. Therefore, knowledge sharing between HCPs and shared decision making between HCPs and patients are important. The objective of this study is to assess the contribution of shared communication and decision-making processes in patient-centered healthcare teams to the generation of innovative concepts and consequently to improvements in patient satisfaction. A theoretical framework covering interaction processes and explorative outcomes, and using patient satisfaction as a measure for operational performance, was developed based on healthcare management, innovation, and social science literature. This theoretical framework forms the basis for a three-phase, mixed-method study. Exploratory phase I will first involve collecting qualitative data to detect central interaction barriers within healthcare teams. The results are related back to theory, and testable hypotheses will be derived. Phase II then comprises the testing of hypotheses through a quantitative survey of patients and their HCPs in six different rare disease patterns. For each of the six diseases, the sample should comprise an average of 30 patients with six HCP per patient-centered healthcare team. Finally, in phase III, qualitative data will be generated via semi-structured telephone interviews with patients to gain a deeper understanding of the communication processes and initiatives that generate innovative solutions. The findings of this proposed study will help to elucidate the necessity of individualized innovative solutions for patients with rare diseases. Therefore, this study will pinpoint the primary interaction and communication processes in multidisciplinary teams, as well as the required interplay between exploratory outcomes and operational performance. Hence, this study will provide healthcare institutions and HCPs with results and information essential for elaborating and implementing individual care solutions through the establishment of appropriate interaction and communication structures and processes within patient-centered healthcare teams.

Desert Research and Technology Studies (DRATS) 2010 science operations: Operational approaches and lessons learned for managing science during human planetary surface missions

NASA Astrophysics Data System (ADS)

Eppler, Dean; Adams, Byron; Archer, Doug; Baiden, Greg; Brown, Adrian; Carey, William; Cohen, Barbara; Condit, Chris; Evans, Cindy; Fortezzo, Corey; Garry, Brent; Graff, Trevor; Gruener, John; Heldmann, Jennifer; Hodges, Kip; Hörz, Friedrich; Hurtado, Jose; Hynek, Brian; Isaacson, Peter; Juranek, Catherine; Klaus, Kurt; Kring, David; Lanza, Nina; Lederer, Susan; Lofgren, Gary; Marinova, Margarita; May, Lisa; Meyer, Jonathan; Ming, Doug; Monteleone, Brian; Morisset, Caroline; Noble, Sarah; Rampe, Elizabeth; Rice, James; Schutt, John; Skinner, James; Tewksbury-Christle, Carolyn M.; Tewksbury, Barbara J.; Vaughan, Alicia; Yingst, Aileen; Young, Kelsey

2013-10-01

Desert Research and Technology Studies (Desert RATS) is a multi-year series of hardware and operations tests carried out annually in the high desert of Arizona on the San Francisco Volcanic Field. These activities are designed to exercise planetary surface hardware and operations in conditions where long-distance, multi-day roving is achievable, and they allow NASA to evaluate different mission concepts and approaches in an environment less costly and more forgiving than space. The results from the RATS tests allow selection of potential operational approaches to planetary surface exploration prior to making commitments to specific flight and mission hardware development. In previous RATS operations, the Science Support Room has operated largely in an advisory role, an approach that was driven by the need to provide a loose science mission framework that would underpin the engineering tests. However, the extensive nature of the traverse operations for 2010 expanded the role of the science operations and tested specific operational approaches. Science mission operations approaches from the Apollo and Mars-Phoenix missions were merged to become the baseline for this test. Six days of traverse operations were conducted during each week of the 2-week test, with three traverse days each week conducted with voice and data communications continuously available, and three traverse days conducted with only two 1-hour communications periods per day. Within this framework, the team evaluated integrated science operations management using real-time, tactical science operations to oversee daily crew activities, and strategic level evaluations of science data and daily traverse results during a post-traverse planning shift. During continuous communications, both tactical and strategic teams were employed. On days when communications were reduced to only two communications periods per day, only a strategic team was employed. The Science Operations Team found that, if communications are good and down-linking of science data is ensured, high quality science returns is possible regardless of communications. What is absent from reduced communications is the scientific interaction between the crew on the planet and the scientists on the ground. These scientific interactions were a critical part of the science process and significantly improved mission science return over reduced communications conditions. The test also showed that the quality of science return is not measurable by simple numerical quantities but is, in fact, based on strongly non-quantifiable factors, such as the interactions between the crew and the Science Operations Teams. Although the metric evaluation data suggested some trends, there was not sufficient granularity in the data or specificity in the metrics to allow those trends to be understood on numerical data alone.

Desert Research and Technology Studies (DRATS) 2010 Science Operations: Operational Approaches and Lessons Learned for Managing Science during Human Planetary Surface Missions

NASA Technical Reports Server (NTRS)

Eppler, Dean; Adams, Byron; Archer, Doug; Baiden, Greg; Brown, Adrian; Carey, William; Cohen, Barbara; Condit, Chris; Evans, Cindy; Fortezzo, Corey;

Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

PubMed

Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

2016-11-01

Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

Patients' views of teamwork in the emergency department offer insights about team performance.

PubMed

Henry, Beverly W; McCarthy, Danielle M; Nannicelli, Anna P; Seivert, Nicholas P; Vozenilek, John A

2016-06-01

Research into efforts to engage patients in the assessment of health-care teams is limited. To explore, through qualitative methods, patient awareness of teamwork-related behaviours observed during an emergency department (ED) visit. Researchers used semi-structured question guides for audio-recorded interviews and analysed their verbatim transcripts. Researchers conducted individual phone interviews with 6 teamwork subject matter experts (SMEs) and held 5 face-to-face group interviews with patients and caregivers (n = 25) about 2 weeks after discharge from the emergency department (ED). SMEs suggested that a range of factors influence patient perspectives of teams. Many patients perceived the health-care team within the context of their expectations of an ED visit and their treatment plan. Four themes emerged: (i) patient-centred views highlight gaps in coordination and communication; (ii) team processes do concern patients; (iii) patients are critical observers of ways that team members present their team roles; (iv) patients' observations of team members relate to patients' views of team effectiveness. Analysis also indicated that patients viewed health-care team members' interactions with each other as proxy for how team members actually felt about patients. Results from both sets of interviews (SME and patient) indicated that patient observations of teamwork could add to assessment of team processes/frameworks. Patients' understanding about teamwork organization seemed helpful and witnessed interteam communication appeared to influence patient confidence in the team. Patients perspectives are an important part of assessment in health care and suggest potential areas for improvement through team training. © 2013 John Wiley & Sons Ltd.

Ubiquitous computing to support co-located clinical teams: using the semiotics of physical objects in system design.

PubMed

Bang, Magnus; Timpka, Toomas

2007-06-01

Co-located teams often use material objects to communicate messages in collaboration. Modern desktop computing systems with abstract graphical user interface (GUIs) fail to support this material dimension of inter-personal communication. The aim of this study is to investigate how tangible user interfaces can be used in computer systems to better support collaborative routines among co-located clinical teams. The semiotics of physical objects used in team collaboration was analyzed from data collected during 1 month of observations at an emergency room. The resulting set of communication patterns was used as a framework when designing an experimental system. Following the principles of augmented reality, physical objects were mapped into a physical user interface with the goal of maintaining the symbolic value of those objects. NOSTOS is an experimental ubiquitous computing environment that takes advantage of interaction devices integrated into the traditional clinical environment, including digital pens, walk-up displays, and a digital desk. The design uses familiar workplace tools to function as user interfaces to the computer in order to exploit established cognitive and collaborative routines. Paper-based tangible user interfaces and digital desks are promising technologies for co-located clinical teams. A key issue that needs to be solved before employing such solutions in practice is associated with limited feedback from the passive paper interfaces.

[Social forces and the communicative scenario in health education: the case of the growth and development program].

PubMed

Peñaranda-Correa, Fernando

2011-10-01

to understand how the significance of child rearing is construed in the Growth and Development Monitoring Program as a way of studying health education and enhancing its theoretical and pedagogical framework. an ethnographic study in four health institutions in Medellín, Colombia, developed through observation of sessions and interviews with actors, namely significant adults and health team members. a communicative process based on a behavioral education model is established to modify behavior and to impose cultural values. the pedagogical setting or micro-context is influenced by powerful macro-contextual forces, which are a product of uneven distribution of social, cultural and economic capital. Consequently, significant adults and health team members are situated at two different communicative levels for the construction of significance, which affects communication between them. Understanding this social process from a wider theoretical perspective strengthens critical positions, which is required for achieving more pertinent health education from a socio-cultural dimension.

A Framework for Successful Research Experiences in the Classroom: Combining the Power of Technology and Mentors

NASA Technical Reports Server (NTRS)

Graff, Paige Valderrama; Stefanov, William L.; Willis, Kim; Runco, Susan; McCollum, Tim; Lindgren, Charles F.; Baker, Marshalyn; Mailhot, Michele

2011-01-01

Authentic research opportunities in the classroom are most impactful when they are student-driven and inquiry-based. These experiences are even more powerful when they involve technology and meaningful connections with scientists. In today's classrooms, activities are driven by state required skills, education standards, and state mandated testing. Therefore, programs that incorporate authentic research must address the needs of teachers. NASA's Expedition Earth and Beyond (EEAB) Program has developed a framework that addresses teacher needs and incorporates the use of technology and access to mentors to promote and enhance authentic research in the classroom. EEAB is a student involvement program that facilitates student investigations of Earth or planetary comparisons using NASA data. To promote student-led research, EEAB provides standards-aligned, inquiry-based curricular resources, an implementation structure to facilitate research, educator professional development, and ongoing support. This framework also provides teachers with the option to incorporate the use of technology and connect students with a mentor, both of which can enrich student research experiences. The framework is structured by a modeled 9-step process of science which helps students organize their research. With more schools gaining increased access to technology, EEAB has created an option to help schools take advantage of students' interest and comfort with technology by leveraging the use of available technologies to enhance student research. The use of technology not only allows students to collaborate and share their research, it also provides a mechanism for them to work with a mentor. This framework was tested during the 2010/2011 school year. Team workspaces hosted on Wikispaces for Educators allow students to initiate their research and refine their research question initially without external input. This allows teams to work independently and rely on the skills and interests of team members. Once teams finalize their research question, they are assigned a mentor. The mentor introduces himself/herself, acknowledges the initial work the team has conducted, and asks a focused question to help open the lines of communication. Students continue to communicate with their mentor throughout their research. As research is completed, teams can share their investigation during a virtual presentation. These live presentations allow students to share their research with their mentor, other scientists, other students, parents, and school administrators. After the initial year of testing this authentic research process, EEAB is working to address the many lessons learned. This will allow the program to refine and improve the overall process in an effort to maximize the benefits. Combined, these powerful strategies provide a successful framework to help teachers enhance the skills and motivation of their students, preparing them to become the next generation of scientists, explorers, and STEM-literate citizens of our nation.

A Framework for Successful Research Experiences in the Classroom: Combining the Power of Technology and Mentors

NASA Astrophysics Data System (ADS)

Graff, P. V.; Stefanov, W. L.; Willis, K.; Runco, S.; McCollum, T.; Lindgren, C. F.; Baker, M.; Mailhot, M.

2011-12-01

Authentic research opportunities in the classroom are most impactful when they are student-driven and inquiry-based. These experiences are even more powerful when they involve technology and meaningful connections with scientists. In today's classrooms, activities are driven by state required skills, education standards, and state mandated testing. Therefore, programs that incorporate authentic research must address the needs of teachers. NASA's Expedition Earth and Beyond (EEAB) Program has developed a framework that addresses teacher needs and incorporates the use of technology and access to mentors to promote and enhance authentic research in the classroom. EEAB is a student involvement program that facilitates student investigations of Earth or planetary comparisons using NASA data. To promote student-led research, EEAB provides standards-aligned, inquiry-based curricular resources, an implementation structure to facilitate research, educator professional development, and ongoing support. This framework also provides teachers with the option to incorporate the use of technology and connect students with a mentor, both of which can enrich student research experiences. The framework is structured by a modeled 9-step process of science which helps students organize their research. With more schools gaining increased access to technology, EEAB has created an option to help schools take advantage of students' interest and comfort with technology by leveraging the use of available technologies to enhance student research. The use of technology not only allows students to collaborate and share their research, it also provides a mechanism for them to work with a mentor. This framework was tested during the 2010/2011 school year. Team workspaces hosted on Wikispaces for Educators allow students to initiate their research and refine their research question initially without external input. This allows teams to work independently and rely on the skills and interests of team members. Once teams finalize their research question, they are assigned a mentor. The mentor introduces himself/herself, acknowledges the initial work the team has conducted, and asks a focused question to help open the lines of communication. Students continue to communicate with their mentor throughout their research. As research is completed, teams can share their investigation during a virtual presentation. These live presentations allow students to share their research with their mentor, other scientists, other students, parents, and school administrators. After the initial year of testing this authentic research process, EEAB is working to address the many lessons learned. This will allow the program to refine and improve the overall process in an effort to maximize the benefits. Combined, these powerful strategies provide a successful framework to help teachers enhance the skills and motivation of their students, preparing them to become the next generation of scientists, explorers, and STEM-literate citizens of our nation.

Do learning collaboratives strengthen communication? A comparison of organizational team communication networks over time.

PubMed

Bunger, Alicia C; Lengnick-Hall, Rebecca

Collaborative learning models were designed to support quality improvements, such as innovation implementation by promoting communication within organizational teams. Yet the effect of collaborative learning approaches on organizational team communication during implementation is untested. The aim of this study was to explore change in communication patterns within teams from children's mental health organizations during a year-long learning collaborative focused on implementing a new treatment. We adopt a social network perspective to examine intraorganizational communication within each team and assess change in (a) the frequency of communication among team members, (b) communication across organizational hierarchies, and (c) the overall structure of team communication networks. A pretest-posttest design compared communication among 135 participants from 21 organizational teams at the start and end of a learning collaborative. At both time points, participants were asked to list the members of their team and rate the frequency of communication with each along a 7-point Likert scale. Several individual, pair-wise, and team level communication network metrics were calculated and compared over time. At the individual level, participants reported communicating with more team members by the end of the learning collaborative. Cross-hierarchical communication did not change. At the team level, these changes manifested differently depending on team size. In large teams, communication frequency increased, and networks grew denser and slightly less centralized. In small teams, communication frequency declined, growing more sparse and centralized. Results suggest that team communication patterns change minimally but evolve differently depending on size. Learning collaboratives may be more helpful for enhancing communication among larger teams; thus, managers might consider selecting and sending larger staff teams to learning collaboratives. This study highlights key future research directions that can disentangle the relationship between learning collaboratives and team networks.

Backtrack Programming: A Computer-Based Approach to Group Problem Solving.

ERIC Educational Resources Information Center

Scott, Michael D.; Bodaken, Edward M.

Backtrack problem-solving appears to be a viable alternative to current problem-solving methodologies. It appears to have considerable heuristic potential as a conceptual and operational framework for small group communication research, as well as functional utility for the student group in the small group class or the management team in the…

Mixed Methods Research with Internally Displaced Colombian Gay and Bisexual Men and Transwomen

ERIC Educational Resources Information Center

Zea, Maria Cecilia; Aguilar-Pardo, Marcela; Betancourt, Fabian; Reisen, Carol A.; Gonzales, Felisa

2014-01-01

We discuss the use of mixed methods research to further understanding of displaced Colombian gay and bisexual men and transwomen, a marginalized population at risk. Within the framework of communicative action, which calls for social change through egalitarian dialog, we describe how our multinational, interdisciplinary research team explored the…

Organizing for teamwork in healthcare: an alternative to team training?

PubMed

Rydenfält, Christofer; Odenrick, Per; Larsson, Per Anders

2017-05-15

Purpose The purpose of this paper is to explore how organizational design could support teamwork and to identify organizational design principles that promote successful teamwork. Design/methodology/approach Since traditional team training sessions take resources away from production, the alternative approach pursued here explores the promotion of teamwork by means of organizational design. A wide and pragmatic definition of teamwork is applied: a team is considered to be a group of people that are set to work together on a task, and teamwork is then what they do in relation to their task. The input - process - output model of teamwork provides structure to the investigation. Findings Six teamwork enablers from the healthcare team literature - cohesion, collaboration, communication, conflict resolution, coordination, and leadership - are discussed, and the organizational design measures required to implement them are identified. Three organizational principles are argued to facilitate the teamwork enablers: team stability, occasions for communication, and a participative and adaptive approach to leadership. Research limitations/implications The findings could be used as a foundation for intervention studies to improve team performance or as a framework for evaluation of existing organizations. Practical implications By implementing these organizational principles, it is possible to achieve many of the organizational traits associated with good teamwork. Thus, thoughtful organization for teamwork can be used as an alternative or complement to the traditional team training approach. Originality/value With regards to the vast literature on team training, this paper offers an alternative perspective on how to improve team performance in healthcare.

Contributions of team climate in the study of interprofessional collaboration: A conceptual analysis.

PubMed

Agreli, Heloise F; Peduzzi, Marina; Bailey, Christopher

2017-11-01

The concept of team climate is widely used to understand and evaluate working environments. It shares some important features with Interprofessional Collaboration (IPC). The four-factor theory of climate for work group innovation, which underpins team climate, could provide a better basis for understanding both teamwork and IPC. This article examines in detail the common ground between team climate and IPC, and assesses the relevance of team climate as a theoretical approach to understanding IPC. There are important potential areas of overlap between team climate and IPC that we have grouped under four headings: (1) interaction and communication between team members; (2) common objectives around which collective work is organised; (3) responsibility for performing work to a high standard; and (4) promoting innovation in working practices. These overlapping areas suggest common characteristics that could provide elements of a framework for considering the contribution of team climate to collaborative working, both from a conceptual perspective and, potentially, in operational terms as, for example, a diagnostic tool.

Care coordination in intensive care units: communicating across information spaces.

PubMed

Miller, Anne; Weinger, Matthew B; Buerhaus, Peter; Dietrich, Mary S

2010-04-01

This study explores the interactions among phases of team coordination, patient-related information, decision-making levels, and role holders in intensive care units (ICUs). The effects of communication improvement initiatives on adverse patient events or improved outcomes have been difficult to establish. Conceptual inconsistencies and methodological shortcomings suggest insufficient understanding about clinical communication and care coordination. Data were collected by shadowing a charge nurse, fellow, resident, and nurse in each of eight ICUs and recording each of their conversations during 12 hrs (32 role holders during 350 hrs). Hierarchical log linear analyses show statistically significant three-way interactions between the patient information, phases of team coordination, and decision levels, chi2(df = 75) = 212, p < .0001; between roles, phases of team coordination, and decision levels, chi2(df = 60) = 109, p < .0001; and between roles, patient information, and decision levels, chi2(df = 60) = 155, p < .0001. Differences among levels of the variables were evaluated with the use of standardized parameter estimates and 95% confidence intervals. ICU communication and care coordination involve complex decision structures and role interactions across two information spaces. Different role holders mediate vertical and lateral process flows with goals and directions representing an important conceptual transition. However, lateral isolation within decision levels (charge nurses) and information overload (residents) are potential communication and care coordination vulnerabilities. Results are consistent with and extend the findings of previous studies. The profile of ICU communication and care coordination provides a systemic framework that may inform future interventions and research.

Ten principles of good interdisciplinary team work

PubMed Central

2013-01-01

Background Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. Method This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. Results Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. Conclusions We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate. PMID:23663329

Ten principles of good interdisciplinary team work.

PubMed

Nancarrow, Susan A; Booth, Andrew; Ariss, Steven; Smith, Tony; Enderby, Pam; Roots, Alison

2013-05-10

Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate.

Cognitive continuum theory in interprofessional healthcare: A critical analysis.

PubMed

Parker-Tomlin, Michelle; Boschen, Mark; Morrissey, Shirley; Glendon, Ian

2017-07-01

Effective clinical decision making is among the most important skills required by healthcare practitioners. Making sound decisions while working collaboratively in interprofessional healthcare teams is essential for modern healthcare planning, successful interventions, and patient care. The cognitive continuum theory (CCT) is a model of human judgement and decision making aimed at orienting decision-making processes. CCT has the potential to improve both individual health practitioner, and interprofessional team understanding about, and communication of, clinical decision-making processes. Examination of the current application of CCT indicates that this theory could strengthen interprofessional team clinical decision making (CDM). However, further research is needed before extending the use of this theoretical framework to a wider range of interprofessional healthcare team processes. Implications for research, education, practice, and policy are addressed.

Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital.

PubMed

Bernardes, Andrea; Cummings, Greta; Évora, Yolanda Dora Martinez; Gabriel, Carmen Silvia

2012-01-01

This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization.

Team effectiveness in academic medical libraries: a multiple case study*

PubMed Central

Russo Martin, Elaine

2006-01-01

Objectives: The objective of this study is to apply J. Richard Hackman's framework on team effectiveness to academic medical library settings. Methods: The study uses a qualitative, multiple case study design, employing interviews and focus groups to examine team effectiveness in three academic medical libraries. Another site was selected as a pilot to validate the research design, field procedures, and methods to be used with the cases. In all, three interviews and twelve focus groups, with approximately seventy-five participants, were conducted at the case study libraries. Findings: Hackman identified five conditions leading to team effectiveness and three outcomes dimensions that defined effectiveness. The participants in this study identified additional characteristics of effectiveness that focused on enhanced communication, leadership personality and behavior, and relationship building. The study also revealed an additional outcome dimension related to the evolution of teams. Conclusions: Introducing teams into an organization is not a trivial matter. Hackman's model of effectiveness has implications for designing successful library teams. PMID:16888659

What parents and carers think medical students should be learning about communication with children and families.

PubMed

Hammond, Margaret; McLean, Elspeth

2009-09-01

Our objective was to dynamically engage with parents and carers of children treated in a large children's hospital as experts by experience, to find out what they thought medical students should be learning about communicating with children and families in order to inform our communication teaching. We used focus groups to facilitate parents and carers in articulating the communication issues they felt were important for medical students to learn. These data were analysed, using qualitative and quantitative methods, to produce a survey for a Delphi consultation. The results of this stage were mapped onto the Calgary-Cambridge framework for the medical interview. There was considerable overlap of the data on the Calgary-Cambridge framework. There was, however, an emphasis by respondents on perceptual skills, self-awareness and partnership. Within the main tasks of the Calgary-Cambridge framework, new objectives emerged, including giving information in the right place, and the importance of the family in the multidisciplinary team. A new main task, Preparation, was highlighted. Active collaboration with parents and carers revealed areas for enhancement in our communication skill teaching, particularly with regard to relational and perceptual skills. Ways of including effective teaching of perceptual skills and the relational and humanistic aspects of communication must be explored in order to meet the needs of child patients and their families.

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.

Ontario's emergency department process improvement program: the experience of implementation.

PubMed

Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

2015-06-01

In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the development and implementation of future similar interventions in health care settings could be useful. © 2015 by the Society for Academic Emergency Medicine.

A competency framework for librarians involved in systematic reviews.

PubMed

Townsend, Whitney A; Anderson, Patricia F; Ginier, Emily C; MacEachern, Mark P; Saylor, Kate M; Shipman, Barbara L; Smith, Judith E

2017-07-01

The project identified a set of core competencies for librarians who are involved in systematic reviews. A team of seven informationists with broad systematic review experience examined existing systematic review standards, conducted a literature search, and used their own expertise to identify core competencies and skills that are necessary to undertake various roles in systematic review projects. The team identified a total of six competencies for librarian involvement in systematic reviews: "Systematic review foundations," "Process management and communication," "Research methodology," "Comprehensive searching," "Data management," and "Reporting." Within each competency are the associated skills and knowledge pieces (indicators). Competence can be measured using an adaptation of Miller's Pyramid for Clinical Assessment, either through self-assessment or identification of formal assessment instruments. The Systematic Review Competencies Framework provides a standards-based, flexible way for librarians and organizations to identify areas of competence and areas in need of development to build capacity for systematic review integration. The framework can be used to identify or develop appropriate assessment tools and to target skill development opportunities.

Team Communication Influence on Procedure Performance: Findings From Interprofessional Simulations with Nursing and Medical Students.

PubMed

Reising, Deanna L; Carr, Douglas E; Gindling, Sally; Barnes, Roxie; Garletts, Derrick; Ozdogan, Zulfukar

Interprofessional team performance is believed to be dependent on the development of effective team communication skills. Yet, little evidence exists in undergraduate nursing programs on whether team communication skills affect team performance. A secondary analysis of a larger study on interprofessional student teams in simulations was conducted to determine if there is a relationship between team communication and team procedure performance. The results showed a positive, significant correlation between interprofessional team communication ratings and procedure accuracy in the simulation. Interprofessional team training in communication skills for nursing and medical students improves the procedure accuracy in a simulated setting.

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

PubMed Central

Lie, Désirée A.; Forest, Christopher P.; Walsh, Anne; Banzali, Yvonne; Lohenry, Kevin

2016-01-01

Background The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students. Purpose To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. Methods The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Results Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Discussion Interprofessional SRC participation promotes learning ‘with, from, and about’ each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice. PMID:27499364

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care.

PubMed

Lie, Désirée A; Forest, Christopher P; Walsh, Anne; Banzali, Yvonne; Lohenry, Kevin

2016-01-01

Background The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students. Purpose To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. Methods The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Results Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Discussion Interprofessional SRC participation promotes learning 'with, from, and about' each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice.

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care.

PubMed

Lie, Désirée A; Forest, Christopher P; Walsh, Anne; Banzali, Yvonne; Lohenry, Kevin

2016-01-01

The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students. To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Interprofessional SRC participation promotes learning 'with, from, and about' each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice.

Interprofessional Teamwork Innovation Model (ITIM) to promote communication and patient-centred, coordinated care.

PubMed

Li, Jing; Talari, Preetham; Kelly, Andrew; Latham, Barbara; Dotson, Sherri; Manning, Kim; Thornsberry, Lisa; Swartz, Colleen; Williams, Mark V

2018-02-14

Despite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM). This quality improvement (QI) study was conducted at an academic medical centre. We followed the system's QI framework, FOCUS-PDSA, with Lean as guiding principles. Primary outcomes included 30-day all-cause same-hospital readmissions and 30-day emergency department (ED) visits. The intervention group consisted of patients receiving care on two hospitalist ITIM teams, and patients receiving care from other hospitalist teams were matched with a control group. Outcomes were assessed using difference-in-difference analysis. Team members reported enhanced communication and overall time savings. In multivariate modelling, patients discharged from hospitalist teams using the ITIM approach were associated with reduced 30-day same-hospital readmissions with an estimated point OR of 0.56 (95% CI 0.34 to 0.92), but there was no impact on 30-day same-hospital ED visits. Difference-in-difference analysis showed that ITIM was not associated with changes in average total direct costs nor average cost per patient day, after adjusting for all other covariates in the models, despite the addition of staff resources in the ITIM model. The ITIM approach facilitates a collaborative environment in which patients and their family caregivers, physicians, nurses, pharmacists, case managers and others work and share in the process of care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improving collaborative learning in online software engineering education

NASA Astrophysics Data System (ADS)

Neill, Colin J.; DeFranco, Joanna F.; Sangwan, Raghvinder S.

2017-11-01

Team projects are commonplace in software engineering education. They address a key educational objective, provide students critical experience relevant to their future careers, allow instructors to set problems of greater scale and complexity than could be tackled individually, and are a vehicle for socially constructed learning. While all student teams experience challenges, those in fully online programmes must also deal with remote working, asynchronous coordination, and computer-mediated communications all of which contribute to greater social distance between team members. We have developed a facilitation framework to aid team collaboration and have demonstrated its efficacy, in prior research, with respect to team performance and outcomes. Those studies indicated, however, that despite experiencing improved project outcomes, students working in effective software engineering teams did not experience significantly improved individual achievement. To address this deficiency we implemented theoretically grounded refinements to the collaboration model based upon peer-tutoring research. Our results indicate a modest, but statistically significant (p = .08), improvement in individual achievement using this refined model.

Impact of clinical leadership development on the clinical leader, nursing team and care-giving process: a case study.

PubMed

Dierckx de Casterlé, Bernadette; Willemse, An; Verschueren, Marc; Milisen, Koen

2008-09-01

This study explored the dynamics related to a leadership development programme and their impact on the clinical leader, the nursing team and the care-giving process. While there is a growing conviction about the need to invest in transformational leadership in nursing, further insight into the true complexity of leadership development and, more specifically, how leadership can make a difference in nursing and patient outcomes is essential. A single instrumental case study was conducted in a unit of a large academic hospital where a Clinical Leadership development Project (CLP) was implemented successfully. We used mixed methods with multiple sources of data to capture the complexity of leadership development. Data were collected through individual interviews, focus groups and observation of participants. A purposive sample of 17 participants representing a wide variety of team members has permitted data saturation. The data were categorized and conceptualized and finally organized into a framework describing leadership development on the unit and its impact on the leader, the nursing team and the care-giving process. Leadership development is an ongoing, interactive process between the clinical leader and the co-workers. The head nurse became more effective in areas of self-awareness, communication skills, performance and vision. The nursing team benefited because more effective leadership promoted effective communication, greater responsibility, empowerment and job clarity. Improved clinical leadership seemed also to influence patient-centred communication, continuity of care and interdisciplinary collaboration. The results of the study give more insight into the processes underlying the leader's progress towards attaining a transformational leadership style and its impact on the team members. The impact of leadership on the care-giving process, however, remains difficult to describe. The interactive nature of leadership development makes CLP a challenge for the leader as well for the team members. Through its impact on the leader and the nursing team, CLP is a valuable instrument for improving work environments of nurses, contributing positively to patient-centred care.

Radio Gaga? Intra-team communication of Australian Rules Football umpires - effect of radio communication on content, structure and frequency.

PubMed

Neville, Timothy J; Salmon, Paul M; Read, Gemma J M

2018-02-01

Intra-team communication plays an important role in team effectiveness in various domains including sport. As such, it is a key consideration when introducing new tools within systems that utilise teams. The difference in intra-team communication of Australian Rules Football (AFL) umpiring teams was studied when umpiring with or without radio communications technology. A cross-sectional observational study was conducted to analyse the verbal communication of seven umpiring teams (20 participants) grouped according to their experience with radio communication. The results identified that radio communication technology increased the frequency and altered the structure of intra-team communication. Examination of the content of the intra-team communication identified impacts on the 'Big Five' teamwork behaviours and associated coordinating mechanisms. Analysis revealed that the communications utilised did not align with the closed-loop form of communication described in the Big Five model. Implications for teamwork models, coaching and training of AFL umpires are discussed. Practitioner Summary: Assessing the impact of technology on performance is of interest to ergonomics practitioners. The impact of radio communications on teamwork is explored in the highly dynamic domain of AFL umpiring. When given radio technology, intra-team communication increased which supported teamwork behaviours, such as backup behaviour and mutual performance monitoring.

The Role of Communication During Trauma Activations: Investigating the Need for Team and Leader Communication Training.

PubMed

Raley, Jessica; Meenakshi, Rani; Dent, Daniel; Willis, Ross; Lawson, Karla; Duzinski, Sarah

Fatal errors due to miscommunication among members of trauma teams are 2 to 4 times more likely to occur than in other medical teams, yet most trauma team members do not receive communication effectiveness training. A needs assessment was conducted to examine trauma team members' miscommunication experiences and research scientists' evaluations of live trauma activations. The purpose of this study is to demonstrate that communication training is necessary and highlight specific team communication competencies that trauma teams should learn to improve communication during activations. Data were collected in 2 phases. Phase 1 required participants to complete a series of surveys. Phase 2 included live observations and assessments of pediatric trauma activations using the assessment of pediatric resuscitation team assessments (APRC-TA) and assessment of pediatric resuscitation leader assessments (APRC-LA). Data were collected at a southwestern pediatric hospital. Trauma team members and leaders completed surveys at a meeting and were observed while conducting activations in the trauma bay. Trained research scientists and clinical staff used the APRC-TA and APRC-LA to measure trauma teams' medical performance and communication effectiveness. The sample included 29 healthcare providers who regularly participate in trauma activations. Additionally, 12 live trauma activations were assessed monday to friday from 8am to 5pm. Team members indicated that communication training should focus on offering assistance, delegating duties, accepting feedback, and controlling emotional expressions. Communication scores were not significantly different from medical performance scores. None of the teams were coded as effective medical performance and ineffective team communication and only 1 team was labeled as ineffective leader communication and effective medical performance. Communication training may be necessary for trauma teams and offer a deeper understanding of the communication competencies that should be addressed. The APRC-TA and APRC-LA both include team communication competencies that could be used as a guide to design training for trauma team members and leaders. Researchers should also continue to examine recommendations for improved team and leader communication during activations using in-depth interviews and focus groups. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Investigating the effect of nurse-team communication on nurse turnover: relationships among communication processes, identification, and intent to leave.

PubMed

Apker, Julie; Propp, Kathleen M; Ford, Wendy S Zabava

2009-03-01

Enhanced team communication may strengthen nurses' attachment to their organizations and teams and improve nurse retention. This study examines the relationships among nurse-team communication, identification (organizational and team), and intent to leave. Hospital nurses (N = 201) completed surveys measuring 3 nurse-team communication processes: promoting team synergy, ensuring quality decisions, and individualizing communication. Hierarchical regression analyses revealed that promoting team synergy was a significant predictor of intent to leave, whereas ensuring quality decisions and individualizing communication did not account for significant additional variance in intent to leave. Separate analyses showed that the relationship between promoting team synergy and intent to leave was partially mediated by team identification or by organizational identification. Further analyses were conducted on the 7 communication practices for promoting team synergy. Mentoring emerged as the only significant predictor of intent to leave; however, its relationship to intent to leave was fully mediated by organizational identification or partially mediated by team identification. Pragmatic suggestions are offered to improve nurse identification and reduce turnover.

Why saying what you mean matters: An analysis of trauma team communication.

PubMed

Jung, Hee Soo; Warner-Hillard, Charles; Thompson, Ryan; Haines, Krista; Moungey, Brooke; LeGare, Anne; Shaffer, David Williamson; Pugh, Carla; Agarwal, Suresh; Sullivan, Sarah

2018-02-01

We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork. Interdisciplinary trauma simulations were conducted. Team performance was rated using the TEAM tool. Team communication was coded for grammatical form and communicative intent. The rate of mixed mode communication (MMC) was calculated. MMC rates were compared to overall TEAM scores. Statements with advisement intent (attempts to guide behavior) and edification intent (objective information) were specifically examined. The rates of MMC with advisement intent (aMMC) and edification intent (eMMC) were also compared to TEAM scores. TEAM scores did not correlate with MMC or eMMC. However, aMMC rates negatively correlated with total TEAM scores (r = -0.556, p = 0.025) and with the TEAM task management component scores (r = -0.513, p = 0.042). Trauma teams with lower rates of mixed mode communication with advisement intent had better non-technical skills as measured by TEAM. Copyright © 2017 Elsevier Inc. All rights reserved.

Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: a reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation.

PubMed

Nancarrow, Susan A; Smith, Tony; Ariss, Steven; Enderby, Pamela M

2015-07-01

Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team. © 2014 John Wiley & Sons Ltd.

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.

Measuring patterns in team interaction sequences using a discrete recurrence approach.

PubMed

Gorman, Jamie C; Cooke, Nancy J; Amazeen, Polemnia G; Fouse, Shannon

2012-08-01

Recurrence-based measures of communication determinism and pattern information are described and validated using previously collected team interaction data. Team coordination dynamics has revealed that"mixing" team membership can lead to flexible interaction processes, but keeping a team "intact" can lead to rigid interaction processes. We hypothesized that communication of intact teams would have greater determinism and higher pattern information compared to that of mixed teams. Determinism and pattern information were measured from three-person Uninhabited Air Vehicle team communication sequences over a series of 40-minute missions. Because team members communicated using push-to-talk buttons, communication sequences were automatically generated during each mission. The Composition x Mission determinism effect was significant. Intact teams' determinism increased over missions, whereas mixed teams' determinism did not change. Intact teams had significantly higher maximum pattern information than mixed teams. Results from these new communication analysis methods converge with content-based methods and support our hypotheses. Because they are not content based, and because they are automatic and fast, these new methods may be amenable to real-time communication pattern analysis.

Climate uniformity: its influence on team communication quality, task conflict, and team performance.

PubMed

González-Romá, Vicente; Hernández, Ana

2014-11-01

We investigated whether climate uniformity (the pattern of climate perceptions of organizational support within the team) is related to task conflict, team communication quality, and team performance. We used a sample composed of 141 bank branches and collected data at 3 time points. The results obtained showed that, after controlling for aggregate team climate, climate strength, and their interaction, a type of nonuniform climate pattern (weak dissimilarity) was directly related to task conflict and team communication quality. Teams with weak dissimilarity nonuniform patterns tended to show higher levels of task conflict and lower levels of team communication quality than teams with uniform climate patterns. The relationship between weak dissimilarity patterns and team performance was fully mediated by team communication quality. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

A qualitative analysis of communication between members of a hospital-based multidisciplinary lung cancer team.

PubMed

Rowlands, S; Callen, J

2013-01-01

The aim of the study was to explore how patient information is communicated between health professionals within a multidisciplinary hospital-based lung cancer team and to identify mechanisms to improve these communications. A qualitative method was employed using semi-structured in-depth interviews with a representative sample (n = 22) of members of a multidisciplinary hospital-based lung cancer team including medical, nursing and allied health professionals. Analysis was undertaken using a thematic grounded theory approach to derive key themes to describe communication patterns within the team and how communication could be improved. Two themes with sub-themes were identified: (1) characteristics of communication between team members including the impact of role on direction of communications, and doctors' dominance in communications; and (2) channels of communication including, preference for face-to-face and the suboptimal roles of the Multidisciplinary Team Meeting and the hospital medical record as mediums for communication. Traditional influences of role delineation and the dominance of doctors were found to impact on communication within the multidisciplinary hospital-based lung cancer team. Existing guidelines on implementation of multidisciplinary cancer care fail to address barriers to effective team communication. The paper-based medical record does not support team communications and alternative electronic solutions need to be used. © 2012 Blackwell Publishing Ltd.

Developing a medication communication framework across continuums of care using the Circle of Care Modeling approach.

PubMed

Kitson, Nicole A; Price, Morgan; Lau, Francis Y; Showler, Grey

2013-10-17

Medication errors are a common type of preventable errors in health care causing unnecessary patient harm, hospitalization, and even fatality. Improving communication between providers and between providers and patients is a key aspect of decreasing medication errors and improving patient safety. Medication management requires extensive collaboration and communication across roles and care settings, which can reduce (or contribute to) medication-related errors. Medication management involves key recurrent activities (determine need, prescribe, dispense, administer, and monitor/evaluate) with information communicated within and between each. Despite its importance, there is a lack of conceptual models that explore medication communication specifically across roles and settings. This research seeks to address that gap. The Circle of Care Modeling (CCM) approach was used to build a model of medication communication activities across the circle of care. CCM positions the patient in the centre of his or her own healthcare system; providers and other roles are then modeled around the patient as a web of relationships. Recurrent medication communication activities were mapped to the medication management framework. The research occurred in three iterations, to test and revise the model: Iteration 1 consisted of a literature review and internal team discussion, Iteration 2 consisted of interviews, observation, and a discussion group at a Community Health Centre, and Iteration 3 consisted of interviews and a discussion group in the larger community. Each iteration provided further detail to the Circle of Care medication communication model. Specific medication communication activities were mapped along each communication pathway between roles and to the medication management framework. We could not map all medication communication activities to the medication management framework; we added Coordinate as a separate and distinct recurrent activity. We saw many examples of coordination activities, for instance, Medical Office Assistants acting as a liaison between pharmacists and family physicians to clarify prescription details. Through the use of CCM we were able to unearth tacitly held knowledge to expand our understanding of medication communication. Drawing out the coordination activities could be a missing piece for us to better understand how to streamline and improve multi-step communication processes with a goal of improving patient safety.

Developing a medication communication framework across continuums of care using the Circle of Care Modeling approach

PubMed Central

2013-01-01

Background Medication errors are a common type of preventable errors in health care causing unnecessary patient harm, hospitalization, and even fatality. Improving communication between providers and between providers and patients is a key aspect of decreasing medication errors and improving patient safety. Medication management requires extensive collaboration and communication across roles and care settings, which can reduce (or contribute to) medication-related errors. Medication management involves key recurrent activities (determine need, prescribe, dispense, administer, and monitor/evaluate) with information communicated within and between each. Despite its importance, there is a lack of conceptual models that explore medication communication specifically across roles and settings. This research seeks to address that gap. Methods The Circle of Care Modeling (CCM) approach was used to build a model of medication communication activities across the circle of care. CCM positions the patient in the centre of his or her own healthcare system; providers and other roles are then modeled around the patient as a web of relationships. Recurrent medication communication activities were mapped to the medication management framework. The research occurred in three iterations, to test and revise the model: Iteration 1 consisted of a literature review and internal team discussion, Iteration 2 consisted of interviews, observation, and a discussion group at a Community Health Centre, and Iteration 3 consisted of interviews and a discussion group in the larger community. Results Each iteration provided further detail to the Circle of Care medication communication model. Specific medication communication activities were mapped along each communication pathway between roles and to the medication management framework. We could not map all medication communication activities to the medication management framework; we added Coordinate as a separate and distinct recurrent activity. We saw many examples of coordination activities, for instance, Medical Office Assistants acting as a liaison between pharmacists and family physicians to clarify prescription details. Conclusions Through the use of CCM we were able to unearth tacitly held knowledge to expand our understanding of medication communication. Drawing out the coordination activities could be a missing piece for us to better understand how to streamline and improve multi-step communication processes with a goal of improving patient safety. PMID:24134454

Communication between members of the cardiac arrest team--a postal survey.

PubMed

Pittman, J; Turner, B; Gabbott, D A

2001-05-01

Effective communication enhances team building and is perceived to improve the quality of team performance. A recent publication from the Resuscitation Council (UK) has highlighted this fact and recommended that cardiac arrest team members make contact daily. We wished to identify how often members of this team communicate prior to a cardiopulmonary arrest. A questionnaire on cardiac arrest team composition, leadership, communication and debriefing was distributed nationally to Resuscitation Training Officers (RTOs) and their responses analysed. One hundred and thirty (55%) RTOs replied. Physicians and anaesthetists were the most prominent members of the team. The Medical Senior House Officer is usually nominated as the team leader. Eighty-seven centres (67%) have no communication between team members prior to attending a cardiopulmonary arrest. In 33%, communication occurs but is either informal or fortuitous. The RTOs felt that communication is important to enhance team dynamics and optimise task allocation. Only 7% achieve a formal debrief following a cardiac arrest. Communication between members of the cardiac arrest team before and after a cardiac arrest is poor. Training and development of these skills may improve performance and should be prioritised. Team leadership does not necessarily reflect experience or training.

Development of an interprofessional competency framework for collaborative practice in Japan.

PubMed

Haruta, Junji; Yoshida, Kazue; Goto, Michiko; Yoshimoto, Hisashi; Ichikawa, Shuhei; Mori, Youhei; Yoshimi, Kenji; Otsuka, Mariko

2018-01-30

Rapid aging of the population necessitates improved collaboration among healthcare professionals. Unfortunately, interprofessional collaboration has yet to be implemented effectively in Japan. Therefore, we aimed to develop an interprofessional competency framework for Japanese healthcare professionals. The project was conducted as a four-step process, starting with initial categorization of potential competency domains,, followed by guiding principle and prototype development, feedback on the prototype, and final consensus. First, authors (JH and MO) collected opinions about competency in interprofessional collaboration at two academic meetings of the Japan Association for Interprofessional Education (JAIPE) and then analyzed the data thematically. Second, a project team consisting of JAIPE and University representatives extracted the domains and statements as prototype 1. Third, seven representatives from professional organizations joined the project team and developed prototype 2. We then called for feedback on the revised prototype 2 at both an open symposium and via public comments. Following revision of prototype 2, a new project team including 20 university, professional organization and health practitioner representatives finally discussed prototype 3, developed the final draft and reached a consensus. In analysis after collecting the data, we extracted 11 themes. We developed four key principles which applied to six domains as prototype 1-3. Finally, our competency framework included two core domains of "Patient-/client-/family-/community-centered" and "Interprofessional communication", and four peripheral domains of "Role contribution", "Facilitation of relationships", "Reflection" and "Understanding of others". We developed an interprofessional competency framework in Japan which consists of two core and four peripheral domains. The interprofessional competency framework is likely to affect the understanding of "high-context" and "relationalism" in Japanese healthcare. We hope that our interprofessional competency framework will encourage the systematic implementation of interprofessional education and collaboration in Japan.

Team communication patterns in emergency resuscitation: a mixed methods qualitative analysis.

PubMed

Calder, Lisa Anne; Mastoras, George; Rahimpour, Mitra; Sohmer, Benjamin; Weitzman, Brian; Cwinn, A Adam; Hobin, Tara; Parush, Avi

2017-12-01

In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations. We interviewed 18 resuscitation team members about shared mental models, roles and goals of team members and procedural expectations. We observed 30 simulated resuscitation video recordings and documented the timing, source and destination of communication and the information category. We observed 12 live resuscitations in the emergency department and recorded baseline characteristics of the type of resuscitations, nature of teams present and type and content of information exchanges. The data were analyzed using a qualitative communication analysis method. We found that resuscitation team members described a shared mental model. Respondents understood the roles and goals of each team member in order to provide rapid, efficient and life-saving care with an overall need for situational awareness. The information flow described in the interviews was reflected during the simulated and live resuscitations with the most responsible physician and charting nurse being central to team communication. We consolidated communicated information into six categories: (1) time; (2) patient status; (3) patient history; (4) interventions; (5) assistance and consultations; 6) team members present. Resuscitation team members expressed a shared mental model and prioritized situational awareness. Our findings support a need for cognitive aids to enhance team communication during resuscitations.

Interprofessional education in team communication: working together to improve patient safety.

PubMed

Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

2013-05-01

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001). Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Interprofessional education in team communication: working together to improve patient safety.

PubMed

Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

2013-11-01

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001). Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Team performance in networked supervisory control of unmanned air vehicles: effects of automation, working memory, and communication content.

PubMed

McKendrick, Ryan; Shaw, Tyler; de Visser, Ewart; Saqer, Haneen; Kidwell, Brian; Parasuraman, Raja

2014-05-01

Assess team performance within a net-worked supervisory control setting while manipulating automated decision aids and monitoring team communication and working memory ability. Networked systems such as multi-unmanned air vehicle (UAV) supervision have complex properties that make prediction of human-system performance difficult. Automated decision aid can provide valuable information to operators, individual abilities can limit or facilitate team performance, and team communication patterns can alter how effectively individuals work together. We hypothesized that reliable automation, higher working memory capacity, and increased communication rates of task-relevant information would offset performance decrements attributed to high task load. Two-person teams performed a simulated air defense task with two levels of task load and three levels of automated aid reliability. Teams communicated and received decision aid messages via chat window text messages. Task Load x Automation effects were significant across all performance measures. Reliable automation limited the decline in team performance with increasing task load. Average team spatial working memory was a stronger predictor than other measures of team working memory. Frequency of team rapport and enemy location communications positively related to team performance, and word count was negatively related to team performance. Reliable decision aiding mitigated team performance decline during increased task load during multi-UAV supervisory control. Team spatial working memory, communication of spatial information, and team rapport predicted team success. An automated decision aid can improve team performance under high task load. Assessment of spatial working memory and the communication of task-relevant information can help in operator and team selection in supervisory control systems.

Goals, Objectives, and Requirements (GOR) of the Ground-based Nuclear Detonation Detection (GNDD) Team for the Office of Defense Nuclear Nonproliferation Research and Development (DNN R&D)

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

Casey, Leslie A.

The goal, objectives, and requirements (GOR) presented in this document define a framework for describing research directed specifically by the Ground-based Nuclear Detonation Detection (GNDD) Team of the National Nuclear Security Administration (NNSA). The intent of this document is to provide a communication tool for the GNDD Team with NNSA management and with its stakeholder community. It describes the GNDD expectation that much of the improvement in the proficiency of nuclear explosion monitoring will come from better understanding of the science behind the generation, propagation, recording, and interpretation of seismic, infrasound, hydroacoustic, and radionuclide signals and development of "game-changer" advancesmore » in science and technology.« less

Cross-Cutting Risk Framework: Mining Data for Common Risks Across the Portfolio

NASA Technical Reports Server (NTRS)

Klein, Gerald A., Jr.; Ruark, Valerie

2017-01-01

The National Aeronautics and Space Administration (NASA) defines risk management as an integrated framework, combining risk-informed decision making and continuous risk management to foster forward-thinking and decision making from an integrated risk perspective. Therefore, decision makers must have access to risks outside of their own project to gain the knowledge that provides the integrated risk perspective. Through the Goddard Space Flight Center (GSFC) Flight Projects Directorate (FPD) Business Change Initiative (BCI), risks were integrated into one repository to facilitate access to risk data between projects. With the centralized repository, communications between the FPD, project managers, and risk managers improved and GSFC created the cross-cutting risk framework (CCRF) team. The creation of the consolidated risk repository, in parallel with the initiation of monthly FPD risk managers and risk governance board meetings, are now providing a complete risk management picture spanning the entire directorate. This paper will describe the challenges, methodologies, tools, and techniques used to develop the CCRF, and the lessons learned as the team collectively worked to identify risks that FPD programs projects had in common, both past and present.

Implicit Coordination Strategies for Effective Team Communication.

PubMed

Butchibabu, Abhizna; Sparano-Huiban, Christopher; Sonenberg, Liz; Shah, Julie

2016-06-01

We investigated implicit communication strategies for anticipatory information sharing during team performance of tasks with varying degrees of complexity. We compared the strategies used by teams with the highest level of performance to those used by the lowest-performing teams to evaluate the frequency and methods of communications used as a function of task structure. High-performing teams share information by anticipating the needs of their teammates rather than explicitly requesting the exchange of information. As the complexity of a task increases to involve more interdependence among teammates, the impact of coordination on team performance also increases. This observation motivated us to conduct a study of anticipatory information sharing as a function of task complexity. We conducted an experiment in which 13 teams of four people performed collaborative search-and-deliver tasks with varying degrees of complexity in a simulation environment. We elaborated upon prior characterizations of communication as implicit versus explicit by dividing implicit communication into two subtypes: (a) deliberative/goal information and (b) reactive status updates. We then characterized relationships between task structure, implicit communication, and team performance. We found that the five teams with the fastest task completion times and lowest idle times exhibited higher rates of deliberative communication versus reactive communication during high-complexity tasks compared with the five teams with the slowest completion times and longest idle times (p = .039). Teams in which members proactively communicated information about their next goal to teammates exhibited improved team performance. The findings from our work can inform the design of communication strategies for team training to improve performance of complex tasks. © 2016, Human Factors and Ergonomics Society.

Preparing the National Capital Region to Conduct a Multijurisdictional and Interdisciplinary Law Enforcement Investigation

DTIC Science & Technology

2013-09-01

of NIMS, there is oftentimes a disconnection between the training and the use of NIMS. The consequences of this disconnection is that when LE needs...motivation, flexibility, communication, consensus decision making, information-sharing, 13 building social capital , having team pride, taking...of regional investigations using the different models. 3. To the National Capital Region By creating a framework for regional investigations and

Developing a General Framework for Human Autonomy Teaming

NASA Technical Reports Server (NTRS)

Lachter, Joel; Brandt, Summer; Shively, Jay

2017-01-01

Automation has entered nearly every aspect of our lives, but it often remains hard to understand. Why is this? Automation is often brittle, requiring constant human oversight to assure it operates as intended. This oversight has become harder as automation has become more complicated. To resolve this problem, Human-Autonomy Teaming (HAT) has been proposed. HAT looks to make automation act as more of a teammate, by having it communicate with human operators in a more human, goal-directed, manner which provides transparency into the reasoning behind automated recommendations and actions. This, in turn, permits more trust in the automation when it is appropriate, and less when it is not, allowing a more targeted supervision of automated functions. This paper proposes a framework for HAT, incorporating two key tenets: bi-directional communication, and operator directed authority. We have successfully applied these tenets to integrating the autonomous constrained flight planner (an aide for planning diverts) into a dispatch station. We propose the development of general design patterns that may allow these results to be generalized to domains such as photography and automotive navigation. While these domains are very different, we find application of our HAT tenets provides a number of opportunities for improving interaction between human operators and automation.

"The era of single disease cowboys is out": evaluating the experiences of students, faculty, and collaborators in an interdisciplinary global health training program.

PubMed

Kalbarczyk, Anna; Martin, Nina A; Combs, Emily; Ward, Marie; Winch, Peter J

2018-03-01

Global Health is an inherently interdisciplinary field but overseas training in global health, particularly among health science institutions, has been an 'individual' or 'individual discipline' experience. Team-based training is an approach to global health education which is increasing in popularity; research on team-training demonstrates that teams are more productive than individuals. In 2015, the Johns Hopkins Center for Global Health (CGH) developed the Global Established Multidisciplinary Sites (GEMS) program, an interdisciplinary training program which was designed to establish a new norm in global health training by bringing interdisciplinary teams of faculty and students together to identify and solve complex global health challenges. This research aims to evaluate the program's first year and contribute to the literature on interdisciplinary team training. We conducted 22 in-depth interviews with students, faculty, and local collaborators from 3 GEMS project sites. Findings were analyzed for themes through a framework approach. The program exposed students, faculty, and collaborators to a wide range of disciplines in global health. Students' desire to learn how other disciplines contribute to global health solutions was an important motivator for joining GEMS; many participants including faculty and collaborators valued exposure to multiple disciplines. Mentorship and communication were a challenge across all teams in part due to members having distinct "disciplinary languages". Balancing disciplinary representation on teams and establishing work plans were also key challenges. Based on the data the CGH provides four recommendations for institutions developing global health interdisciplinary teams to optimize team functioning and address challenges in mentorship, language, and roles: 1) address interdisciplinary communication early, 2) develop work plans during group formation, 3) meet as a team prior to travel, and 4) establish regular check ins. This article provides first-hand reflections on interdisciplinary team experiences in a global context and provides a pathway for the development of innovative strategies in global health training.

Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study.

PubMed

Mundt, Marlon P; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I; Kamnetz, Sandra A; Gilchrist, Valerie J

2016-06-01

Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (rate ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care information to the PCP, had greater shared team vision, better patient outcomes, and lower medical costs for their diabetes patient panels. Copyright © 2016 Elsevier Ltd. All rights reserved.

Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study

PubMed Central

Mundt, Marlon P.; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I.; Kamnetz, Sandra A.; Gilchrist, Valerie J.

2016-01-01

Background Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. Objective To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. Methods A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. Participants 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Results Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (Rate Ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds Ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Conclusions Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care information to the PCP, had greater shared team vision, better patient outcomes, and lower medical costs for their diabetes patient panels. PMID:27087293

Cross-Level Effects Between Neurophysiology and Communication During Team Training.

PubMed

Gorman, Jamie C; Martin, Melanie J; Dunbar, Terri A; Stevens, Ronald H; Galloway, Trysha L; Amazeen, Polemnia G; Likens, Aaron D

2016-02-01

We investigated cross-level effects, which are concurrent changes across neural and cognitive-behavioral levels of analysis as teams interact, between neurophysiology and team communication variables under variations in team training. When people work together as a team, they develop neural, cognitive, and behavioral patterns that they would not develop individually. It is currently unknown whether these patterns are associated with each other in the form of cross-level effects. Team-level neurophysiology and latent semantic analysis communication data were collected from submarine teams in a training simulation. We analyzed whether (a) both neural and communication variables change together in response to changes in training segments (briefing, scenario, or debriefing), (b) neural and communication variables mutually discriminate teams of different experience levels, and (c) peak cross-correlations between neural and communication variables identify how the levels are linked. Changes in training segment led to changes in both neural and communication variables, neural and communication variables mutually discriminated between teams of different experience levels, and peak cross-correlations indicated that changes in communication precede changes in neural patterns in more experienced teams. Cross-level effects suggest that teamwork is not reducible to a fundamental level of analysis and that training effects are spread out across neural and cognitive-behavioral levels of analysis. Cross-level effects are important to consider for theories of team performance and practical aspects of team training. Cross-level effects suggest that measurements could be taken at one level (e.g., neural) to assess team experience (or skill) on another level (e.g., cognitive-behavioral). © 2015, Human Factors and Ergonomics Society.

Trauma team leaders' non-verbal communication: video registration during trauma team training.

PubMed

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

2016-03-25

There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training. Eighteen trauma teams were audio and video recorded during trauma team training in the emergency department of a hospital in northern Sweden. Quantitative content analysis was used to categorize the team members' positions and the leaders' non-verbal communication: gaze direction, vocal nuances, and gestures. The quantitative data were interpreted in relation to the specific context. Time sequences of the leaders' gaze direction, speech time, and gestures were identified separately and registered as time (seconds) and proportions (%) of the total training time. The team leaders who gained control over the most important area in the emergency room, the "inner circle", positioned themselves as heads over the team, using gaze direction, gestures, vocal nuances, and verbal commands that solidified their verbal message. Changes in position required both attention and collaboration. Leaders who spoke in a hesitant voice, or were silent, expressed ambiguity in their non-verbal communication: and other team members took over the leader's tasks. In teams where the leader had control over the inner circle, the members seemed to have an awareness of each other's roles and tasks, knowing when in time and where in space these tasks needed to be executed. Deviations in the leaders' communication increased the ambiguity in the communication, which had consequences for the teamwork. Communication cannot be taken for granted; it needs to be practiced regularly just as technical skills need to be trained. Simulation training provides healthcare professionals the opportunity to put both verbal and non-verbal communication in focus, in order to improve patient safety. Non-verbal communication plays a decisive role in the interaction between the trauma team members, and so both verbal and non-verbal communication should be in focus in trauma team training. This is even more important for inexperienced leaders, since vague non-verbal communication reinforces ambiguity and can lead to errors.

Integrating Science Communication, Outreach and Awareness into the R&D Investment Framework of SKA in order to drive a knowledge economy

NASA Astrophysics Data System (ADS)

Raynard, Lorenzo; Garnier, William

2015-08-01

The emergence of the "knowledge society" has reshaped the context and content of public communication of science and technology. The construction and design of SKA and associated science research are increasingly characterised by the formation of large, multidisciplinary and multi-institute research teams. The integration of science communication into the scientific endeavour is key to building the foundations of a thriving knowledge-based economy identified by new technology investments, high-technology industries and highly skilled labour. Knowledge Economy Indicators profile, among others, the efficient and effective Management of Knowledge Assets. This presentation will explore the strategic trade and positioning of Knowledge Assets in order to drive and stimulate innovation.

Memory and communication support in dementia: research-based strategies for caregivers.

PubMed

Smith, Erin R; Broughton, Megan; Baker, Rosemary; Pachana, Nancy A; Angwin, Anthony J; Humphreys, Michael S; Mitchell, Leander; Byrne, Gerard J; Copland, David A; Gallois, Cindy; Hegney, Desley; Chenery, Helen J

2011-03-01

Difficulties with memory and communication are prominent and distressing features of dementia which impact on the person with dementia and contribute to caregiver stress and burden. There is a need to provide caregivers with strategies to support and maximize memory and communication abilities in people with dementia. In this project, a team of clinicians, researchers and educators in neuropsychology, psychogeriatrics, nursing and speech pathology translated research-based knowledge from these fields into a program of practical strategies for everyday use by family and professional caregivers. From the available research evidence, the project team identified compensatory or facilitative strategies to assist with common areas of difficulty, and structured these under the mnemonics RECAPS (for memory) and MESSAGE (for communication). This information was adapted for presentation in a DVD-based education program in accordance with known characteristics of effective caregiver education. The resultant DVD comprises (1) information on the nature and importance of memory and communication in everyday life; (2) explanations of common patterns of difficulty and preserved ability in memory and communication across the stages of dementia; (3) acted vignettes demonstrating the strategies, based on authentic samples of speech in dementia; and (4) scenarios to prompt the viewer to consider the benefits of using the strategies. Using a knowledge-translation framework, information and strategies can be provided to family and professional caregivers to help them optimize residual memory and communication in people with dementia. Future development of the materials, incorporating consumer feedback, will focus on methods for enabling wider dissemination.

Communication and Influencing for ED Professionals: A training programme developed in the emergency department for the emergency department.

PubMed

Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony

2016-08-01

The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Assessment of a Statewide Palliative Care Team Training Course: COMFORT Communication for Palliative Care Teams.

PubMed

Wittenberg, Elaine; Ferrell, Betty; Goldsmith, Joy; Ragan, Sandra L; Paice, Judith

2016-07-01

Despite increased attention to communication skill training in palliative care, few interprofessional training programs are available and little is known about the impact of such training. This study evaluated a communication curriculum offered to interprofessional palliative care teams and examined the longitudinal impact of training. Interprofessional, hospital-based palliative care team members were competitively selected to participate in a two-day training using the COMFORT(TM SM) (Communication, Orientation and options, Mindful communication, Family, Openings, Relating, Team) Communication for Palliative Care Teams curriculum. Course evaluation and goal assessment were tracked at six and nine months postcourse. Interprofessional palliative care team members (n = 58) representing 29 teams attended the course and completed course goals. Participants included 28 nurses, 16 social workers, 8 physicians, 5 chaplains, and one psychologist. Precourse surveys assessed participants' perceptions of institution-wide communication performance across the continuum of care and resources supporting optimum communication. Postcourse evaluations and goal progress monitoring were used to assess training effectiveness. Participants reported moderate communication effectiveness in their institutions, with the weakest areas being during bereavement and survivorship care. Mean response to course evaluation across all participants was greater than 4 (scale of 1 = low to 5 = high). Participants taught an additional 962 providers and initiated institution-wide training for clinical staff, new hires, and volunteers. Team member training improved communication processes and increased attention to communication with family caregivers. Barriers to goal implementation included a lack of institutional support as evidenced in clinical caseloads and an absence of leadership and funding. The COMFORT(TM SM) communication curriculum is effective palliative care communication training for interprofessional teams.

Cohesion in Online Student Teams versus Traditional Teams

ERIC Educational Resources Information Center

Hansen, David E.

2016-01-01

Researchers have found that the electronic methods in use for online team communication today increase communication quality in project-based work situations. Because communication quality is known to influence group cohesion, the present research examined whether online student project teams are more cohesive than traditional teams. We tested…

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.

Collaboration, credibility, compassion, and coordination: professional nurse communication skill sets in health care team interactions.

PubMed

Apker, Julie; Propp, Kathleen M; Zabava Ford, Wendy S; Hofmeister, Nancee

2006-01-01

This study explored how nurses communicate professionalism in interactions with members of their health care teams. Extant research show that effective team communication is a vital aspect of a positive nursing practice environment, a setting that has been linked to enhanced patient outcomes. Although communication principles are emphasized in nursing education as an important component of professional nursing practice, actual nurse interaction skills in team-based health care delivery remain understudied. Qualitative analysis of interview transcripts with 50 participants at a large tertiary hospital revealed four communicative skill sets exemplified by nursing professionals: collaboration, credibility, compassion, and coordination. Study findings highlight specific communicative behaviors associated with each skill set that exemplify nurse professionalism to members of health care teams. Theoretical and pragmatic conclusions are drawn regarding the communicative responsibilities of professional nurses in health care teams. Specific interaction techniques that nurses could use in nurse-team communication are then offered for use in baccalaureate curriculum and organizational in-service education.

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

The objective of the Tropical Ecology Assessment and Monitoring Network (www.teamnetwork.org) is "To generate real time data for monitoring long-term trends in tropical biodiversity through a global network of TEAM sites (i.e. field stations in tropical forests), providing an early warning system on the status of biodiversity to effectively guide conservation action". To achieve this, the TEAM Network operates by collecting data via standardized protocols at TEAM Sites. The standardized TEAM protocols include the Climate, Vegetation and Terrestrial Vertebrate Protocols. Some sites also implement additional protocols. There are currently 7 TEAM Sites with plans to grow the network to 15 by June 30, 2009 and 50 TEAM Sites by the end of 2010. Climate Protocol The Climate Protocol entails the collection of climate data via meteorological stations located at the TEAM Sites. This includes information such as precipitation, temperature, wind direction and strength and various solar radiation measurements. Vegetation Protocol The Vegetation Protocol collects standardized information on tropical forest trees and lianas. A TEAM Site will have between 6-9 1ha plots where trees and lianas larger than a pre-specified size are mapped, identified and measured. This results in each TEAM Site repeatedly measuring between 3000-5000 trees annually. Terrestrial Vertebrate Protocol The Terrestrial Vertebrate Protocol collects standardized information on mid-sized tropical forest fauna (i.e. birds and mammals). This information is collected via camera traps (i.e. digital cameras with motion sensors housed in weather proof casings). The images taken by the camera trap are reviewed to identify what species are captured in the image by the camera trap. The image and the interpretation of what is in the image are the data for the Terrestrial Vertebrate Protocol. The amount of data collected through the TEAM protocols provides a significant yet exciting IT challenge. The TEAM Network is currently partnering with the San Diego Super Computer Center to build the data management infrastructure. Data collected from the three core protocols as well as others are currently made available through the TEAM Network portal, which provides the content management framework, the data scheduling and management framework, an administrative framework to implement and manage TEAM sites, collaborative tools and a number of tools and applications utilizing Google Map and Google Earth products. A critical element of the TEAM Network data management infrastructure is to make the data publicly available in as close to real-time as possible (the TEAM Network Data Use Policy: http://www.teamnetwork.org/en/data/policy). This requires two essential tasks to be accomplished, 1) A data collection schedule has to be planned, proposed and approved for a given TEAM site. This is a challenging process since TEAM sites are geographically distributed across the tropics and hence have different seasons where they schedule field sampling for the different TEAM protocols. Capturing this information and ensuring that TEAM sites follow the outlined legal contract is key to the data collection process and 2) A stream-lined and efficient information management system to ensure data collected from the field meet the minimum data standards (i.e. are of the highest scientific quality) and are securely transferred, archived, processed and be rapidly made publicaly available, as a finished consumable product via the TEAM Network portal. The TEAM Network is achieving these goals by implementing an end-to-end framework consisting of the Sampling Scheduler application and the Data Management Framework. Sampling Scheduler The Sampling Scheduler is a project management, calendar based portal application that will allow scientists at a TEAM site to schedule field sampling for each of the TEAM protocols implemented at that site. The sampling scheduler addresses the specific requirements established in the 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. References • TEAM Network, http://www.teamnetwork.org • Center for Applied Biodiversity Science, Conservation International. http://science.conservation.org/portal/server.pt • TEAM Data Query and Download Application, http://www.teamnetwork.org/en/data/query

Meeting the complex needs of the health care team: identification of nurse-team communication practices perceived to enhance patient outcomes.

PubMed

Propp, Kathleen M; Apker, Julie; Zabava Ford, Wendy S; Wallace, Nancy; Serbenski, Michele; Hofmeister, Nancee

2010-01-01

Nurses occupy a central position in today's increasingly collaborative health care teams that place a premium on quality patient care. In this study we examined critical team processes and identified specific nurse-team communication practices that were perceived by team members to enhance patient outcomes. Fifty patient-care team members were interviewed to uncover forms of nurse communication perceived to improve team performance. Using a grounded theory approach and constant comparative analysis, study findings reveal two critical processes nurses contribute to as the most central and consistent members of the health care team: ensuring quality decisions and promoting a synergistic team. Moreover, the findings reveal 15 specific nurse-team communication practices that comprise these processes, and thereby are theorized to improve patient outcomes.

Understanding Implementation of Complex Interventions in Primary Care Teams.

PubMed

Luig, Thea; Asselin, Jodie; Sharma, Arya M; Campbell-Scherer, Denise L

2018-01-01

The implementation of interventions to support practice change in primary care settings is complex. Pragmatic strategies, grounded in empiric data, are needed to navigate real-world challenges and unanticipated interactions with context that can impact implementation and outcomes. This article uses the example of the "5As Team" randomized control trial to explore implementation strategies to promote knowledge transfer, capacity building, and practice integration, and their interaction within the context of an interdisciplinary primary care team. We performed a qualitative evaluation of the implementation process of the 5As Team intervention study, a randomized control trial of a complex intervention in primary care. We conducted thematic analysis of field notes of intervention sessions, log books of the practice facilitation team members, and semistructured interviews with 29 interdisciplinary clinician participants. We used and further developed the Interactive Systems Framework for dissemination and implementation to interpret and structure findings. Three themes emerged that illuminate interactions between implementation processes, context, and outcomes: (1) facilitating team communication supported collective and individual sense-making and adoption of the innovation, (2) iterative evaluation of the implementation process and real-time feedback-driven adaptions of the intervention proved crucial for sustainable, context-appropriate intervention impact, (3) stakeholder engagement led to both knowledge exchange that contributes to local problem solving and to shaping a clinical context that is supportive to practice change. Our findings contribute pragmatic strategies that can help practitioners and researchers to navigate interactions between context, intervention, and implementation factors to increase implementation success. We further developed an implementation framework that includes sustained engagement with stakeholders, facilitation of team sense-making, and dynamic evaluation and intervention design as integral parts of complex intervention implementation. NCT01967797. 18 October 2013. © Copyright 2018 by the American Board of Family Medicine.

Taxonomy of Trauma Leadership Skills: A Framework for Leadership Training and Assessment.

PubMed

Leenstra, Nico F; Jung, Oliver C; Johnson, Addie; Wendt, Klaus W; Tulleken, Jaap E

2016-02-01

Good leadership is essential for optimal trauma team performance, and targeted training of leadership skills is necessary to achieve such leadership proficiency. To address the need for a taxonomy of leadership skills that specifies the skill components to be learned and the behaviors by which they can be assessed across the five phases of trauma care, the authors developed the Taxonomy of Trauma Leadership Skills (TTLS). Critical incident interviews were conducted with trauma team leaders and members from different specialties-emergency physicians, trauma surgeons, anesthesiologists, and emergency ward nurses-at three teaching hospitals in the Netherlands during January-June 2013. Data were iteratively analyzed for examples of excellent leadership skills at each phase of trauma care. Using the grounded theory approach, elements of excellent leadership skills were identified and classified. Elements and behavioral markers were sorted and categorized using multiple raters. In a two-round verification process in late 2013, the taxonomy was reviewed and rated by trauma team leaders and members from the multiple specialties for its coverage of essential items. Data were gathered from 28 interviews and 14 raters. The TTLS details 5 skill categories (information coordination, decision making, action coordination, communication management, and coaching and team development) and 37 skill elements. The skill elements are captured by 67 behavioral markers. The three-level taxonomy is presented according to five phases of trauma care. The TTLS provides a framework for teaching, learning, and assessing team leadership skills in trauma care and other complex, acute care situations.

Strategic implementation and accountability: the case of the long-term care alliance.

PubMed

Seaman, Al; Elias, Maria; O'Neill, Bill; Yatabe, Karen

2010-01-01

A group of chief executives of long-term care homes formed an alliance in order to tap the resources residing within their management teams. Adopting a strategic implementation project based on a framework of accountability, the executives were able to better understand the uncertainties of the environment and potentially structure their strategic implementation to best use scarce resources. The framework of accountability allowed the homes to recognize the need for a strong business approach to long-term care. Communication improved throughout the organizations while systems and resources showed improved utilization. Quality became the driving force for all actions taken to move the organizations toward achieving their visions.

The impact of team building on communication and job satisfaction of nursing staff.

PubMed

Amos, Mary Anne; Hu, Jie; Herrick, Charlotte A

2005-01-01

A series of team-building activities were conducted on a medical-surgical unit and their impact on staff's communication and job satisfaction was examined. Forty-four unit personnel participated in the interventions. Staff communication and job satisfaction were measured before and after the intervention. The findings linked team-building activities with improved staff communication and job satisfaction. Team-building strategies assisted the nurse leader/manager to build an effective work team by strengthening communication and interpersonal relationships so that the staff could function as a more cohesive group. Staff development consultants can help nurse managers become more effective team leaders by identifying the necessary resources and by helping to plan and coordinate team-building strategies.

Computer-mediated interdisciplinary teams: theory and reality.

PubMed

Vroman, Kerryellen; Kovacich, Joann

2002-05-01

The benefit of experience, tempered with the wisdom of hindsight and 5 years of text-based, asynchronous, computer-mediated, interdisciplinary team communications, provides the energy, insights and data shared in this article. Through the theoretical lens of group dynamics and the epistemology of interdisciplinary teaming, we analyze the interactions of a virtual interdisciplinary team to provide an understanding and appreciation of collaborative interdisciplinary communication in the context of interactive technologies. Whilst interactive technologies may require new patterns of language similar to that of learning a foreign language, what is communicated in the interdisciplinary team process does not change. Most important is the recognition that virtual teams, similar to their face-to-face counterparts, undergo the same challenges of interdisciplinary teaming and group developmental processes of formation: forming, storming, norming, performing, and transforming. After examining these dynamics of communication and collaboration in the context of the virtual team, the article concludes with guidelines facilitating interdisciplinary team computer-mediated communication.

Relating Communications Mode Choice and Teamwork Quality: Conversational versus Textual Communication in IT System and Software Development Teams

ERIC Educational Resources Information Center

Smith, James Robert

2012-01-01

This cross-sectional study explored how IT system and software development team members communicated in the workplace and whether teams that used more verbal communication (and less text-based communication) experienced higher levels of collaboration as measured using the Teamwork Quality (TWQ) scale. Although computer-mediated communication tools…

A re-conceptualization of access for 21st century healthcare.

PubMed

Fortney, John C; Burgess, James F; Bosworth, Hayden B; Booth, Brenda M; Kaboli, Peter J

2011-11-01

Many e-health technologies are available to promote virtual patient-provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital "encounterless" utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access.

Comparison of language used and patterns of communication in interprofessional and multidisciplinary teams.

PubMed

Sheehan, D; Robertson, L; Ormond, T

2007-02-01

Can the language used and the patterns of communication differentiate a multidisciplinary team from an interprofessional team? This research question arose from an unexpected outcome of a study that investigated clinical reasoning of health professional team members in the elder care wards of two different hospitals. The issue at stake was the apparent disparity in the way in which the two teams communicated. To further explore this, the original transcribed interview data was analysed from a symbolic interactionist perspective in order that the language and communication patterns between the two teams could be identified and compared. Differences appeared to parallel the distinctions between multidisciplinary and interprofessional teams as reported in the literature. Our observations were that an interprofessional team was characterized by its use of inclusive language, continual sharing of information between team members and a collaborative working approach. In the multidisciplinary team, the members worked in parallel, drawing information from one another but did not have a common understanding of issues that could influence intervention. The implications of these communication differences for team members, team leaders and future research are then discussed.

Effect of focused debriefing on team communication skills.

PubMed

Nwokorie, Ndidi; Svoboda, Deborah; Rovito, Debra K; Krugman, Scott D

2012-10-01

Community hospitals often lack tertiary care support such as pediatric intensivists and anesthesiologists. Resuscitation of critically ill and injured children in community hospitals requires a well-coordinated team effort, because good team performance improves quality of care. The lack of subspecialty support makes team coordination and communication more imperative yet much more challenging. This study sought to determine if the addition of a defined focused post-mock code debriefing session improved communication skills among team members in a community pediatric emergency department. Twenty-two volunteer members of the pediatric emergency and respiratory therapy departments at Medstar Franklin Square Medical Center took part in monthly simulated resuscitations for 3 consecutive months. After each simulation, participants answered an 18-item survey on observed communication among their team members. Members then participated in a 30-minute debriefing session in which they reflected on their own communication skills. A video taping of the resuscitation was later scored by one of the investigators by using a rubric designed by the investigators. Descriptive statistics were calculated for both the participant survey and the team communication indicator scores. Paired-sample Wilcoxon signed rank test examined the difference in the scores between each of 3 sessions. The mean scores by investigator-scored video recordings of the teams' mock resuscitation by session showed overall team communication improved between sessions 1 and 3 for all communication areas (P = .03), with significant improvement in 4 of 9 communication areas by the third session. All team members improved communication skills as well, with the greatest improvement by the clinical multifunctional technicians. Communication skills improve with the addition of focused debriefing sessions after mock codes as perceived by participants during debriefing sessions and evidenced by investigator-scored video recordings of resuscitations.

From Communication Skills to Skillful Communication: A Longitudinal Integrated Curriculum for Critical Care Medicine Fellows.

PubMed

Roze des Ordons, Amanda L; Doig, Christopher J; Couillard, Philippe; Lord, Jason

2017-04-01

Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication. A departmental needs assessment informed curriculum development. Five 4-hour classroom sessions were developed: basic communication principles, family meetings about goals and transitions of care, discussing patient safety incidents, addressing conflict, and offering organ donation. Teaching methods-including instructor-led presentations incorporating a consistent framework for approaching challenging conversations, simulation and clinical practice, and feedback from peers, trained facilitators, family members, and clinicians-supported integration of skills into the clinical setting and longitudinal development of skillful communication. Seven fellows participated during the first year of the curriculum. CCM fellows engaged enthusiastically in the program, commented that the framework provided was helpful, and highly valued the opportunity to practice challenging communication scenarios, learn from observing their peers, and receive immediate feedback. More detailed accounts of fellows', patients', and family members' experiences will be obtained to guide curricular development. The curriculum will be expanded to involve other members of the multidisciplinary intensive care unit team, and faculty education initiatives will be offered to enhance the quality of the feedback provided. The impact of the curriculum on initial skill development, retention, and progression will be assessed.

Reconfigurable, Intelligently-Adaptive, Communication System, an SDR Platform

NASA Technical Reports Server (NTRS)

Roche, Rigoberto

2016-01-01

The Space Telecommunications Radio System (STRS) provides a common, consistent framework to abstract the application software from the radio platform hardware. STRS aims to reduce the cost and risk of using complex, configurable and reprogrammable radio systems across NASA missions. The Glenn Research Center (GRC) team made a software-defined radio (SDR) platform STRS compliant by adding an STRS operating environment and a field programmable gate array (FPGA) wrapper, capable of implementing each of the platforms interfaces, as well as a test waveform to exercise those interfaces. This effort serves to provide a framework toward waveform development on an STRS compliant platform to support future space communication systems for advanced exploration missions. Validated STRS compliant applications provided tested code with extensive documentation to potentially reduce risk, cost and efforts in development of space-deployable SDRs. This paper discusses the advantages of STRS, the integration of STRS onto a Reconfigurable, Intelligently-Adaptive, Communication System (RIACS) SDR platform, the sample waveform, and wrapper development efforts. The paper emphasizes the infusion of the STRS Architecture onto the RIACS platform for potential use in next generation SDRs for advance exploration missions.

Team communications in the operating room: talk patterns, sites of tension, and implications for novices.

PubMed

Lingard, Lorelei; Reznick, Richard; Espin, Sherry; Regehr, Glenn; DeVito, Isabella

2002-03-01

Although the communication that occurs within health care teams is important to both team function and the socialization of novices, the nature of team communication and its educational influence are not well documented. This study explored the nature of communications among operating room (OR) team members from surgery, nursing, and anesthesia to identify common communicative patterns, sites of tension, and their impact on novices. Paired researchers observed 128 hours of OR interactions during 35 procedures from four surgical divisions at one teaching hospital. Brief, unstructured interviews were conducted following each observation. Field notes were independently read by each researcher and coded for emergent themes in the grounded theory tradition. Coding consensus was achieved via regular discussion. Findings were returned to insider "experts" for their assessment of authenticity and adequacy. Patterns of communication were complex and socially motivated. Dominant themes were time, safety and sterility, resources, roles, and situation. Communicative tension arose regularly in relation to these themes. Each procedure had one to four "higher-tension" events, which often had a ripple effect, spreading tension to other participants and contexts. Surgical trainees responded to tension by withdrawing from the communication or mimicking the senior staff surgeon. Both responses had negative implications for their own team relations. Team communications in the OR follow observable patterns and are influenced by recurrent themes that suggest sites of team tension. Tension in team communication affects novices, who respond with behaviors that may intensify rather than resolve interprofessional conflict.

The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings.

PubMed

Roberts, Nicole K; Williams, Reed G; Schwind, Cathy J; Sutyak, John A; McDowell, Christopher; Griffen, David; Wall, Jarrod; Sanfey, Hilary; Chestnut, Audra; Meier, Andreas H; Wohltmann, Christopher; Clark, Ted R; Wetter, Nathan

2014-02-01

Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care. Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication. Teams completed a postinstruction simulated trauma encounter immediately afterward and 3 weeks later, then completed a questionnaire. Blinded raters rated videotapes of the simulations. Participants expressed high levels of satisfaction and intent to change practice after the intervention. Participants changed teamwork and communication behavior on the posttest, and changes were sustained after a 3-week interval, though there was some loss of retention. Brief training exercises can change teamwork and communication behaviors on ad hoc trauma teams. Copyright © 2014 Elsevier Inc. All rights reserved.

Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs.

PubMed

Mundt, Marlon P; Zakletskaia, Larissa I; Shoham, David A; Tuan, Wen-Jan; Carayon, Pascale

2015-10-01

Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes. Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three-level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol-related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team's primary care patient panel. Teams (n = 31) whose registered nurses displayed more strong (at least daily) face-to-face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol-related hospital days (rate ratio [RR] = 0.90; 95% confidence interval [CI]: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1,030 (95% CI: -$1,819, -$241) lower alcohol-related patient healthcare costs per 1,000 team patients in the past 12 months. Conversely, teams whose primary care practitioner (PCP) had more strong face-to-face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol-related hospital days (RR = 1.12; 95% CI: 1.03, 1.23) and $1,428 (95% CI: $378, $2,478) higher alcohol-related healthcare costs per 1,000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and comorbidity diagnoses. Excessive alcohol-using patients may fair better if cared for by teams whose face-to-face and electronic communication networks include more team members and whose communication to the PCP has been streamlined to fewer team members. Copyright © 2015 by the Research Society on Alcoholism.

Shared responsibility: school nurses' experience of collaborating in school-based interprofessional teams.

PubMed

Reuterswärd, Marina; Hylander, Ingrid

2017-06-01

The Swedish Education Act (2011) mandated a new combination of services to boost students' physical health, their mental health and special education through interprofessional pupil health and well-being (PH) teams. For Swedish school nurses, providing these services presents new challenges. To describe how Swedish school nurses experience their work and collaboration within the interprofessional PH teams. Twenty-five school nurses (SNs) were interviewed in five focus groups. Content analysis was used to examine the data and to explore SNs' workplace characteristics by using the components of the sense of coherence (SOC) framework. SNs' experiences of work and collaboration within PH teams can be described using three domains: the expectations of others regarding SNs' roles, SNs' contributions to pupils' health and well-being, and collaboration among SNs within PH teams. The results indicate a discrepancy between SNs' own experiences of their contribution and their experiences of other professionals' expectations regarding those contributions. Some duties were perceived as expected, comprehensible, manageable and meaningful, while other duties - though expected - were perceived as less meaningful, taking time away from school-related matters. Other duties that were not explicitly expected - promoting general health and creating safety zones for pupils, teachers and parents, for example - were nonetheless perceived as meaningful. Collaboration within PH teams was considered meaningful, comprehensible and manageable only if the objectives of the team meetings were clear, if other professionals were available and if professional roles on the team were clearly communicated. The SNs reported a lack of clarity regarding their role in PH and its implementation in schools, indicating that professionals in PH teams need to discuss collaboration so as to find their niche given the new conditions. SOC theory emerged as a useful framework for discussing concrete work-related factors in the school environment. © 2016 Nordic College of Caring Science.

Effective communication and teamwork promotes patient safety.

PubMed

Gluyas, Heather

2015-08-05

Teamwork requires co-operation, co-ordination and communication between members of a team to achieve desired outcomes. In industries with a high degree of risk, such as health care, effective teamwork has been shown to achieve team goals successfully and efficiently, with fewer errors. This article introduces behaviours that support communication, co-operation and co-ordination in teams. The central role of communication in enabling co-operation and co-ordination is explored. A human factors perspective is used to examine tools to improve communication and identify barriers to effective team communication in health care.

Using GTO-Velo to Facilitate Communication and Sharing of Simulation Results in Support of the Geothermal Technologies Office Code Comparison Study

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

White, Signe K.; Purohit, Sumit; Boyd, Lauren W.

The Geothermal Technologies Office Code Comparison Study (GTO-CCS) aims to support the DOE Geothermal Technologies Office in organizing and executing a model comparison activity. This project is directed at testing, diagnosing differences, and demonstrating modeling capabilities of a worldwide collection of numerical simulators for evaluating geothermal technologies. Teams of researchers are collaborating in this code comparison effort, and it is important to be able to share results in a forum where technical discussions can easily take place without requiring teams to travel to a common location. Pacific Northwest National Laboratory has developed an open-source, flexible framework called Velo that providesmore » a knowledge management infrastructure and tools to support modeling and simulation for a variety of types of projects in a number of scientific domains. GTO-Velo is a customized version of the Velo Framework that is being used as the collaborative tool in support of the GTO-CCS project. Velo is designed around a novel integration of a collaborative Web-based environment and a scalable enterprise Content Management System (CMS). The underlying framework provides a flexible and unstructured data storage system that allows for easy upload of files that can be in any format. Data files are organized in hierarchical folders and each folder and each file has a corresponding wiki page for metadata. The user interacts with Velo through a web browser based wiki technology, providing the benefit of familiarity and ease of use. High-level folders have been defined in GTO-Velo for the benchmark problem descriptions, descriptions of simulator/code capabilities, a project notebook, and folders for participating teams. Each team has a subfolder with write access limited only to the team members, where they can upload their simulation results. The GTO-CCS participants are charged with defining the benchmark problems for the study, and as each GTO-CCS Benchmark problem is defined, the problem creator can provide a description using a template on the metadata page corresponding to the benchmark problem folder. Project documents, references and videos of the weekly online meetings are shared via GTO-Velo. A results comparison tool allows users to plot their uploaded simulation results on the fly, along with those of other teams, to facilitate weekly discussions of the benchmark problem results being generated by the teams. GTO-Velo is an invaluable tool providing the project coordinators and team members with a framework for collaboration among geographically dispersed organizations.« less

The communication in industrialised building system (IBS) construction project: Virtual environment

NASA Astrophysics Data System (ADS)

Pozin, Mohd Affendi Ahmad; Nawi, Mohd Nasrun Mohd

2017-10-01

Large portion of numbers team organization in the IBS construction sector is known are being fragmented. That is contributed from a segregation of construction activity thus create team working in virtually. Virtual team are the nature when teams are working in distributed area, across culture and time. Therefore, teams can be respond to the task without relocating to the site project and settle down a problem through information and communication technology (ICT). The emergence of virtual team are carry out by advancements in communication technologies as a medium to improve project team communication in project delivery process on IBS construction. Based on literature review from previous study and data collected from interviewing, this paper aim to identified communication challenges among project team members according to current project development practices in IBS construction project. Hence, in attempt to develop effective communication through the advantages of virtual team approach for IBS construction project. In order to ensure the data is gathered comprehensively and accurately, the data was collected from project managers by using semi structured interview method. It was found that virtual team approach could be enable competitive challenges on complexity in the construction project management process.

A systems engineering initiative for NASA's space communications

NASA Technical Reports Server (NTRS)

Hornstein, Rhoda S.; Hei, Donald J., Jr.; Kelly, Angelita C.; Lightfoot, Patricia C.; Bell, Holland T.; Cureton-Snead, Izeller E.; Hurd, William J.; Scales, Charles H.

1993-01-01

In addition to but separate from the Red and Blue Teams commissioned by the NASA Administrator, NASA's Associate Administrator for Space Communications commissioned a Blue Team to review the Office of Space Communications (Code O) Core Program and determine how the program could be conducted faster, better, and cheaper, without compromising safety. Since there was no corresponding Red Team for the Code O Blue Team, the Blue Team assumed a Red Team independent attitude and challenged the status quo. The Blue Team process and results are summarized. The Associate Administrator for Space Communications subsequently convened a special management session to discuss the significance and implications of the Blue Team's report and to lay the groundwork and teamwork for the next steps, including the transition from engineering systems to systems engineering. The methodology and progress toward realizing the Code O Family vision and accomplishing the systems engineering initiative for NASA's space communications are presented.

Together Achieving More: Primary Care Team Communication and Alcohol-Related Health Care Utilization and Costs

PubMed Central

Mundt, Marlon P.; Zakletskaia, Larissa I.; Shoham, David A.; Tuan, Wen-Jan; Carayon, Pascale

2015-01-01

Background Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes. Methods Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three-level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol-related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team’s primary care patient panel. Results Teams (n=31) whose RNs displayed more strong (at least daily) face-to-face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol-related hospital days (RR=0.90; 95% CI: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1030 (95% CI: −$1819, −$241) lower alcohol-related patient health care costs per 1000 team patients in the past 12 months. Conversely, teams whose primary care practitioner had more strong face-to-face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol-related hospital days (RR=1.12; 95: CI: 1.03, 1.23) and $1428 (95% CI: $378, $2478) higher alcohol-related healthcare costs per 1000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and co-morbidity diagnoses. Conclusions Excessive alcohol-using patients may fair better if cared for by teams whose face-to-face and electronic communication networks include more team members and whose communication to the PCP has been streamlined to fewer team members. PMID:26350957

Communication skills to develop trusting relationships on global virtual engineering capstone teams

NASA Astrophysics Data System (ADS)

Zaugg, Holt; Davies, Randall S.

2013-05-01

As universities seek to provide cost-effective, cross-cultural experiences using global virtual (GV) teams, the 'soft' communication skills typical of all teams, increases in importance for GV teams. Students need to be taught how to navigate through cultural issues and virtual tool issues to build strong trusting relationships with distant team members. Weekly team meetings provide an excellent opportunity to observe key team interactions that facilitate relationship and trust-building among team members. This study observed the weekly team meetings of engineering students attending two US universities and one Asian university as they collaborated as a single GV capstone GV team. In addition local team members were interviewed individually and collectively throughout the project to determine strategies that facilitated team relations and trust. Findings indicate the importance of student choice of virtual communication tools, the refining of communication practices, and specific actions to build trusting relationships. As student developed these attributes, collaboration and success was experienced on this GV team.

Share (And Not) Share Alike: Improving Virtual Team Climate and Decision Performance

ERIC Educational Resources Information Center

Cordes, Sean

2017-01-01

Virtual teams face unique communication and collaboration challenges that impact climate development and performance. First, virtual teams rely on technology mediated communication which can constrain communication. Second, team members lack skill for adapting process to the virtual setting. A collaboration process structure was designed to…

Guiding principles and clinical applications for speech-language pathology practice in early intervention.

PubMed

Paul, Diane; Roth, Froma P

2011-07-01

This article describes guiding principles in early intervention (EI) and demonstrates how speech-language pathologists (SLPs) can apply these principles to best serve infants and toddlers with communication and related problems and their families. Four principles guide the implementation of speech-language pathology services. EI services are services that are (a) family centered and culturally and linguistically responsive; (b) developmentally supportive, promoting children's participation in their natural environments; (c) comprehensive, coordinated, and team based; and (d) based on the highest quality evidence available. Actual clinical scenarios are presented to illustrate each principle. The four principles provide a framework for the wide range of roles and responsibilities assumed by SLPs in EI: (a) screening/evaluation/assessment, (b) goal setting and intervention, (c) consultation with and education for team members, (d) service coordination, (e) transition planning, and (f) advocacy. It is critical that families of infants and toddlers who are at risk for, or who have been diagnosed with, communication disorders receive all necessary services and supports. EI services should be tailored to the individual and the changing needs, preferences, and priorities of each family. The earlier services are provided, the more likely is the child's chance to develop effective communication.

Design of an Information System for Palliative Care: User Analysis.

PubMed

Alvarez-Tobón, Veronica A; Luna-Gómez, Ivan F; Torres-Silva, Ever A; Florez-Arango, Jose F; Rivera-Mejia, Paula T; Higuita Usuga, Andrea

2018-01-01

To explore the demographic factors and the level of knowledge related to information and communication technologies of potential users of a palliative care information system. The Task, User, Representation, Functionality (TURF) framework was applied to characterize potential users (patients and caregivers) of an information system for palliative care in a private clinic in Medellin, Colombia, through a survey. We analyzed 35 patients and 39 caregivers. The majority were women, that lived in urban area and belonged to middle-income socioeconomic stratum. Caregivers, in contrast to patients, are common users of information and communication technologies. An information system should focus on the needs of caregivers, and it would be targeted to subjects facing challenges related to technology adoption; information and communication technologies are interesting and important tools for the improvement of health team.

Coordinating teams of autonomous vehicles: an architectural perspective

NASA Astrophysics Data System (ADS)

Czichon, Cary; Peterson, Robert W.; Mettala, Erik G.; Vondrak, Ivo

2005-05-01

In defense-related robotics research, a mission level integration gap exists between mission tasks (tactical) performed by ground, sea, or air applications and elementary behaviors enacted by processing, communications, sensors, and weaponry resources (platform specific). The gap spans ensemble (heterogeneous team) behaviors, automatic MOE/MOP tracking, and tactical task modeling/simulation for virtual and mixed teams comprised of robotic and human combatants. This study surveys robotic system architectures, compares approaches for navigating problem/state spaces by autonomous systems, describes an architecture for an integrated, repository-based modeling, simulation, and execution environment, and outlines a multi-tiered scheme for robotic behavior components that is agent-based, platform-independent, and extendable via plug-ins. Tools for this integrated environment, along with a distributed agent framework for collaborative task performance are being developed by a U.S. Army funded SBIR project (RDECOM Contract N61339-04-C-0005).

Strategic thinking for radiology.

PubMed

Schilling, R B

1997-08-01

We have now analyzed the use and benefits of four Strategic Thinking Tools for Radiology: the Vision Statement, the High Five, the Two-by-Two, and Real-Win-Worth. Additional tools will be provided during the tutorial. The tools provided above should be considered as examples. They all contain the 10 benefits outlined earlier to varying degrees. It is extremely important that the tools be used in a manner consistent with the Vision Statement of the organization. The specific situation, the effectiveness of the team, and the experience developed with the tools over time will determine the true benefits of the process. It has also been shown that with active use of the types of tools provided above, teams have learned to modify the tools for increased effectiveness and have created additional tools for specific purposes. Once individuals in the organization become committed to improving communication and to using tools/frameworks for solving problems as a team, effectiveness becomes boundless.

Conceptual framework of acute care nurse practitioner role enactment, boundary work, and perceptions of team effectiveness.

PubMed

Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Lamothe, Lise; Ritchie, Judith A; Doran, Diane

2013-01-01

This article describes a new conceptual framework for acute care nurse practitioner role enactment, boundary work and perceptions of team effectiveness. Acute care nurse practitioners contribute positively to patient care by enacting an expanded scope of practise. Researchers have found both positive and negative reactions to the introduction of acute care nurse practitioners in healthcare teams. The process of role enactment, shifting role boundaries, and perceptions of team effectiveness has been studied disparately. A framework linking team structures and processes to desirable outcomes is needed. Literature was obtained by searching CINAHL, PsycInfo, MedLine, PubMed, British Nursing Index, Cochrane Library, JSTOR Archive, Web of Science, and Google Scholar from 1985-2010. A descriptive multiple-case study was completed from March 2009-May 2009. A new conceptual framework describing how role enactment and boundary work affect perceptions of team effectiveness was developed by combining theoretical and empirical sources. The framework proposes proximal indicators used by team members to assess their team's performance. The framework identifies the inter-related dimensions and concepts that different stakeholders need to consider when introducing nurse practitioners in healthcare teams. Further study is needed to identify team-level outcomes that reflect the contributions of all providers to quality patient care, and explore the patients' and families' perceptions of team effectiveness following the introduction of acute care nurse practitioners. The new framework can guide decision-making and research related to the structures, processes, and outcomes of nurse practitioner roles in healthcare teams. © 2012 Blackwell Publishing Ltd.

Grounding theories of W(e)Learn: a framework for online interprofessional education.

PubMed

Casimiro, Lynn; MacDonald, Colla J; Thompson, Terrie Lynn; Stodel, Emma J

2009-07-01

Interprofessional care (IPC) is a prerequisite for enhanced communication between healthcare team members, improved quality of care, and better outcomes for patients. A move to an IPC model requires changing the learning experiences of healthcare providers during and after their qualification program. With the rapid growth of online and blended approaches to learning, an educational framework that explains how to construct quality learning events to provide IPC is pressing. Such a framework would offer a quality standard to help educators design, develop, deliver, and evaluate online interprofessional education (IPE) programs. IPE is an extremely delicate process due to issues related to knowledge, status, power, accountability, personality traits, and culture that surround IPC. In this paper, a review of the pertinent literature that would inform the development of such a framework is presented. The review covers IPC, IPE, learning theories, and eLearning in healthcare.

Evaluating trauma team performance in a Level I trauma center: Validation of the trauma team communication assessment (TTCA-24).

PubMed

DeMoor, Stephanie; Abdel-Rehim, Shady; Olmsted, Richard; Myers, John G; Parker-Raley, Jessica

2017-07-01

Nontechnical skills (NTS), such as team communication, are well-recognized determinants of trauma team performance and good patient care. Measuring these competencies during trauma resuscitations is essential, yet few valid and reliable tools are available. We aimed to demonstrate that the Trauma Team Communication Assessment (TTCA-24) is a valid and reliable instrument that measures communication effectiveness during activations. Two tools with adequate psychometric strength (Trauma Nontechnical Skills Scale [T-NOTECHS], Team Emergency Assessment Measure [TEAM]) were identified during a systematic review of medical literature and compared with TTCA-24. Three coders used each tool to evaluate 35 stable and 35 unstable patient activations (defined according to Advanced Trauma Life Support criteria). Interrater reliability was calculated between coders using the intraclass correlation coefficient. Spearman rank correlation coefficient was used to establish concurrent validity between TTCA-24 and the other two validated tools. Coders achieved an intraclass correlation coefficient of 0.87 for stable patient activations and 0.78 for unstable activations scoring excellent on the interrater agreement guidelines. The median score for each assessment showed good team communication for all 70 videos (TEAM, 39.8 of 54; T-NOTECHS, 17.4 of 25; and TTCA-24, 87.4 of 96). A significant correlation between TTTC-24 and T-NOTECHS was revealed (p = 0.029), but no significant correlation between TTCA-24 and TEAM (p = 0.77). Team communication was rated slightly better across all assessments for stable versus unstable patient activations, but not statistically significant. TTCA-24 correlated with T-NOTECHS, an instrument measuring nontechnical skills for trauma teams, but not TEAM, a tool that assesses communication in generic emergency settings. TTCA-24 is a reliable and valid assessment that can be a useful adjunct when evaluating interpersonal and team communication during trauma activations. Diagnostic tests or criteria, level II.

Mixed Methods Research With Internally Displaced Colombian Gay and Bisexual Men and Transwomen

PubMed Central

Zea, Maria Cecilia; Aguilar-Pardo, Marcela; Betancourt, Fabian; Reisen, Carol A.; Gonzales, Felisa

2014-01-01

We discuss the use of mixed methods research to further understanding of displaced Colombian gay and bisexual men and transwomen, a marginalized population at risk. Within the framework of communicative action, which calls for social change through egalitarian dialog, we describe how our multinational, interdisciplinary research team explored the subjective, objective, and social worlds of participants through life history interviews and surveys. We also describe the unique Colombian context, conscious efforts to establish egalitarian relationships among research team members, and efforts to disseminate and reflect on findings. Through discussion of our research process and results, we aim to demonstrate how mixed methods research can be utilized to facilitate noncoercive discourse and contribute to social change. PMID:24926225

Implementing change in primary care practices using electronic medical records: a conceptual framework.

PubMed

Nemeth, Lynne S; Feifer, Chris; Stuart, Gail W; Ornstein, Steven M

2008-01-16

Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to implement clinical guidelines for primary and secondary prevention of cardiovascular disease in primary care practices that used a common electronic medical record (EMR). Multiple conceptual frameworks informed the design of this study designed to explain the complex phenomena of implementing change in primary care practice. Qualitative methods were used to examine the processes of change that practice members used to implement the guidelines. Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II) clinical trial yielded 28 staff members and clinicians who were interviewed regarding how change in practice occurred while implementing clinical guidelines for primary and secondary prevention of cardiovascular disease and strokes. A conceptual framework for implementing clinical guidelines into primary care practice was developed through this research. Seven concepts and their relationships were modelled within this framework: leaders setting a vision with clear goals for staff to embrace; involving the team to enable the goals and vision for the practice to be achieved; enhancing communication systems to reinforce goals for patient care; developing the team to enable the staff to contribute toward practice improvement; taking small steps, encouraging practices' tests of small changes in practice; assimilating the electronic medical record to maximize clinical effectiveness, enhancing practices' use of the electronic tool they have invested in for patient care improvement; and providing feedback within a culture of improvement, leading to an iterative cycle of goal setting by leaders. This conceptual framework provides a mental model which can serve as a guide for practice leaders implementing clinical guidelines in primary care practice using electronic medical records. Using the concepts as implementation and evaluation criteria, program developers and teams can stimulate improvements in their practice settings. Investing in collaborative team development of clinicians and staff may enable the practice environment to be more adaptive to change and improvement.

In search for a public health leadership competency framework to support leadership curriculum-a consensus study.

PubMed

Czabanowska, Katarzyna; Smith, Tony; Könings, Karen D; Sumskas, Linas; Otok, Robert; Bjegovic-Mikanovic, Vesna; Brand, Helmut

2014-10-01

Competency-based education is increasingly popular, especially in the area of continuing professional development. Many competency frameworks have been developed; however, few address leadership competencies for European public health professionals. The aim of this study was to develop a public health leadership competency framework to inform a leadership curriculum for public health professionals. The framework was developed as part of the Leaders for European Public Health project-supported by the EU Lifelong Learning Programme. The study was carried out in three phases: a literature review, consensus development panel and Delphi survey. The public health leadership competency framework was initially developed from a literature review. A preliminary list of competencies was submitted to a panel of experts. Two consensus development panels were held to evaluate and make changes to the initial draft competency framework. Then two rounds of a Delphi survey were carried out in an effort to reach consensus. Both surveys were presented through Survey Monkey to members of the Association of the Schools of Public Health in the European Region Working Group on Innovation in Public Health Teaching and Education. The framework was developed consisting of 52 competencies organized into eight domains: Systems Thinking; Political Leadership; Collaborative Leadership: Building and Leading Interdisciplinary Teams; Leadership and Communication; Leading Change; Emotional Intelligence and Leadership in Team-based Organizations; Leadership, Organizational Learning and Development and Ethics and Professionalism. The framework can serve as a useful tool in identifying gaps in knowledge and skills, and shaping competency-based continuing professional development leadership curricula for public health professionals in Europe. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Mapping planetary caves with an autonomous, heterogeneous robot team

NASA Astrophysics Data System (ADS)

Husain, Ammar; Jones, Heather; Kannan, Balajee; Wong, Uland; Pimentel, Tiago; Tang, Sarah; Daftry, Shreyansh; Huber, Steven; Whittaker, William L.

Caves on other planetary bodies offer sheltered habitat for future human explorers and numerous clues to a planet's past for scientists. While recent orbital imagery provides exciting new details about cave entrances on the Moon and Mars, the interiors of these caves are still unknown and not observable from orbit. Multi-robot teams offer unique solutions for exploration and modeling subsurface voids during precursor missions. Robot teams that are diverse in terms of size, mobility, sensing, and capability can provide great advantages, but this diversity, coupled with inherently distinct low-level behavior architectures, makes coordination a challenge. This paper presents a framework that consists of an autonomous frontier and capability-based task generator, a distributed market-based strategy for coordinating and allocating tasks to the different team members, and a communication paradigm for seamless interaction between the different robots in the system. Robots have different sensors, (in the representative robot team used for testing: 2D mapping sensors, 3D modeling sensors, or no exteroceptive sensors), and varying levels of mobility. Tasks are generated to explore, model, and take science samples. Based on an individual robot's capability and associated cost for executing a generated task, a robot is autonomously selected for task execution. The robots create coarse online maps and store collected data for high resolution offline modeling. The coordination approach has been field tested at a mock cave site with highly-unstructured natural terrain, as well as an outdoor patio area. Initial results are promising for applicability of the proposed multi-robot framework to exploration and modeling of planetary caves.

Using the International Classification of Functioning, Disability and Health Framework to Achieve Interprofessional Functional Outcomes for Young Children: A Speech-Language Pathology Perspective.

PubMed

McNeilly, Lemmietta G

2018-02-01

The International Classification of Functioning, Disability and Health (ICF) framework is an excellent tool to facilitate the writing of functional goals for children who exhibit communication disorders and other developmental problems that require services from professionals in multiple therapeutic areas. The holistic view of children provides each professional with an approach that integrates how one's specific health conditions and contextual factors influence a child's functioning and participation in daily activities. This allows the interprofessional team to view the child as a person, recognizing how one need influences another within his or her environment. Copyright © 2017 Elsevier Inc. All rights reserved.

Is it possible to improve radiotherapy team members' communication skills? A randomized study assessing the efficacy of a 38-h communication skills training program.

PubMed

Gibon, Anne-Sophie; Merckaert, Isabelle; Liénard, Aurore; Libert, Yves; Delvaux, Nicole; Marchal, Serge; Etienne, Anne-Marie; Reynaert, Christine; Slachmuylder, Jean-Louis; Scalliet, Pierre; Van Houtte, Paul; Coucke, Philippe; Salamon, Emile; Razavi, Darius

2013-10-01

Optimizing communication between radiotherapy team members and patients and between colleagues requires training. This study applies a randomized controlled design to assess the efficacy of a 38-h communication skills training program. Four radiotherapy teams were randomly assigned either to a training program or to a waiting list. Team members' communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient were the primary endpoints. These encounters were scheduled at the baseline and after training for the training group, and at the baseline and four months later for the waiting list group. Encounters were audiotaped and transcribed. Transcripts were analyzed with content analysis software (LaComm) and by an independent rater. Eighty team members were included in the study. Compared to untrained team members, trained team members used more turns of speech with content oriented toward available resources in the team (relative rate [RR]=1.38; p=0.023), more assessment utterances (RR=1.69; p<0.001), more empathy (RR=4.05; p=0.037), more negotiation (RR=2.34; p=0.021) and more emotional words (RR=1.32; p=0.030), and their self-efficacy to communicate increased (p=0.024 and p=0.008, respectively). The training program was effective in improving team members' communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient. Future study should assess the effect of this training program on communication with actual patients and their satisfaction. Moreover a cost-benefit analysis is needed, before implementing such an intensive training program on a broader scale. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Pilot study of the development of a theory-based instrument to evaluate the communication process during multidisciplinary team conferences in rheumatology.

PubMed

Verhoef, J; Toussaint, P J; Putter, H; Zwetsloot-Schonk, J H M; Vliet Vlieland, T P M

2005-10-01

Coordinated teams with multidisciplinary team conferences are generally seen as a solution to the management of complex health conditions. However, problems regarding the process of communication during team conferences are reported, such as the absence of a common language or viewpoint and the exchange of irrelevant or repeated information. To determine the outcome of interventions aimed at improving communication during team conferences, a reliable and valid assessment method is needed. To investigate the feasibility of a theory-based measurement instrument for assessing the process of the communication during multidisciplinary team conferences in rheumatology. An observation instrument was developed based on communication theory. The instrument distinguishes three types of communication: (I) grounding activities, (II) coordination of non-team activities, and (III) coordination of team activities. To assess the process of communication during team conferences in a rheumatology clinic with inpatient and day patient facilities, team conferences were videotaped. To determine the inter-rater reliability, in 20 conferences concerning 10 patients with rheumatoid arthritis admitted to the inpatient unit, the instrument was applied by two investigators independently. Content validity was determined by analysing and comparing the results of initial and follow-up team conferences of 25 consecutive patients with rheumatoid arthritis admitted to the day patient unit (Wilcoxon signed rank test). The inter-rater reliability was excellent with the intra-class correlation coefficients being >0.98 for both types I and III communications in 10 initial and 10 follow-up conferences (type II was not observed). An analysis of an additional 25 initial and 86 follow-up team conferences showed that time spent on grounding (type I) made up the greater part of the contents of communication (87% S.D. 14 and 60% S.D. 29 in initial and follow-up conferences, respectively), which is significantly more compared to time spent on co-ordination (p<0.001 and 0.02 for categories II and III, respectively). Moreover, significantly less time spent was spent on grounding in follow-up as compared to initial team conferences, whereas the time spent on coordination (type III) increased (both p-values<0.001). This theory-based measurement instrument for describing and evaluating the communication process during team conferences proved to be reliable and valid in this pilot study. Its usefulness to detect changes in the communication process, e.g. after implementing systems for re-structuring team conferences mediated by ICT applications, should be further examined.

Innovation in globally distributed teams: the role of LMX, communication frequency, and member influence on team decisions.

PubMed

Gajendran, Ravi S; Joshi, Aparna

2012-11-01

For globally distributed teams charged with innovation, member contributions to the team are crucial for effective performance. Prior research, however, suggests that members of globally distributed teams often feel isolated and excluded from their team's activities and decisions. How can leaders of such teams foster member inclusion in team decisions? Drawing on leader-member exchange (LMX) theory, we propose that for distributed teams, LMX and communication frequency jointly shape member influence on team decisions. Findings from a test of our hypotheses using data from 40 globally distributed teams suggest that LMX can enhance member influence on team decisions when it is sustained through frequent leader-member communication. This joint effect is strengthened as team dispersion increases. At the team level, member influence on team decisions has a positive effect on team innovation. (c) 2012 APA, all rights reserved.

Building an Economical and Sustainable Lunar Infrastructure to Enable Lunar Science and Space Commerce

NASA Technical Reports Server (NTRS)

Zuniga, Allison; Turner, Mark; Rasky, Dan

2017-01-01

A new concept study was initiated to examine the framework needed to gradually develop an economical and sustainable lunar infrastructure using a public private partnerships approach. This approach would establish partnership agreements between NASA and industry teams to develop cis-lunar and surface capabilities for mutual benefit while sharing cost and risk in the development phase and then allowing for transfer of operation of these infrastructure services back to its industry owners in the execution phase. These infrastructure services may include but are not limited to the following: lunar cargo transportation, power stations, energy storage devices, communication relay satellites, local communication towers, and surface mobility operations.

Optimizing Language for Stroke Motor Rehabilitation: Recommendations from the ACRM Stroke Movement Interventions Subcommittee

PubMed Central

Page, Stephen J.; Schmid, Arlene; Harris, Jocelyn

2012-01-01

As knowledge and interest in stroke motor rehabilitation continue to increase, consistent terminologies that are specific to this discipline must be established. Such language is critical to effective rehabilitative team communication, and is important to facilitating communication among the diverse groups interested in the science and practice of stroke motor rehabilitation. The purpose of this paper is to provide operational definitions for three concepts that are common - and commonly mislabeled - attributes of stroke motor rehabilitation interventions: intensity, duration, and frequency. In developing these guidelines, conceptual frameworks used in the pharmaceutical, exercise, and rehabilitative therapy realms were used. Implications of these definitions for research and clinical practice are also discussed. PMID:22446292

Planning in context: A situated view of children's management of science projects

NASA Astrophysics Data System (ADS)

Marshall, Susan Katharine

This study investigated children's collaborative planning of a complex, long-term software design project. Using sociocultural methods, it examined over time the development of design teams' planning negotiations and tools to document the coconstruction of cultural frameworks to organize teams' shared understanding of what and how to plan. Results indicated that student teams developed frameworks to address a set of common planning functions that included design planning, project metaplanning (things such as division of labor or sharing of computer resources) and team collaboration management planning. There were also some between-team variations in planning frameworks, within a bandwidth of options. Teams engaged in opportunistic planning, which reflected shifts in strategies in response to new circumstances over time. Team members with past design project experience ("oldtimers") demonstrated the transfer of their planning framework to the current design task, and they supported the developing participation of "newcomers." Teams constructed physical tools (e.g. planning boards) that acted as visual representations of teams' planning frameworks, and inscriptions of team thinking. The assigned functions of the tools also shifted over time with changing project circumstances. The discussion reexamines current approaches to the study of planning and discusses their educational implications.

Virtual Team Leadership: The Effects of Leadership Style and Communication Medium on Team Interaction Styles and Outcomes

ERIC Educational Resources Information Center

Hambley, Laura A.; O'Neill, Thomas A.; Kline, Theresa J. B.

2007-01-01

This study investigated the effects of transformational and transactional leadership styles and communication media on team interaction styles and outcomes. Teams communicated through one of the following three ways: (a) face-to-face, (b) desktop videoconference, or (c) text-based chat. Results indicated that transformational and transactional…

Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

PubMed

Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

2010-12-01

We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

A Lego Mindstorms NXT based test bench for multiagent exploratory systems and distributed network partitioning

NASA Astrophysics Data System (ADS)

Patil, Riya Raghuvir

Networks of communicating agents require distributed algorithms for a variety of tasks in the field of network analysis and control. For applications such as swarms of autonomous vehicles, ad hoc and wireless sensor networks, and such military and civilian applications as exploring and patrolling a robust autonomous system that uses a distributed algorithm for selfpartitioning can be significantly helpful. A single team of autonomous vehicles in a field may need to self-dissemble into multiple teams, conducive to completing multiple control tasks. Moreover, because communicating agents are subject to changes, namely, addition or failure of an agent or link, a distributed or decentralized algorithm is favorable over having a central agent. A framework to help with the study of self-partitioning of such multi agent systems that have most basic mobility model not only saves our time in conception but also gives us a cost effective prototype without negotiating the physical realization of the proposed idea. In this thesis I present my work on the implementation of a flexible and distributed stochastic partitioning algorithm on the LegoRTM Mindstorms' NXT on a graphical programming platform using National Instruments' LabVIEW(TM) forming a team of communicating agents via NXT-Bee radio module. We single out mobility, communication and self-partition as the core elements of the work. The goal is to randomly explore a precinct for reference sites. Agents who have discovered the reference sites announce their target acquisition to form a network formed based upon the distance of each agent with the other wherein the self-partitioning begins to find an optimal partition. Further, to illustrate the work, an experimental test-bench of five Lego NXT robots is presented.

A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center.

PubMed

Nurok, Michael; Lipsitz, Stuart; Satwicz, Paul; Kelly, Andrea; Frankel, Allan

2010-05-01

To create and test a reproducible method for measuring emotional climate, surgical team skills, and threats to patient outcome by conducting an observational study to assess the impact of a surgical team skills and communication improvement intervention on these measurements. Observational study. Operating rooms in a high-volume thoracic surgery center from September 5, 2007, through June 30, 2008. Thoracic surgery operating room teams. Two 90-minute team skills training sessions focused on findings from a standardized safety culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication, and leadership. The sessions created an interactive forum to educate team members on the importance of communication and to role-play optimal interactive and communication strategies. Calculated indices of emotional climate, team skills, and threat to patient outcome. The calculated communication and team skills score improved from the preintervention to postintervention periods, but the improvement extinguished during the 3 months after the intervention (P < .001). The calculated threat-to-outcome score improved following the team training intervention and remained statistically improved 3 months later (P < .001). Using a new method for measuring emotional climate, teamwork, and threats to patient outcome, we were able to determine that a teamwork training intervention can improve a calculated score of team skills and communication and decrease a calculated score of threats to patient outcome. However, the effect is only durable for threats to patient outcome.

Communication Among Team Members Within the Patient-centered Medical Home and Patient Satisfaction With Providers: The Mediating Role of Patient-Provider Communication.

PubMed

Stockdale, Susan E; Rose, Danielle; Darling, Jill E; Meredith, Lisa S; Helfrich, Christian D; Dresselhaus, Timothy R; Roos, Philip; Rubenstein, Lisa V

2018-06-01

The Patient-centered Medical Home (PCMH) uses team-based care to improve patient outcomes, including satisfaction. The quality of patients' communication with their primary care providers (PCPs) is a key determinant of patient satisfaction. A shift to team-based care could disrupt the therapeutic relationship between patients and their PCPs and reduce patient satisfaction if communication and coordination among primary care team members is poor. Little is known about the relationship between intrateam communication within a PCMH and patient satisfaction with PCPs, and whether patient-provider communication might mediate this relationship. To examine the relationship between intrateam communication in a PCMH and patients' satisfaction with assigned PCPs, and whether patient-provider communication mediates this relationship. Cross-sectional surveys of Veterans Health Administration PCPs (2011-2012, n=149) matched with their assigned patients' surveys (n=3329). Mediation analyses using a nested data structure, controlling for patient and provider characteristics. Patient satisfaction with PCPs, patient-reported patient-provider communication, and PCP-reported intrateam communication within the PCMH. Intrateam communication and patient-provider communication were independently associated with patients' satisfaction with their PCPs. Patient-provider communication mediated 56% of the association between intrateam communication and patient satisfaction. Better intrateam communication combined with better patient-provider communication predicted high satisfaction (81%), compared with poor intrateam communication and poor patient-provider communication (22%). PCMH environments with better communication among team members are likely to experience better patient-provider communication and high patient satisfaction. PCMH practices with low ratings of patient satisfaction may need to look beyond individual PCPs to communication within and across teams.

A Cognitive Framework for Resource-Aware Sensor Net Organizations

DTIC Science & Technology

2008-07-01

The AFRL/RI team had procured and were experimenting with several Sony AIBO R © “dog” platforms as low-cost mobility robots that could potentially...available. 14 a cycle, it keeps its radio turned on for that long to hear if any agent (including console and regional nodes) wants to communicate. If...08), Estoril, Portugal, May 2008. To appear. [10] Daniel D. Corkill and Victor R . Lesser. The use of meta-level control for coordination in a dis

A common body of care: the ethics and politics of teamwork in the operating theater are inseparable.

PubMed

Bleakley, Alan

2006-06-01

In the operating theater, the micro-politics of practice, such as interpersonal communications, are central to patient safety and are intimately tied with values as well as knowledge and skills. Team communication is a shared and distributed work activity. In an era of "professionalism," that must now encompass "interprofessionalism," a virtue ethics framework is often invoked to inform practice choices, with reference to phronesis or practical wisdom. However, such a framework is typically cast in individualistic terms as a character trait, rather than in terms of a distributed quality that may be constituted through intentionally collaborative practice, or is an emerging property of a complex, adaptive system. A virtue ethics approach is a necessary but not sufficient condition for a collaborative bioethics within the operating theater. There is also an ecological imperative-the patient's entry into the household (oikos) of the operating theater invokes the need for "hospitality" as a form of ethical practice.

Using a human patient simulator to study the relationship between communication and nursing students' team performance.

PubMed

Hirokawa, Randy Y; Daub, Katharyn; Lovell, Eileen; Smith, Sarah; Davis, Alice; Beck, Christine

2012-11-01

This study examined the relationship between communication and nursing students' team performance by determining whether variations in team performance are related to differences in communication regarding five task-relevant functions: assessment, diagnosis, planning, implementation, and evaluation. The study results indicate a positive relationship between nursing students' team performance and comments focused on the implementation of treatment(s) and the evaluation of treatment options. A negative relationship between nursing students' team performance and miscellaneous comments made by team members was also observed. Copyright 2012, SLACK Incorporated.

Championship Communication

ERIC Educational Resources Information Center

VanDerveer, Beth; Butterick, Betsy

2017-01-01

This article discusses team development and focuses specifically on championship communication and team-building activities. Team development takes time and the process typically occurs in stages. Regardless of the sport or what the competitive field may look like, communication is an often overlooked, yet vital element in cultivating a…

Style Guide: An Interdisciplinary Communication Tool to Support the Process of Generating Tailored Infographics From Electronic Health Data Using EnTICE3.

PubMed

Arcia, Adriana; Velez, Mark; Bakken, Suzanne

2015-01-01

In this case study we describe key features of the structured communication tool-a style guide-used to support interdisciplinary collaboration, and we propose the use of such a tool for research teams engaged in similar projects. We employ tailored infographics to present patient reported outcome data from a community health survey back, in a comprehensible and actionable manner, to the individuals who provided it. The style guide was developed to bridge the semantic gap between the domain and programming experts engaged in this effort. The style guide supports the communication of complex design specifications in a highly structured format that is nevertheless flexible enough to accommodate project growth. Unlike the typical corporate style guide that has a more narrative format, our style guide is innovative in its use of consistent fields across multiple, standalone entries. The process of populating the style guide prompted the designer toward greater design efficiency and led to consistent and specific instructions that met the framework architect's stated information needs. The guiding values in the creation of the style guide were consistency, clarity, and flexibility. It serves as a durable reference to the desired look and functionality of the final infographic product without dictating an implementation strategy. The style guide format can be adapted to meet the communication needs of other interdisciplinary teams facing a semantic gap.

Clinical team functioning and IT innovation: a study of the diffusion of a point-of-care online evidence system.

PubMed

Gosling, A Sophie; Westbrook, Johanna I; Braithwaite, Jeffrey

2003-01-01

To investigate the association between clinical team functioning and diffusion (awareness, use, and impact) of a 24-hour online evidence retrieval system. To examine the relationships between clinical team characteristics and the adoption of the online evidence system. 18 clinical teams, consisting of 180 clinicians from three Australian hospitals, were identified and studied. Teams were categorized as small ( 15). Clinical team functioning was assessed using the Team Climate Inventory (TCI). Awareness, use, and impact of an online evidence retrieval system were measured using a self-administered questionnaire. The relationships between TCI scores and awareness, use, and impact were examined using t-tests and one-way ANOVAs. Chi square analyses were used to examine differences between small and large teams. RESULTS were interpreted within a diffusion of innovations framework. Clinical team functioning was not related to awareness or use of the online evidence retrieval system. However, clinical team functioning was significantly associated with the impact of online evidence in terms of reported experience of improved patient care following system use. Clinicians in small teams ( 15) teams. Team functioning had the greatest impact on the fourth stage of innovation diffusion, the effective use of online evidence for clinical care. This supports Rogers' diffusion of innovation theory, to the effect that different types of communication about an innovation are important at different stages in the diffusion process. Members of small teams were more aware of the system than members of large teams. Team functioning is amenable to improvement through interventions. The findings suggest that the role of team climate in the diffusion of information systems is a promising area for future research.

Effects of team-building on communication and teamwork among nursing students.

PubMed

Yi, Y J

2016-03-01

The aim of this study was to assess the effects of team-building on communication and teamwork (i.e. teamwork skills and team effectiveness) among nursing students. Team-building is effective for improving communication and teamwork among the nursing organization. However, the effects of team-building are not well known especially in Korea. This study used a quasi-experimental design. The sample was composed of 195 junior-year nursing students in Korea. The experimental group (100 subjects) participated in team-building activities over a 100-day period, whereas no intervention was applied to the control group (95 subjects). Pretest was conducted in both groups, and post-test was conducted after the 100-day intervention. The pre-post change in mean communication competence score did not differ between the two groups. However, the mean scores for teamwork skills and team effectiveness differed significantly between the two groups after team-building activity. This study was not a double-blind test, and randomized sampling was not implemented. Caution should thus be used when interpreting the findings. Team-building activities were effective for improving the teamwork skills and team effectiveness among Korean nursing students. It is recommended that team-building activities should be included regularly as an integral educational approach in nursing education. The findings suggest that suggests that team-building for improving communication and teamwork should be designated as one of the required criteria for nursing college programme accreditation in many countries, including Korea. However team-building requires further testing to verify this across cultures. Nurses need to receive formal team-building training for improving communication and teamwork, and formal education should be included in their job training schedule. It is recommended that communication competence and teamwork be used as one of job performance evaluations in their workplace. © 2015 International Council of Nurses.

Collaboration and entanglement: An actor-network theory analysis of team-based intraprofessional care for patients with advanced heart failure

PubMed Central

McDougall, A.; Goldszmidt, M.; Kinsella, E.A.; Smith, S.; Lingard, L.

2017-01-01

Despite calls for more interprofessional and intraprofessional team-based approaches in healthcare, we lack sufficient understanding of how this happens in the context of patient care teams. This multi-perspective, team-based interview study examined how medical teams negotiated collaborative tensions. From 2011 to 2013, 50 patients across five sites in three Canadian provinces were interviewed about their care experiences and were asked to identify members of their health care teams. Patient-identified team members were subsequently interviewed to form 50 “Team Sampling Units” (TSUs), consisting of 209 interviews with patients, caregivers and healthcare providers. Results are gathered from a focused analysis of 13 TSUs where intraprofessional collaborative tensions involved treating fluid overload, or edema, a common HF symptom. Drawing on actor-network theory (ANT), the analysis focused on intraprofessional collaboration between specialty care teams in cardiology and nephrology. The study found that despite a shared narrative of common purpose between cardiology teams and nephrology teams, fluid management tools and techniques formed sites of collaborative tension. In particular, care activities involved asynchronous clinical interpretations, geographically distributed specialist care, fragmented forms of communication, and uncertainty due to clinical complexity. Teams ‘disentangled’ fluid in order to focus on its physiological function and mobilisation. Teams also used distinct ‘framings’ of fluid management that created perceived collaborative tensions. This study advances collaborative entanglement as a conceptual framework for understanding, teaching, and potentially ameliorating some of the tensions that manifest during intraprofessional care for patients with complex, chronic disease. PMID:27490299

A multi-level approach of evaluating crew resource management training: a laboratory-based study examining communication skills as a function of team congruence.

PubMed

Sauer, J; Darioly, A; Mast, M Schmid; Schmid, P C; Bischof, N

2010-11-01

The article proposes a multi-level approach for evaluating communication skills training (CST) as an important element of crew resource management (CRM) training. Within this methodological framework, the present work examined the effectiveness of CST in matching or mismatching team compositions with regard to hierarchical status and competence. There is little experimental research that evaluated the effectiveness of CRM training at multiple levels (i.e. reaction, learning, behaviour) and in teams composed of members of different status and competence. An experiment with a two (CST: with vs. without) by two (competence/hierarchical status: congruent vs. incongruent) design was carried out. A total of 64 participants were trained for 2.5 h on a simulated process control environment, with the experimental group being given 45 min of training on receptiveness and influencing skills. Prior to the 1-h experimental session, participants were assigned to two-person teams. The results showed overall support for the use of such a multi-level approach of training evaluation. Stronger positive effects of CST were found for subjective measures than for objective performance measures. STATEMENT OF RELEVANCE: This work provides some guidance for the use of a multi-level evaluation of CRM training. It also emphasises the need to collect objective performance data for training evaluation in addition to subjective measures with a view to gain a more accurate picture of the benefits of such training approaches.

Team training in obstetrics: A multi-level evaluation.

PubMed

Sonesh, Shirley C; Gregory, Megan E; Hughes, Ashley M; Feitosa, Jennifer; Benishek, Lauren E; Verhoeven, Dana; Patzer, Brady; Salazar, Maritza; Gonzalez, Laura; Salas, Eduardo

2015-09-01

Obstetric complications and adverse patient events are often preventable. Teamwork and situational awareness (SA) can improve detection and coordination of critical obstetric (OB) emergencies, subsequently improving decision making and patient outcomes. The purpose of this study was to assess the effectiveness of a team training intervention in improving learning and transfer of teamwork, SA, decision making, and cognitive bias as well as patient outcomes in OB. An adapted TeamSTEPPS training program was delivered to OB clinicians. Training targeted communication, mutual support, situation monitoring, leadership, SA, and cognitive bias. We conducted a repeated measures multilevel evaluation of the training using Kirkpatrick's (1994) framework of training evaluation to determine impact on trainee reactions, learning, transfer, and results. Data were collected using surveys, situational judgment tests (SJTs), observations, and patient chart reviews. Participants perceived the training as useful. Additionally, participants acquired knowledge of communication strategies, though knowledge of other team competencies did not significantly improve nor did self-reported teamwork on the unit. Although SJT decision accuracy did not significantly improve for all scenarios, results of behavioral observation suggest that decision accuracy significantly improved on the job, and there was a marginally significant reduction in babies' hospital length of stay. These findings indicate that the training intervention was partially effective, but more work needs to be done to determine the conditions under which training is most effective, and the ways in which to sustain improvements. Future research is needed to confirm its generalizability to additional OB units and departments. (c) 2015 APA, all rights reserved).

Carol Laurie | NREL

Science.gov Websites

Wind Energy Association WINDPOWER. Prior to joining the wind communications team, Carol served on NREL's solar communications team, where she managed communications for the U.S. Department of Energy Solar Decathlon, a highly visible international student competition. Carol led a team of writers

Application of the VALUE communication principles in ACTIVE hospice team meetings.

PubMed

Washington, Karla T; Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Demiris, George; Shaunfield, Sara; Crumb, Edith

2013-01-01

The ACTIVE (Assessing Caregivers for Team Intervention through Video Encounters) intervention uses technology to enable family caregivers to participate in hospice interdisciplinary team (IDT) meetings from geographically remote locations. Previous research has suggested that effective communication is critical to the success of these meetings. The purpose of this study was to explore communication in ACTIVE IDT meetings involving family caregivers and to assess the degree to which hospice teams use specific communication principles (summarized in the mnemonic VALUE: value, acknowledge, listen, understand, and elicit), which have been supported in previous research in intensive care settings. Researchers analyzed team-family communication during 84 video- and/or audio-recorded care plan discussions that took place during ACTIVE team meetings, using a template approach to text analysis to determine the extent and quality of VALUE principles. The total content analyzed was 9 hours, 28 minutes in length. Hospice clinicians routinely employed the VALUE communication principles in communication during ACTIVE IDT meetings with family caregivers, but the quality of this communication was frequently rated moderate or poor. The majority of such communication was task-focused. Less often, communication centered on emotional concerns and efforts to gain a more holistic understanding of patients and families. This analysis suggests an opportunity for improving support for family members during ACTIVE IDT meetings. Members of hospice IDTs should remain aware of the opportunity for additional attention to the emotional realities of the hospice experience for family caregivers and could improve support for family caregivers during IDT meetings by ensuring that messages used to exemplify VALUE principles during team-family communication are of a high quality.

Re-engineering NASA's space communications to remain viable in a constrained fiscal environment

NASA Astrophysics Data System (ADS)

Hornstein, Rhoda Shaller; Hei, Donald J., Jr.; Kelly, Angelita C.; Lightfoot, Patricia C.; Bell, Holland T.; Cureton-Snead, Izeller E.; Hurd, William J.; Scales, Charles H.

1994-11-01

Along with the Red and Blue Teams commissioned by the NASA Administrator in 1992, NASA's Associate Administrator for Space Communications commissioned a Blue Team to review the Office of Space Communications (Code O) Core Program and determine how the program could be conducted faster, better, and cheaper. Since there was no corresponding Red Team for the Code O Blue Team, the Blue Team assumed a Red Team independent attitude and challenged the status quo, including current work processes, functional distinctions, interfaces, and information flow, as well as traditional management and system development practices. The Blue Team's unconstrained, non-parochial, and imaginative look at NASA's space communications program produced a simplified representation of the space communications infrastructure that transcends organizational and functional boundaries, in addition to existing systems and facilities. Further, the Blue Team adapted the 'faster, better, cheaper' charter to be relevant to the multi-mission, continuous nature of the space communications program and to serve as a gauge for improving customer services concurrent with achieving more efficient operations and infrastructure life cycle economies. This simplified representation, together with the adapted metrics, offers a future view and process model for reengineering NASA's space communications to remain viable in a constrained fiscal environment. Code O remains firm in its commitment to improve productivity, effectiveness, and efficiency. In October 1992, the Associate Administrator reconstituted the Blue Team as the Code O Success Team (COST) to serve as a catalyst for change. In this paper, the COST presents the chronicle and significance of the simplified representation and adapted metrics, and their application during the FY 1993-1994 activities.

Re-engineering NASA's space communications to remain viable in a constrained fiscal environment

NASA Technical Reports Server (NTRS)

Hornstein, Rhoda Shaller; Hei, Donald J., Jr.; Kelly, Angelita C.; Lightfoot, Patricia C.; Bell, Holland T.; Cureton-Snead, Izeller E.; Hurd, William J.; Scales, Charles H.

1994-01-01

Along with the Red and Blue Teams commissioned by the NASA Administrator in 1992, NASA's Associate Administrator for Space Communications commissioned a Blue Team to review the Office of Space Communications (Code O) Core Program and determine how the program could be conducted faster, better, and cheaper. Since there was no corresponding Red Team for the Code O Blue Team, the Blue Team assumed a Red Team independent attitude and challenged the status quo, including current work processes, functional distinctions, interfaces, and information flow, as well as traditional management and system development practices. The Blue Team's unconstrained, non-parochial, and imaginative look at NASA's space communications program produced a simplified representation of the space communications infrastructure that transcends organizational and functional boundaries, in addition to existing systems and facilities. Further, the Blue Team adapted the 'faster, better, cheaper' charter to be relevant to the multi-mission, continuous nature of the space communications program and to serve as a gauge for improving customer services concurrent with achieving more efficient operations and infrastructure life cycle economies. This simplified representation, together with the adapted metrics, offers a future view and process model for reengineering NASA's space communications to remain viable in a constrained fiscal environment. Code O remains firm in its commitment to improve productivity, effectiveness, and efficiency. In October 1992, the Associate Administrator reconstituted the Blue Team as the Code O Success Team (COST) to serve as a catalyst for change. In this paper, the COST presents the chronicle and significance of the simplified representation and adapted metrics, and their application during the FY 1993-1994 activities.

A Customized Workflow-Driven Instant Messaging System Support Team Communication in the Hospital.

PubMed

Lee, Ying-Li; Chien, Tsai-Feng; Chen, Hsiu-Chin

2016-01-01

Effective communication among the healthcare team is a very important skill to support team resource management (TRM). However, we take too much effort to connect with other team members by using traditional telephone communication. In this study, we developed an instant messaging system embedded in the original hospital information system and evaluated the preliminary outcome and the usage of the system.

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.

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 organizations. Copyright © 2018. Published by Elsevier B.V.

Researcher readiness for participating in community-engaged dissemination and implementation research: a conceptual framework of core competencies.

PubMed

Shea, Christopher M; Young, Tiffany L; Powell, Byron J; Rohweder, Catherine; Enga, Zoe K; Scott, Jennifer E; Carter-Edwards, Lori; Corbie-Smith, Giselle

2017-09-01

Participating in community-engaged dissemination and implementation (CEDI) research is challenging for a variety of reasons. Currently, there is not specific guidance or a tool available for researchers to assess their readiness to conduct CEDI research. We propose a conceptual framework that identifies detailed competencies for researchers participating in CEDI and maps these competencies to domains. The framework is a necessary step toward developing a CEDI research readiness survey that measures a researcher's attitudes, willingness, and self-reported ability for acquiring the knowledge and performing the behaviors necessary for effective community engagement. The conceptual framework for CEDI competencies was developed by a team of eight faculty and staff affiliated with a university's Clinical and Translational Science Award (CTSA). The authors developed CEDI competencies by identifying the attitudes, knowledge, and behaviors necessary for carrying out commonly accepted CE principles. After collectively developing an initial list of competencies, team members individually mapped each competency to a single domain that provided the best fit. Following the individual mapping, the group held two sessions in which the sorting preferences were shared and discrepancies were discussed until consensus was reached. During this discussion, modifications to wording of competencies and domains were made as needed. The team then engaged five community stakeholders to review and modify the competencies and domains. The CEDI framework consists of 40 competencies organized into nine domains: perceived value of CE in D&I research, introspection and openness, knowledge of community characteristics, appreciation for stakeholder's experience with and attitudes toward research, preparing the partnership for collaborative decision-making, collaborative planning for the research design and goals, communication effectiveness, equitable distribution of resources and credit, and sustaining the partnership. Delineation of CEDI competencies advances the broader CE principles and D&I research goals found in the literature and facilitates development of readiness assessments tied to specific training resources for researchers interested in conducting CEDI research.

Reconfigurable, Intelligently-Adaptive, Communication System, an SDR Platform

NASA Technical Reports Server (NTRS)

Roche, Rigoberto J.; Shalkhauser, Mary Jo; Hickey, Joseph P.; Briones, Janette C.

2016-01-01

The Space Telecommunications Radio System (STRS) provides a common, consistent framework to abstract the application software from the radio platform hardware. STRS aims to reduce the cost and risk of using complex, configurable and reprogrammable radio systems across NASA missions. The NASA Glenn Research Center (GRC) team made a software defined radio (SDR) platform STRS compliant by adding an STRS operating environment and a field programmable gate array (FPGA) wrapper, capable of implementing each of the platforms interfaces, as well as a test waveform to exercise those interfaces. This effort serves to provide a framework toward waveform development onto an STRS compliant platform to support future space communication systems for advanced exploration missions. The use of validated STRS compliant applications provides tested code with extensive documentation to potentially reduce risk, cost and e ort in development of space-deployable SDRs. This paper discusses the advantages of STRS, the integration of STRS onto a Reconfigurable, Intelligently-Adaptive, Communication System (RIACS) SDR platform, and the test waveform and wrapper development e orts. The paper emphasizes the infusion of the STRS Architecture onto the RIACS platform for potential use in next generation flight system SDRs for advanced exploration missions.

Care team identification in the electronic health record: A critical first step for patient-centered communication.

PubMed

Dalal, Anuj K; Schnipper, Jeffrey L

2016-05-01

Patient-centered communication is essential to coordinate care and safely progress patients from admission through discharge. Hospitals struggle with improving the complex and increasingly electronic conversation patterns among care team members, patients, and caregivers to achieve effective patient-centered communication across settings. Accurate and reliable identification of all care team members is a precursor to effective patient-centered communication and ideally should be facilitated by the electronic health record. However, the process of identifying care team members is challenging, and team lists in the electronic health record are typically neither accurate nor reliable. Based on the literature and on experience from 2 initiatives at our institution, we outline strategies to improve care team identification in the electronic health record and discuss potential implications for patient-centered communication. Journal of Hospital Medicine 2016;11:381-385. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Characteristics of team briefings in gynecological surgery.

PubMed

Forsyth, Katherine L; Hildebrand, Emily A; Hallbeck, M Susan; Branaghan, Russell J; Blocker, Renaldo C

2018-02-24

Preoperative briefings have been proven beneficial for improving team performance in the operating room. However, there has been minimal research regarding team briefings in specific surgical domains. As part of a larger project to develop a briefing structure for gynecological surgery, the study aimed to better understand the current state of pre-operative team briefings in one department of an academic hospital. Twenty-four team briefings were observed and video recorded. Communication was analyzed and social network metrics were created based on the team member verbal interactions. Introductions occurred in only 25% of the briefings. Network analysis revealed that average team briefings exhibited a hierarchical structure of communication, with the surgeon speaking the most frequently. The average network for resident-led briefings displayed a non-hierarchical structure with all team members communicating with the resident. Briefings conducted without a standardized protocol can produce variable communication between the role leading and the team members present. Copyright © 2018 Elsevier Ltd. All rights reserved.

Closing service system gaps for homeless clients with a dual diagnosis: integrated teams and interagency cooperation.

PubMed

Rosenheck, Robert A; Resnick, Sandra G; Morrissey, Joseph P

2003-06-01

There is great concern about fragmentation of mental health service delivery, especially for dually diagnosed homeless people, and apprehension that such fragmentation adversely affects service access and outcomes. This study first seeks to articulate two alternative approaches to the integration of psychiatric and substance abuse services, one involving an integrated team model and the other a collaborative relationship between agencies. It then applies this conceptualization to a sample of dually diagnosed homeless people who participated in the ACCESS demonstration. Longitudinal outcome data were obtained through interviews at baseline, 3 months, and 12 months with homeless clients with a dual diagnosis (N = 1074) who received ACT-like case management services through the ACCESS demonstration. A survey of ACCESS case managers was conducted to obtain information on: (i) the proportion of clients who received substance abuse services directly from ACCESS case management teams, and the proportion who received services from other agencies; and (ii) the perceived quality of the relationship (i.e. communication, cooperation and trust) between providers--both within the same teams and between agencies. Hierarchical linear modeling was then used to examine the relationship of these two factors to service use and outcome with mixed-model regression analysis. Significant (p<.05) and positive relationships were observed in 4 of the 20 analyses of the association of service use and measures of communication, cooperation, and trust (either intrateam or inter-agency) while none were significant and negative. At 12 months, receipt of a higher proportion of services from agencies other than the ACCESS team was associated with fewer days homeless, and greater reduction of psychiatric symptoms, contradicting the hypothesis that integrated team care is more effective than interagency collaborations. This study broadens the conceptual framework for addressing service system fragmentation by considering both single team integration and interagency coordination, and by considering both program structure and the quality of relationships between providers. Data from a multi-site outcome study demonstrated suggestive associations between perceptions of communication, cooperation and measures of clinical service use. However, the proportion of clients treated entirely within a single team was associated with poorer housing and psychiatric outcomes. These empirical results must be regarded as illustrative rather than conclusive because of the use of a non-experimental study design, imperfections in the available measures, and the incomplete sampling of case managers. This study suggests that fragmentation of services for dually diagnosed clients may be reduced by improving the interactions within and between agencies providing these services. While primary emphasis has been placed on developing integrated teams, interagency approaches should not be prematurely excluded. Research on approaches to reducing system fragmentation have focused on either global efforts to integrate numerous agencies in a community or highly focused efforts to develop specialized teams. Future research should also focus on the possibility of fostering constructive relationships between selected pairs or subsets of agencies. Research in this area will also benefit from the further development measures of team integration and of both intra-team and inter-agency communication, collaboration, and trust.

Modeling and simulating human teamwork behaviors using intelligent agents

NASA Astrophysics Data System (ADS)

Fan, Xiaocong; Yen, John

2004-12-01

Among researchers in multi-agent systems there has been growing interest in using intelligent agents to model and simulate human teamwork behaviors. Teamwork modeling is important for training humans in gaining collaborative skills, for supporting humans in making critical decisions by proactively gathering, fusing, and sharing information, and for building coherent teams with both humans and agents working effectively on intelligence-intensive problems. Teamwork modeling is also challenging because the research has spanned diverse disciplines from business management to cognitive science, human discourse, and distributed artificial intelligence. This article presents an extensive, but not exhaustive, list of work in the field, where the taxonomy is organized along two main dimensions: team social structure and social behaviors. Along the dimension of social structure, we consider agent-only teams and mixed human-agent teams. Along the dimension of social behaviors, we consider collaborative behaviors, communicative behaviors, helping behaviors, and the underpinning of effective teamwork-shared mental models. The contribution of this article is that it presents an organizational framework for analyzing a variety of teamwork simulation systems and for further studying simulated teamwork behaviors.

Students' perceptions of the interprofessional team in practice through the application of servant leadership principles.

PubMed

Neill, Mark; Hayward, Karen S; Peterson, Teri

2007-08-01

This study examined students' perceptions of interprofessional practice within a framework of servant leadership principles, applied in the care of rural older adults utilizing a service learning model. Mobile wellness services were provided through the Idaho State University Senior Health Mobile project in a collaborative team approach in the community-based setting. Students from varied health professional programs were placed in teams for the provision of wellness care, with communication among team members facilitated by a health professions faculty member serving as field coordinator. The Interdisciplinary Education Perception Scale (IEPS) was used to measure students' perceptions of interprofessional practice using a pretest post-test research design. Multivariate analysis was performed revealing a significant pretest to post-test effect on students' perceptions as measured by factors inherent in the IEPS and deemed essential to effective interprofessional practice. Univariate analysis revealed a significant change in students' perception of professional competence and autonomy, actual cooperation and resource sharing within and across professions, and an understanding of the value and contributions of other professionals from pretest to post-test.

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.

Teamwork and delegation in medical homes: primary care staff perspectives in the Veterans Health Administration.

PubMed

True, Gala; Stewart, Greg L; Lampman, Michelle; Pelak, Mary; Solimeo, Samantha L

2014-07-01

The patient-centered medical home (PCMH) relies on a team approach to patient care. For organizations engaged in transitioning to a PCMH model, identifying and providing the resources needed to promote team functioning is essential. To describe team-level resources required to support PCMH team functioning within the Veterans Health Administration (VHA), and provide insight into how the presence or absence of these resources facilitates or impedes within-team delegation. Semi-structured interviews with members of pilot teams engaged in PCMH implementation in 77 primary care clinics serving over 300,000 patients across two VHA regions covering the Mid-Atlantic and Midwest United States. A purposive sample of 101 core members of pilot teams, including 32 primary care providers, 42 registered nurse care managers, 15 clinical associates, and 12 clerical associates. Investigators from two evaluation sites interviewed frontline primary care staff separately, and then collaborated on joint analysis of parallel data to develop a broad, comprehensive understanding of global themes impacting team functioning and within-team delegation. We describe four themes key to understanding how resources at the team level supported ability of primary care staff to work as effective, engaged teams. Team-based task delegation was facilitated by demarcated boundaries and collective identity; shared goals and sense of purpose; mature and open communication characterized by psychological safety; and ongoing, intentional role negotiation. Our findings provide a framework for organizations to identify assets already in place to support team functioning, as well as areas in need of improvement. For teams struggling to make practice changes, our results indicate key areas where they may benefit from future support. In addition, this research sheds light on how variation in medical home implementation and outcomes may be associated with variation in team-based task delegation.

Interprofessional teamwork and team interventions in chronic care: A systematic review.

PubMed

Körner, Mirjam; Bütof, Sarah; Müller, Christian; Zimmermann, Linda; Becker, Sonja; Bengel, Jürgen

2016-01-01

To identify key features of teamwork and interventions for enhancing interprofessional teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systematic literature review of IPT in chronic care for the years 2002-2014. Database searches yielded 3217 abstracts, 21 of which fulfilled inclusion criteria. We identified two more studies on the topic by scanning the reference lists of included articles, which resulted in a final total of 23 included studies. The key features identified in the articles (e.g., team member characteristics, common task, communication, cooperation, coordination, responsibility, participation, staff satisfaction, patient satisfaction, and efficiency) were structured in line with the input-process-output model, and evaluated interventions, such as tools, workshops, and changes in team structure, were added to the model. The most frequently evaluated team interventions were complex intervention programs. All but one of the 14 evaluation studies resulted in enhancement of teamwork and/or staff-related, patient-related, and organization-related outcome criteria. To date, there is no consensus about the main features of IPT and the most effective team interventions in chronic care. However, the findings may be used to standardize the implementation and evaluation of IPT and team interventions in practice and for further research.

The Team Boat Exercise: Enhancing Team Communication Midsemester

ERIC Educational Resources Information Center

Cox, Pamela L.; Friedman, Barry A.

2009-01-01

This paper discusses the Team Boat Exercise, which was developed to provide students with a mechanism for addressing team problems and enhancing team communication midsemester. The inspiration for the exercise came from a video by Prentice Hall, Inc. (2001). Part III of the video, entitled "Corporate Coaching," shows senior staff members from the…

Building esprit de corps: learning to better navigate between "my" patient and "our" patient.

PubMed

DeRenzo, Evan G; Schwartz, Jack

2010-01-01

Excellence in the care of hospital patients, particularly those in an intensive care unit, reflects esprit de corps among the care team. Esprit de corps depends on a delicate balance; each clinician must preserve a sense of personal responsibility for "my" patient and yet participate in the collaborative work essential to the care of "our" patient. A harmful imbalance occurs when a physician demands total control of the decision-making process, especially concerning end-of-life treatment options. Although emotional factors may push a physician to claim decision-making exclusivity, compounded by a legal framework that overemphasizes individual responsibility, esprit de corps can be preserved through timely communication among clinicians and a recognition that optimal care for "my" patient requires effective team practice.

Use of a Shared Mental Model by a Team Composed of Oncology, Palliative Care, and Supportive Care Clinicians to Facilitate Shared Decision Making in a Patient With Advanced Cancer.

PubMed

D'Ambruoso, Sarah F; Coscarelli, Anne; Hurvitz, Sara; Wenger, Neil; Coniglio, David; Donaldson, Dusty; Pietras, Christopher; Walling, Anne M

2016-11-01

Our case describes the efforts of team members drawn from oncology, palliative care, supportive care, and primary care to assist a woman with advanced cancer in accepting care for her psychosocial distress, integrating prognostic information so that she could share in decisions about treatment planning, involving family in her care, and ultimately transitioning to hospice. Team members in our setting included a medical oncologist, oncology nurse practitioner, palliative care nurse practitioner, oncology social worker, and primary care physician. The core members were the patient and her sister. Our team grew organically as a result of patient need and, in doing so, operationalized an explicitly shared understanding of care priorities. We refer to this shared understanding as a shared mental model for care delivery, which enabled our team to jointly set priorities for care through a series of warm handoffs enabled by the team's close proximity within the same clinic. When care providers outside our integrated team became involved in the case, significant communication gaps exposed the difficulty in extending our shared mental model outside the integrated team framework, leading to inefficiencies in care. Integration of this shared understanding for care and close proximity of team members proved to be key components in facilitating treatment of our patient's burdensome cancer-related distress so that she could more effectively participate in treatment decision making that reflected her goals of care.

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

Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams.

PubMed

Johnston, Maximilian J; King, Dominic; Arora, Sonal; Behar, Nebil; Athanasiou, Thanos; Sevdalis, Nick; Darzi, Ara

2015-01-01

Outdated communication technologies in healthcare can place patient safety at risk. This study aimed to evaluate implementation of the WhatsApp messaging service within emergency surgical teams. A prospective mixed-methods study was conducted in a London hospital. All emergency surgery team members (n = 40) used WhatsApp for communication for 19 weeks. The initiator and receiver of communication were compared for response times and communication types. Safety events were reported using direct quotations. More than 1,100 hours of communication pertaining to 636 patients were recorded, generating 1,495 communication events. The attending initiated the most instruction-giving communication, whereas interns asked the most clinical questions (P < .001). The resident was the speediest responder to communication compared to the intern and attending (P < .001). The participants felt that WhatsApp helped flatten the hierarchy within the team. WhatsApp represents a safe, efficient communication technology. This study lays the foundations for quality improvement innovations delivered over smartphones. Copyright © 2015 Elsevier Inc. All rights reserved.

Linguistic correlates of team performance: toward a tool for monitoring team functioning during space missions.

PubMed

Fischer, Ute; McDonnell, Lori; Orasanu, Judith

2007-05-01

Approaches to mitigating the likelihood of psychosocial problems during space missions emphasize preflight measures such as team training and team composition. Additionally, it may be necessary to monitor team interactions during missions for signs of interpersonal stress. The present research was conducted to identify features in team members' communications indicative of team functioning. Team interactions were studied in the context of six computer-simulated search and rescue missions. There were 12 teams of 4 U.S. men who participated; however, the present analyses contrast the top two teams with the two least successful teams. Communications between team members were analyzed using linguistic analysis software and a coding scheme developed to characterize task-related and social dimensions of team interactions. Coding reliability was established by having two raters independently code three transcripts. Between-rater agreement ranged from 78.1 to 97.9%. Team performance was significantly associated with team members' task-related communications, specifically with the extent to which task-critical information was shared. Successful and unsuccessful teams also showed different interactive patterns, in particular concerning the frequencies of elaborations and no-responses. Moreover, task success was negatively correlated with variability in team members' word count, and positively correlated with the number of positive emotion words and the frequency of assenting relative to dissenting responses. Analyses isolated certain task-related and social features of team communication related to team functioning. Team success was associated with the extent to which team members shared task-critical information, equally participated and built on each other's contributions, showed agreement, and positive affect.

Intraoperative neurophysiological monitoring team's communiqué with anesthesia professionals.

PubMed

Tewari, Anurag; Francis, Lisa; Samy, Ravi N; Kurth, Dean C; Castle, Joshua; Frye, Tiffany; Mahmoud, Mohamed

2018-01-01

Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers. We conducted a retrospective review of IONM-related quality assurance data to identify how changes in the evoked potentials observed during the surgery were communicated within our IONM-anesthesia team and determined the resulting qualitative outcomes. Quality assurance records of 3,112 patients who underwent surgical procedures with IONM (from 2010 to 2015) were reviewed. We examined communications regarding perioperative evoked potential or electroencephalography (EEG) fluctuations that prompted neurophysiologists to alert/notify the anesthesia team to consider alteration of anesthetic depth/drug regimen or patient positioning and analyzed the outcomes of these interventions. Of the total of 1280 (41.13%) communications issued, there were 347 notifications and 11 alerts made by the neurophysiologist to the anesthesia team for various types of neuro/orthopedic surgeries. Prompt communication led to resolution of 90% of alerts and 80% of notifications after corrective measures were executed by the anesthesiologists. Notifications mainly related to limb malpositioning and extravasation of intravenous fluid. Based on our institutions' protocol and algorithm for intervention during IONM-supported surgeries, our findings of resolution in alerts and notifications indicate that successful communications between the two teams could potentially lead to improved anesthetic care and patient safety.

Preparing Nursing Students for Interprofessional Practice: The Interdisciplinary Curriculum for Oncology Palliative Care Education.

PubMed

Hermann, Carla P; Head, Barbara A; Black, Karen; Singleton, Karen

2016-01-01

Interprofessional educational experiences for baccalaureate nursing students are essential to prepare them for interprofessional communication, collaboration, and team work. Nurse educators are ideally positioned to develop and lead such initiatives. The purpose of this article is to describe the development and implementation of an interprofessional education (IPE) project involving students in nursing, medicine, social work, and chaplaincy. The Interdisciplinary Curriculum for Oncology Palliative Care Education project uses team-based palliative oncology education as the framework for teaching students interprofessional practice skills. The need for IPE is apparent, but there are very few comprehensive, successful projects for nurse educators to use as models. This article describes the development of the curriculum by the interprofessional faculty team. Issues encountered by nursing faculty members as they implemented the IPE experience are discussed. Solutions developed to address the issues and ongoing challenges are presented. This project can serve as a model of a successful IPE initiative involving nursing students. Copyright © 2016 Elsevier Inc. All rights reserved.

Verbal communication improves laparoscopic team performance.

PubMed

Shiliang Chang; Waid, Erin; Martinec, Danny V; Bin Zheng; Swanstrom, Lee L

2008-06-01

The impact of verbal communication on laparoscopic team performance was examined. A total of 24 dyad teams, comprised of residents, medical students, and office staff, underwent 2 team tasks using a previously validated bench model. Twelve teams (feedback groups) received instant verbal instruction and feedback on their performance from an instructor which was compared with 12 teams (control groups) with minimal or no verbal feedback. Their performances were both video and audio taped for analysis. Surgical backgrounds were similar between feedback and control groups. Teams with more verbal feedback achieved significantly better task performance (P = .002) compared with the control group with less feedback. Impact of verbal feedback was more pronounced for tasks requiring team cooperation (aiming and navigation) than tasks depending on individual skills (knotting). Verbal communication, especially the instructions and feedback from an experienced instructor, improved team efficiency and performance.

Conveying empathy to hospice family caregivers: Team responses to caregiver empathic communication

PubMed Central

Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Rankin, Anna; Shaunfield, Sara; Kruse, Robin L.

2012-01-01

Objective The goal of this study was to explore empathic communication opportunities presented by family caregivers and responses from interdisciplinary hospice team members. Methods Empathic opportunities and hospice team responses were analyzed from biweekly web-based videoconferences between family caregivers and hospice teams. The authors coded the data using the Empathic Communication Coding System (ECCS) and identified themes within and among the coded data. Results Data analysis identified 270 empathic opportunity-team response sequences. Caregivers expressed statements of emotion and decline most frequently. Two-thirds of the hospice team responses were implicit acknowledgments of caregiver statements and only one-third of the team responses were explicit recognitions of caregiver empathic opportunities. Conclusion Although hospice team members frequently express emotional concerns with family caregivers during one-on-one visits, there is a need for more empathic communication during team meetings that involve caregivers. Practice implications Hospice clinicians should devote more time to discussing emotional issues with patients and their families to enhance patient-centered hospice care. Further consideration should be given to training clinicians to empathize with patients and family caregivers. PMID:22554387

Conveying empathy to hospice family caregivers: team responses to caregiver empathic communication.

PubMed

Wittenberg-Lyles, Elaine; Debra, Parker Oliver; Demiris, George; Rankin, Anna; Shaunfield, Sara; Kruse, Robin L

2012-10-01

The goal of this study was to explore empathic communication opportunities presented by family caregivers and responses from interdisciplinary hospice team members. Empathic opportunities and hospice team responses were analyzed from bi-weekly web-based videoconferences between family caregivers and hospice teams. The authors coded the data using the Empathic Communication Coding System (ECCS) and identified themes within and among the coded data. Data analysis identified 270 empathic opportunity-team response sequences. Caregivers expressed statements of emotion and decline most frequently. Two-thirds of the hospice team responses were implicit acknowledgements of caregiver statements and only one-third of the team responses were explicit recognitions of caregiver empathic opportunities. Although hospice team members frequently express emotional concerns with family caregivers during one-on-one visits, there is a need for more empathic communication during team meetings that involve caregivers. Hospice clinicians should devote more time to discussing emotional issues with patients and their families to enhance patient-centered hospice care. Further consideration should be given to training clinicians to empathize with patients and family caregivers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Let's Talk About It: Supporting Family Communication during End-of-Life Care of Pediatric Patients.

PubMed

Marsac, Meghan L; Kindler, Christine; Weiss, Danielle; Ragsdale, Lindsay

2018-05-18

Communication is key in optimizing medical care when a child is approaching end of life (EOL). Research is yet to establish best practices for how medical teams can guide intrafamily communication (including surviving siblings) when EOL care is underway or anticipated for a pediatric patient. While recommendations regarding how medical teams can facilitate communication between the medical team and the family exist, various barriers may prevent the implementation of these recommendations. This review aims to provide a summary of research-to-date on family and medical provider perceptions of communication during pediatric EOL care. Systematic review. Findings from a review of 65 studies suggest that when a child enters EOL care, many parents try to protect their child and/or themselves by avoiding discussions about death. Despite current recommendations, medical teams often refrain from discussing EOL care with pediatric patients until death is imminent for a variety of reasons (e.g., family factors and discomfort with EOL conversations). Parents consistently report a need for honest complete information, delivered with sensitivity. Pediatric patients often report a preference to be informed of their prognosis, and siblings express a desire to be involved in EOL discussions. Families may benefit from enhanced communication around EOL planning, both within the family and between the family and medical team. Future research should investigate a potential role for medical teams in supporting intrafamily communication about EOL challenges and should examine how communication between medical teams and families can be facilitated as EOL approaches.

'Achieving ensemble': communication in orthopaedic surgical teams and the development of situation awareness--an observational study using live videotaped examples.

PubMed

Bleakley, Alan; Allard, Jon; Hobbs, Adrian

2013-03-01

Focused dialogue, as good communication between practitioners, offers a condition of possibility for development of high levels of situation awareness in surgical teams. This has been termed "achieving ensemble". Situation awareness grasps what is happening in time and space with regard to one's own unfolding work in relation to that of colleagues, and is necessary to maintain patient safety throughout a surgical list. We refined a typology, initially developed for use in studying the dynamics of teams in aviation safety, of 10 kinds of communication within two broad areas: 'Reports', or authoritative acts of communication setting up a monological or authoritative climate; and 'Requests', or facilitative acts of communication setting up a dialogical or participatory climate. We systematically mapped how orthopaedic surgical teams use verbal communication through analysis of videotaped operations using the typology. We asked: 'do orthopaedic surgical teams set up the conditions of possibility for the emergence of situation awareness through effective communication?' We found that orthopaedic surgical teams tend to produce monological rather than dialogical climates. Dialogue increases with more complex cases, but in routine work, communication levels are depressed and one-way, influenced by surgeons working within a traditionally hierarchical and authoritative culture. We suggest that such a monological climate inhibits development of situation awareness and then compromises patient safety. The same teams, however, generate potentially rich educational climates through exchange of profession-specific knowledge and skills, and we suggest that where technical skill exchange is good, non-technical or interpersonal communication skill levels can follow.

Exploring leadership and team communication within the organizational environment of a dental practice.

PubMed

Chilcutt, Alexa Stough

2009-10-01

A lack of training in leadership and communication skills can place dentists at a disadvantage, leading to high degrees of staff-related stress and turnover. A dentist's leadership style directly affects an office's communication practices, and specific leadership behaviors affect the degree of team identity, interdependence and social distance (a measure of the influential power of team members). The author recruited 10 dental offices to take part in a study. Qualitative methods included in-depth interviews of one dentist, one senior staff member and one newer staff member from each office. The interview findings show that clear and definable relationships exist between leadership behaviors--hierarchical or team-oriented organizational perspectives, proactive or laissez-faire leadership styles, and autocratic or participative decision-making processes--and the team's communication practices. Decision-making processes directly affect the degree of team identification experienced by staff members, and conflict-management tactics affect team members' sense of interdependence and social distance. The findings of this study indicate that dentists should engage in participative decision-making processes that include staff members, thereby communicating their value to the practice and empowering employees. They also must become proactive in facilitating an environment that encourages collaboration and confrontation as healthy forms of conflict management. These leadership and communication behaviors are the most significant in creating a real rather than nominal team culture, which, in turn, leads to increased overall productivity, an enhanced level of services provided to patients and improved team member satisfaction.

A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.

PubMed

Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida

2017-06-01

Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.

EarthCube: A Community Organization for Geoscience Cyberinfrastructure

NASA Astrophysics Data System (ADS)

Patten, K.; Allison, M. L.

2014-12-01

The National Science Foundation's (NSF) EarthCube initiative is a community-driven approach to building cyberinfrastructure for managing, sharing, and exploring geoscience data and information to better address today's grand-challenge science questions. The EarthCube Test Enterprise Governance project is a two-year effort seeking to engage diverse geo- and cyber-science communities in applying a responsive approach to the development of a governing system for EarthCube. During Year 1, an Assembly of seven stakeholder groups representing the broad EarthCube community developed a draft Governance Framework. Finalized at the June 2014 EarthCube All Hands Meeting, this framework will be tested during the demonstration phase in Year 2, beginning October 2014. A brief overview of the framework: Community-elected members of the EarthCube Leadership Council will be responsible for managing strategic direction and identifying the scope of EarthCube. Three Standing Committees will also be established to oversee the development of technology and architecture, to coordinate among new and existing data facilities, and to represent the academic geosciences community in driving development of EarthCube cyberinfrastructure. An Engagement Team and a Liaison Team will support communication and partnerships with internal and external stakeholders, and a central Office will serve a logistical support function to the governance as a whole. Finally, ad hoc Working Groups and Special Interest Groups will take on other issues related to EarthCube's goals. The Year 2 demonstration phase will test the effectiveness of the proposed framework and allow for elements to be changed to better meet community needs. It will begin by populating committees and teams, and finalizing leadership and decision-making processes to move forward on community-selected priorities including identifying science drivers, coordinating emerging technical elements, and coming to convergence on system architecture. A January mid-year review will assemble these groups to analyze the effectiveness of the framework and make adjustments as necessary. If successful, this framework will move EarthCube forward as a collaborative platform and potentially act as a model for future NSF investments in geoscience cyberinfrastructure.

A team approach to an undergraduate interprofessional communication course.

PubMed

Doucet, Shelley; Buchanan, Judy; Cole, Tricia; McCoy, Carolyn

2013-05-01

Interprofessional communication is a team-taught upper-level undergraduate course for Nursing and Health Sciences students. In addition to teaching fundamental communication skills, this course weaves interprofessional competencies into weekly learning activities and assignments. The utilization of the principles and practices of team-based learning in the classroom enhances the attainment and practice of communication and interprofessional collaboration skills. Lessons learned from conducting informal course evaluations and delivering the course multiple times are presented.

Cooperative Team Networks

DTIC Science & Technology

2016-06-01

team processes, such as identifying motifs of dynamic communication exchanges which goes well beyond simple dyadic and triadic configurations; as well...new metrics and ways to formulate team processes, such as identifying motifs of dynamic communication exchanges which goes well beyond simple dyadic ...sensing, communication , information, and decision networks - Darryl Ahner (AFIT: Air Force Inst Tech) Panel Session: Mathematical Models of

Improving Communication Skills among High School Assistant Principals To Increase Administrative Team Effectiveness.

ERIC Educational Resources Information Center

Hosack, Mary Browne

This paper describes a practicum program that was developed to increase the effectiveness of the administrative team at one high school. A lack of communication skills had prevented the target group from working together as a team. Strategies included role-play activities, workshops, and communication skill-development meetings. A series of…

Frequency and Form of Team Communication from the Perspective of Parents of Preschool Children with Disabilities: Implications for Diverse Families

ERIC Educational Resources Information Center

Sheppard, Mary Erin

2017-01-01

Effective communication between parents of children with disabilities and other team members positively impacts family-school collaboration. Parents of children with special needs were asked how and how often they communicated with their children's preschool teams. The frequency of both formal and informal meetings varied tremendously. Parents…

The Effect of Communication Strategy and Planning Intervention on the Processes and Performance of Course Material Development Teams

ERIC Educational Resources Information Center

Padmo Putri, Dewi A.

2012-01-01

In most open and distance learning institutions, the development of learning materials, whether in print or electronic form, is created by teams consisting of people with different skills. Team communication has a critical influence on the development of team shared mental models (SMMs) as well as team performance. A review of the literature…

Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study.

PubMed

Teunissen, E; Gravenhorst, K; Dowrick, C; Van Weel-Baumgarten, E; Van den Driessen Mareeuw, F; de Brún, T; Burns, N; Lionis, C; Mair, F S; O'Donnell, C; O'Reilly-de Brún, M; Papadakaki, M; Saridaki, A; Spiegel, W; Van Weel, C; Van den Muijsenbergh, M; MacFarlane, A

2017-02-10

Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice. We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers' fieldwork reports, were coded and thematically analysed by each team using NPT. In all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants' needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP's diagnoses and GPs reported a clearer understanding of migrants' symptoms. Migrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.

Partnering With a Family Advisor to Improve Communication in a Pediatric Intensive Care Unit.

PubMed

Czulada, Laura; Leino, Patience; Willis, Tina Schade

2016-11-01

Inadequate communication between medical teams and families can lead to errors and poor-quality care. The objective was to understand why communication between the clinical team and families was not occurring consistently in the pediatric intensive care unit and improve the system using a multidisciplinary improvement team including a family advisor. This improvement project used Lean Six Sigma. The team observed updates and collected documented communication, survey, interview, and focus group data from families and staff. Root causes of failures included lack of assigned responsibility, lack of defined daily update, and lack of a daily communication standard. Process changes were implemented, resulting in an increased mean documented communication rate from 13% pre intervention to 65% post intervention that was sustained for more than 2 years (P < .001). Including a family advisor as an equal member of an improvement team provides family empowerment and a greater chance of success in complex areas. © The Author(s) 2015.

Style Guide: An Interdisciplinary Communication Tool to Support the Process of Generating Tailored Infographics From Electronic Health Data Using EnTICE3

PubMed Central

Arcia, Adriana; Velez, Mark; Bakken, Suzanne

2015-01-01

Purpose: In this case study we describe key features of the structured communication tool—a style guide—used to support interdisciplinary collaboration, and we propose the use of such a tool for research teams engaged in similar projects. We employ tailored infographics to present patient reported outcome data from a community health survey back, in a comprehensible and actionable manner, to the individuals who provided it. The style guide was developed to bridge the semantic gap between the domain and programming experts engaged in this effort. Innovation: The style guide supports the communication of complex design specifications in a highly structured format that is nevertheless flexible enough to accommodate project growth. Unlike the typical corporate style guide that has a more narrative format, our style guide is innovative in its use of consistent fields across multiple, standalone entries. Credibility: The process of populating the style guide prompted the designer toward greater design efficiency and led to consistent and specific instructions that met the framework architect’s stated information needs. Discussion and Conclusion: The guiding values in the creation of the style guide were consistency, clarity, and flexibility. It serves as a durable reference to the desired look and functionality of the final infographic product without dictating an implementation strategy. The style guide format can be adapted to meet the communication needs of other interdisciplinary teams facing a semantic gap. PMID:25848634

Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making.

PubMed

Brown, Edwina A; Bekker, Hilary L; Davison, Sara N; Koffman, Jonathan; Schell, Jane O

2016-10-07

Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo-American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients' responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient's specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs. Copyright © 2016 by the American Society of Nephrology.

What is happening under the surface? Power, conflict and the performance of medical teams.

PubMed

Janss, Rozemarijn; Rispens, Sonja; Segers, Mien; Jehn, Karen A

2012-09-01

The effect of teamwork on team performance is broadly recognised in the medical field. This recognition is manifested in educational programmes in which attention to interpersonal behaviours during teamwork is growing. Conflict and power differences influence interpersonal behaviours and are marked topics in studies of group functioning in the social and organisational psychology literature. Insights from the domain of social sciences put the ongoing improvement of teamwork into broader perspective. This paper shows how knowledge from the domain of social and organisational psychology contributes to the understanding of teamwork in the medical environment. More specifically, this paper suggests that unfolding the underlying issues of power and conflict within medical teams can be of extra help in the development of educational interventions aimed at improving team performance. We review the key social psychology and organisational behaviour literature concerning power and conflict, and relate the insights derived from this to the team process of ad hoc medical action teams. We present a theoretical framework in which insights into power and conflict are used to explain and predict team dynamics in ad hoc medical action teams. Power and conflict strongly influence interpersonal behaviour. Characteristics of medical action teams give rise to all kinds of issues of disagreement and are accompanied by complex issues of intra-team power distribution. We argue that how team members coordinate, cooperate and communicate is steered by members' personal motivations, which, in turn, strongly depend on their perceptions of power and conflict. Given the importance of the performance of these teams, we suggest future directions for the development of training interventions building on knowledge and theories derived from social and organisational psychology. © Blackwell Publishing Ltd 2012.

Effective factor of virtual team: Resolving communication breakdown in IBS construction project

NASA Astrophysics Data System (ADS)

Pozin, Mohd Affendi Ahmad; Nawi, Mohd. Nasrun Mohd.

2016-08-01

Currently, rapid development of information technology has provided new opportunities to organisation toward increasing the effectiveness of collaboration and teamwork management. Thus the virtual team approach has been implemented in numerous of field. However, there is limited study of virtual team in construction project management. Currently IBS project is still based on traditional construction process which is isolation team working environment. Therefore this approach has been declared as a main barrier to ensure cooperative working relation in term of communication and information in between project stakeholders. Thus, this paper through literature review is attempted to present a discussion of the virtual team approach toward IBS project in developing effective team communication during construction project.

Coupled hydrological, ecological, decision and economic models for monetary valuation of riparian ecosystem services

NASA Astrophysics Data System (ADS)

Goodrich, D. C.; Brookshire, D.; Broadbent, C.; Dixon, M. D.; Brand, L. A.; Thacher, J.; Benedict, K. K.; Lansey, K. E.; Stromberg, J. C.; Stewart, S.; McIntosh, M.

2011-12-01

Water is a critical component for sustaining both natural and human systems. Yet the value of water for sustaining ecosystem services is not well quantified in monetary terms. Ideally decisions involving water resource management would include an apples-to-apples comparison of the costs and benefits in dollars of both market and non-market goods and services - human and ecosystem. To quantify the value of non-market ecosystem services, scientifically defensible relationships must be developed that link the effect of a decision (e.g. human growth) to the change in ecosystem attributes from current conditions. It is this linkage that requires the "poly-disciplinary" coupling of knowledge and models from the behavioral, physical, and ecological sciences. In our experience another key component of making this successful linkage is development of a strong poly-disciplinary scientific team that can readily communicate complex disciplinary knowledge to non-specialists outside their own discipline. The time to build such a team that communicates well and has a strong sense of trust should not be underestimated. The research described in the presentation incorporated hydrologic, vegetation, avian, economic, and decision models into an integrated framework to determine the value of changes in ecological systems that result from changes in human water use. We developed a hydro-bio-economic framework for the San Pedro River Region in Arizona that considers groundwater, stream flow, and riparian vegetation, as well as abundance, diversity, and distribution of birds. In addition, we developed a similar framework for the Middle Rio Grande of New Mexico. There are six research components for this project: (1) decision support and scenario specification, (2) regional groundwater model, (3) the riparian vegetation model, (4) the avian model, (5) methods for displaying the information gradients in the valuation survey instruments (Choice Modeling and Contingent Valuation), and (6) the economic framework. Our modeling framework began with the identification of factors that influence spatial and temporal changes in riparian vegetation on the two rivers. The linked modeling framework was then employed for making spatial predictions of the changes in presence of surface water, vegetation change, and avian populations in both river systems. An overview of the overall project will be provided, with lessons learned, and initial valuation survey results.

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.

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/

Communication Skills to Develop Trusting Relationships on Global Virtual Engineering Capstone Teams

ERIC Educational Resources Information Center

Zaugg, Holt; Davies, Randall S.

2013-01-01

As universities seek to provide cost-effective, cross-cultural experiences using global virtual (GV) teams, the "soft" communication skills typical of all teams, increases in importance for GV teams. Students need to be taught how to navigate through cultural issues and virtual tool issues to build strong trusting relationships with…

A Method to Improve Learning Analysing Communication in Team Working

ERIC Educational Resources Information Center

Bermejo, Miren; Sanchez, Ana; Gutierrez, Julian; Perez, Tomas A.

2011-01-01

In recent years learning how to work in teams has become a common subject in higher education. Communication between student team members can be monitored using a bulletin board system, and hence, analyse individual and group role development. The composition and distribution of roles in a team are relevant characteristics that will considerably…

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.

Flexible knowledge repertoires: communication by leaders in trauma teams

PubMed Central

2012-01-01

Background In emergency situations, it is important for the trauma team to efficiently communicate their observations and assessments. One common communication strategy is “closed-loop communication”, which can be described as a transmission model in which feedback is of great importance. The role of the leader is to create a shared goal in order to achieve consensus in the work for the safety of the patient. The purpose of this study was to analyze how formal leaders communicate knowledge, create consensus, and position themselves in relation to others in the team. Methods Sixteen trauma teams were audio- and video-recorded during high fidelity training in an emergency department. Each team consisted of six members: one surgeon or emergency physician (the designated team leader), one anaesthesiologist, one nurse anaesthetist, one enrolled nurse from the theatre ward, one registered nurse and one enrolled nurse from the emergency department (ED). The communication was transcribed and analyzed, inspired by discourse psychology and Strauss’ concept of “negotiated order”. The data were organized and coded in NVivo 9. Results The findings suggest that leaders use coercive, educational, discussing and negotiating strategies to work things through. The leaders in this study used different repertoires to convey their knowledge to the team, in order to create a common goal of the priorities of the work. Changes in repertoires were dependent on the urgency of the situation and the interaction between team members. When using these repertoires, the leaders positioned themselves in different ways, either on an authoritarian or a more egalitarian level. Conclusion This study indicates that communication in trauma teams is complex and consists of more than just transferring messages quickly. It also concerns what the leaders express, and even more importantly, how they speak to and involve other team members. PMID:22747848

Building a Framework that Supports Project Teams: An Example from a University/Community Collaborative Initiative

ERIC Educational Resources Information Center

Kolb, Judith A.; Sandmeyer, Louise E.

2007-01-01

In the university initiative described in this article, a series of project teams were funded to work on a variety of collaborative projects. The focus of this piece is on the framework that was developed and executed to select, support, and evaluate these teams. The framework is explained and described using data gathered throughout the study and…

Cyberinfrastructure and Scientific Collaboration: Application of a Virtual Team Performance Framework with Potential Relevance to Education. WCER Working Paper No. 2010-12

ERIC Educational Resources Information Center

Kraemer, Sara; Thorn, Christopher A.

2010-01-01

The purpose of this exploratory study was to identify and describe some of the dimensions of scientific collaborations using high throughput computing (HTC) through the lens of a virtual team performance framework. A secondary purpose was to assess the viability of using a virtual team performance framework to study scientific collaborations using…

Disruption or innovation? A qualitative descriptive study on the use of electronic patient-physician communication in patients with advanced cancer.

PubMed

Voruganti, Teja; Husain, Amna; Grunfeld, Eva; Webster, Fiona

2018-03-04

In the advanced cancer context, care coordination is often inadequate, leading to suboptimal continuity of care. We evaluated an electronic web-based tool which assembles the patient, their caregivers, and their healthcare providers in a virtual space for team-based communication. We sought to understand participant perceptions on electronic communication in general and the added value of the new tool in particular. We conducted a qualitative descriptive study with participants (patients, caregivers, cancer physicians) who participated in a 3-month pilot trial evaluating the tool. Interviews were thematically analyzed and the perspectives from patients, caregivers, and cancer physicians were triangulated. Interviews from six patients, five of their caregivers, and seven cancer physicians conducted alongside monthly outcome assessments were analyzed. We identified five themes relating participants' perspectives on electronic communication to their experience of care: (1) apparent gaps in care, (2) uncertainty in defining the circle of care, (3) relational aspects of communication, (4) incongruence between technology and social norms of patient-physician communication, and (5) appreciation but apprehension about the team-based communication tool for improving the experience of care. The potential of tools for electronic communication to bring together a team of healthcare providers with the patient and caregivers is significant but may pose new challenges to existing team structure and interpersonal dynamics. Patients and physicians were worried about the impact that electronic communication may have on the patient-physician relationship. Implementation approaches, which build on the relationship and integrate the team as a whole, could positively position electronic communication to enhance the team-based care.

Temporal patterns of mental model convergence: implications for distributed teams interacting in electronic collaboration spaces.

PubMed

McComb, Sara; Kennedy, Deanna; Perryman, Rebecca; Warner, Norman; Letsky, Michael

2010-04-01

Our objective is to capture temporal patterns in mental model convergence processes and differences in these patterns between distributed teams using an electronic collaboration space and face-to-face teams with no interface. Distributed teams, as sociotechnical systems, collaborate via technology to work on their task. The way in which they process information to inform their mental models may be examined via team communication and may unfold differently than it does in face-to-face teams. We conducted our analysis on 32 three-member teams working on a planning task. Half of the teams worked as distributed teams in an electronic collaboration space, and the other half worked face-to-face without an interface. Using event history analysis, we found temporal interdependencies among the initial convergence points of the multiple mental models we examined. Furthermore, the timing of mental model convergence and the onset of task work discussions were related to team performance. Differences existed in the temporal patterns of convergence and task work discussions across conditions. Distributed teams interacting via an electronic interface and face-to-face teams with no interface converged on multiple mental models, but their communication patterns differed. In particular, distributed teams with an electronic interface required less overall communication, converged on all mental models later in their life cycles, and exhibited more linear cognitive processes than did face-to-face teams interacting verbally. Managers need unique strategies for facilitating communication and mental model convergence depending on teams' degrees of collocation and access to an interface, which in turn will enhance team performance.

Human Factors in Training - Space Flight Resource Management Training

NASA Technical Reports Server (NTRS)

Bryne, Vicky; Connell, Erin; Barshi, Immanuel; Arsintescu, L.

2009-01-01

Accidents and incidents show that high workload-induced stress and poor teamwork skills lead to performance decrements and errors. Research on teamwork shows that effective teams are able to adapt to stressful situations, and to reduce workload by using successful strategies for communication and decision making, and through dynamic redistribution of tasks among team members. Furthermore, superior teams are able to recognize signs and symptoms of workload-induced stress early, and to adapt their coordination and communication strategies to the high workload, or stress conditions. Mission Control Center (MCC) teams often face demanding situations in which they must operate as an effective team to solve problems with crew and vehicle during onorbit operations. To be successful as a team, flight controllers (FCers) must learn effective teamwork strategies. Such strategies are the focus of Space Flight Resource Management (SFRM) training. SFRM training in MOD has been structured to include some classroom presentations of basic concepts and case studies, with the assumption that skill development happens in mission simulation. Integrated mission simulations do provide excellent opportunities for FCers to practice teamwork, but also require extensive technical knowledge of vehicle systems, mission operations, and crew actions. Such technical knowledge requires lengthy training. When SFRM training is relegated to integrated simulations, FCers can only practice SFRM after they have already mastered the technical knowledge necessary for these simulations. Given the centrality of teamwork to the success of MCC, holding SFRM training till late in the flow is inefficient. But to be able to train SFRM earlier in the flow, the training cannot rely on extensive mission-specific technical knowledge. Hence, the need for a generic SFRM training framework that would allow FCers to develop basic teamwork skills which are mission relevant, but without the required mission knowledge. Work on SFRM training has been conducted in collaboration with the Expedition Vehicle Division at the Mission Operations Directorate (MOD) and with United Space Alliance (USA) which provides training to Flight Controllers. The space flight resource management training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at the Ames Research Center have been investigating team work and distributed decision making processes to develop a generic SFRM training framework for flight controllers. The work proposed for FY10 continues to build on this strong collaboration with MOD and the USA Training Group as well as previous research in relevant domains such as aviation. In FY10, the work focuses on documenting and analyzing problem solving strategies and decision making processes used in MCC by experienced FCers.

Information Issues and Contexts that Impair Team Based Communication Workflow: A Palliative Sedation Case Study.

PubMed

Cornett, Alex; Kuziemsky, Craig

2015-01-01

Implementing team based workflows can be complex because of the scope of providers involved and the extent of information exchange and communication that needs to occur. While a workflow may represent the ideal structure of communication that needs to occur, information issues and contextual factors may impact how the workflow is implemented in practice. Understanding these issues will help us better design systems to support team based workflows. In this paper we use a case study of palliative sedation therapy (PST) to model a PST workflow and then use it to identify purposes of communication, information issues and contextual factors that impact them. We then suggest how our findings could inform health information technology (HIT) design to support team based communication workflows.

Apollo experience report: Communications system flight evaluation and verification

NASA Technical Reports Server (NTRS)

Travis, D.; Royston, C. L., Jr.

1972-01-01

Flight tests of the synergetic operation of the spacecraft and earth based communications equipment were accomplished during Apollo missions AS-202 through Apollo 12. The primary goals of these tests were to verify that the communications system would adequately support lunar landing missions and to establish the inflight communications system performance characteristics. To attain these goals, a communications system flight verification and evaluation team was established. The concept of the team operations, the evolution of the evaluation processes, synopses of the team activities associated with each mission, and major conclusions and recommendations resulting from the performance evaluation are represented.

Perturbed Communication in a Virtual Environment to Train Medical Team Leaders.

PubMed

Huguet, Lauriane; Lourdeaux, Domitile; Sabouret, Nicolas; Ferrer, Marie-Hélène

2016-01-01

The VICTEAMS project aims at designing a virtual environment for training medical team leaders to non-technical skills. The virtual environment is populated with autonomous virtual agents who are able to make mistakes (in action or communication) in order to train rescue team leaders and to make them adaptive with all kinds of situations or teams.

Intrateam Communication and Performance in Doubles Tennis

ERIC Educational Resources Information Center

Lausic, Domagoj; Tennebaum, Gershon; Eccles, David; Jeong, Allan; Johnson, Tristan

2009-01-01

Verbal and nonverbal communication is a critical mediator of performance in team sports and yet there is little extant research in sports that involves direct measures of communication. Our study explored communication within NCAA Division I female tennis doubles teams. Video and audio recordings of players during doubles tennis matches captured…

Impact of communication delays to and from the International Space Station on self-reported individual and team behavior and performance: A mixed-methods study

NASA Astrophysics Data System (ADS)

Kintz, Natalie M.; Chou, Chih-Ping; Vessey, William B.; Leveton, Lauren B.; Palinkas, Lawrence A.

2016-12-01

Deep space explorations will involve significant delays in communication to and from Earth that will likely impact individual and team outcomes. However, the extent of these impacts and the appropriate countermeasures for their mitigation remain largely unknown. This study utilized the International Space Station (ISS), a high-fidelity analog for deep space, as a research platform to assess the impact of communication delays on individual and team performance, mood, and behavior. Three astronauts on the ISS and 18 mission support personnel performed tasks with and without communication delays (50-s one-way) during a mission lasting 166 days. Self-reported assessments of individual and team performance and mood were obtained after each task. Secondary outcomes included communication quality and task autonomy. Qualitative data from post-mission interviews with astronauts were used to validate and expand on quantitative data, and to elicit recommendations for countermeasures. Crew well-being and communication quality were significantly reduced in communication delay tasks compared to control. Communication delays were also significantly associated with increased individual stress/frustration. Qualitative data suggest communication delays impacted operational outcomes (i.e. task efficiency), teamwork processes (i.e. team/task coordination) and mood (i.e. stress/frustration), particularly when tasks involved high task-related communication demands, either because of poor communication strategies or low crew autonomy. Training, teamwork, and technology-focused countermeasures were identified to mitigate or prevent adverse impacts.

Communication and relationship skills for rapid response teams at hamilton health sciences.

PubMed

Cziraki, Karen; Lucas, Janie; Rogers, Toni; Page, Laura; Zimmerman, Rosanne; Hauer, Lois Ann; Daniels, Charlotte; Gregoroff, Susan

2008-01-01

Rapid response teams (RRT) are an important safety strategy in the prevention of deaths in patients who are progressively failing outside of the intensive care unit. The goal is to intervene before a critical event occurs. Effective teamwork and communication skills are frequently cited as critical success factors in the implementation of these teams. However, there is very little literature that clearly provides an education strategy for the development of these skills. Training in simulation labs offers an opportunity to assess and build on current team skills; however, this approach does not address how to meet the gaps in team communication and relationship skill management. At Hamilton Health Sciences (HHS) a two-day program was developed in collaboration with the RRT Team Leads, Organizational Effectiveness and Patient Safety Leaders. Participants reflected on their conflict management styles and considered how their personality traits may contribute to team function. Communication and relationship theories were reviewed and applied in simulated sessions in the relative safety of off-site team sessions. The overwhelming positive response to this training has been demonstrated in the incredible success of these teams from the perspective of the satisfaction surveys of the care units that call the team, and in the multi-phased team evaluation of their application to practice. These sessions offer a useful approach to the development of the soft skills required for successful RRT implementation.

GRIP Collaboration Portal: Information Management for a Hurricane Field Campaign

NASA Astrophysics Data System (ADS)

Conover, H.; Kulkarni, A.; Garrett, M.; Smith, T.; Goodman, H. M.

2010-12-01

NASA’s Genesis and Rapid Intensification Processes (GRIP) experiment, carried out in August and September of 2010, was a complex operation, involving three aircraft and their crews based at different airports, a dozen instrument teams, mission scientists, weather forecasters, project coordinators and a variety of other participants. In addition, GRIP was coordinated with concurrent airborne missions: NOAA’s IFEX and then NSF-funded PREDICT. The GRIP Collaboration Portal was developed to facilitate communication within and between the different teams and serve as an information repository for the field campaign, providing a single access point for project documents, plans, weather forecasts, flight reports and quicklook data. The portal was developed using the Drupal open source content management framework. This presentation will cover both technology and participation issues. Specific examples include: Drupal’s large and diverse open source developer community is an advantage in that we were able to reuse many modules rather than develop capabilities from scratch, but integrating multiple modules developed by many people adds to the overall complexity of the site. Many of the communication capabilities provided by the site, such as discussion forums and blogs, were not used. Participants were diligent about posting necessary documents, but the favored communication method remained email. Drupal's developer-friendly nature allowed for quick development of the customized functionality needed to accommodate the rapidly changing requirements of GRIP experiment. DC-8 Overflight of Hurricane Earl during GRIP Mission

Role of the dental team in mass fatality incidents.

PubMed

Fixott, R H; Arendt, D; Chrz, B; Filippi, J; McGivney, J; Warnick, A

2001-04-01

The process of dental identification for a mass fatality incident has unique aspects in comparison with that of a routine dental identification, outside of the obvious increase in the number of victims and responders. The dental team is a small part of a large effort to resolve the incident. Incident command structure applies to the dental team as a unit as well as to the entire organization of the response. Teamwork and planning are essential on all levels. Discussing the casework is limited to the public information officer; only the public information officer is authorized to talk to anyone outside the medical examiner's office. For the team, communication is essential between the team members and between the team and other morgue sections. Daily meetings not only update progress, but also identify and solve problems as they arise. Redundancy and cross-checking occur each step in each section. A core team of trained individuals provides a framework for the use of less experienced members. Use of a dental identification computer program is extremely beneficial, especially as the amount of fragmentation or number of victims increases. Because of the magnitude of the response, the physical and mental stresses require critical incident stress debriefing for all responders, regardless of their experience. The past and future service of the dental profession to the victims of mass fatality incidents and their families is an excellent example of the ideal of service on which the profession is based.

Patient perspectives on communication with the medical team: pilot study using the Communication Assessment Tool-Team (CAT-T).

PubMed

Mercer, Laura Min; Tanabe, Paula; Pang, Peter S; Gisondi, Michael A; Courtney, D Mark; Engel, Kirsten G; Donlan, Sarah M; Adams, James G; Makoul, Gregory

2008-11-01

Effective communication is an essential aspect of high-quality patient care and a core competency for physicians. To date, assessment of communication skills in team-based settings has not been well established. We sought to tailor a psychometrically validated instrument, the Communication Assessment Tool, for use in Team settings (CAT-T), and test the feasibility of collecting patient perspectives of communication with medical teams in the emergency department (ED). A prospective, cross-sectional study in an academic, tertiary, urban, Level 1 trauma center using the CAT-T, a 15-item instrument. Items were answered via a 5-point scale, with 5 = excellent. All adult ED patients (> or = 18 y/o) were eligible if the following exclusion criteria did not apply: primary psychiatric issues, critically ill, physiologically unstable, non-English speaking, or under arrest. 81 patients were enrolled (mean age: 44, S.D. = 17; 44% male). Highest ratings were for treating the patient with respect (69% excellent), paying attention to the patient (69% excellent), and showing care and concern (69% excellent). Lowest ratings were for greeting the patient appropriately (54%), encouraging the patient to ask questions (54%), showing interest in the patient's ideas about his or her health (53% excellent), and involving the patient in decisions as much as he or she wanted (53% excellent). Although this pilot study has several methodological limitations, it demonstrates a signal that patient assessment of communication with the medical team is feasible and offers important feedback. Results indicate the need to improve communication in the ED. In the ED, focusing on the medical team rather then individual caregivers may more accurately reflect patients' experience.

A network model of communication in an interprofessional team of healthcare professionals: A cross-sectional study of a burn unit.

PubMed

Shoham, David A; Harris, Jenine K; Mundt, Marlon; McGaghie, William

2016-09-01

Healthcare teams consist of individuals communicating with one another during patient care delivery. Coordination of multiple specialties is critical for patients with complex health conditions, and requires interprofessional and intraprofessional communication. We examined a communication network of 71 health professionals in four professional roles: physician, nurse, health management, and support personnel (dietitian, pharmacist, or social worker), or other health professionals (including physical, respiratory, and occupational therapists, and medical students) working in a burn unit. Data for this cross-sectional study were collected by surveying members of a healthcare team. Ties were defined by asking team members whom they discussed patient care matters with on the shift. We built an exponential random graph model to determine: (1) does professional role influence the likelihood of a tie; (2) are ties more likely between team members from different professions compared to between team members from the same profession; and (3) which professions are more likely to form interprofessional ties. Health management and support personnel ties were 94% interprofessional while ties among nurses were 60% interprofessional. Nurses and other health professionals were significantly less likely than physicians to form ties. Nurses were 1.64 times more likely to communicate with nurses than non-nurses (OR = 1.64, 95% CI: 1.01-2.66); there was no significant role homophily for physicians, other health professionals, or health management and support personnel. Understanding communication networks in healthcare teams is an early step in understanding how teams work together to provide care; future work should evaluate the types and quality of interactions between members of interprofessional healthcare teams.

Effective Team Practices: Interprofessional Contributions to Communication Issues With a Parent's Perspective.

PubMed

Cooper-Duffy, Karena; Eaker, Kerri

2017-05-17

This clinical focus article contains a detailed description of how to build effective teams that use interprofessional collaborative practice (IPCP) with special-education professionals, speech-language pathologists, and families of children with severe disabilities. This clinical focus article provides information on using the essential elements of team building and IPCP to provide quality care to families who have children with severe disabilities. The 6 essential elements for team building are described, with suggestions for including families in each: goal-setting, roles and responsibilities, effective and efficient process, communication and interpersonal relationships, collaborative problem solving, and evaluation. The 4 competency domains of IPCP are embedded into each of the team-building elements to demonstrate how teams can implement IPCP. A case study illustrates the difficulty one parent experienced working with a team across the 6 essential team-building elements when seeking communication services for her child with severe disabilities. Building teams with IPCP can be effective for including families and creating high-quality outcomes for individuals with severe disabilities.

Transfer of communication skills to the workplace: impact of a 38-hour communication skills training program designed for radiotherapy teams.

PubMed

Merckaert, Isabelle; Delevallez, France; Gibon, Anne-Sophie; Liénard, Aurore; Libert, Yves; Delvaux, Nicole; Marchal, Serge; Etienne, Anne-Marie; Bragard, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Scalliet, Pierre; Van Houtte, Paul; Coucke, Philippe; Razavi, Darius

2015-03-10

This study assessed the efficacy of a 38-hour communication skills training program designed to train a multidisciplinary radiotherapy team. Four radiotherapy teams were randomly assigned to a training program or a waiting list. Assessments were scheduled at baseline and after training for the training group and at baseline and 4 months later for the waiting list group. Assessments included an audio recording of a radiotherapy planning session to assess team members' communication skills and expression of concerns of patients with breast cancer (analyzed with content analysis software) and an adapted European Organisation for Research and Treatment of Cancer satisfaction with care questionnaire completed by patients at the end of radiotherapy. Two hundred thirty-seven radiotherapy planning sessions were recorded. Compared with members of the untrained teams, members of the trained teams acquired, over time, more assessment skills (P = .003) and more supportive skills (P = .050) and provided more setting information (P = .010). Over time, patients interacting with members of the trained teams asked more open questions (P = .022), expressed more emotional words (P = .025), and exhibited a higher satisfaction level regarding nurses' interventions (P = .028). The 38-hour training program facilitated transfer of team member learned communication skills to the clinical practice and improved patients' satisfaction with care. © 2015 by American Society of Clinical Oncology.

Using detailed inter-network simulation and model abstraction to investigate and evaluate joint battlespace infosphere (JBI) support technologies

NASA Astrophysics Data System (ADS)

Green, David M.; Dallaire, Joel D.; Reaper, Jerome H.

2004-08-01

The Joint Battlespace Infosphere (JBI) program is performing a technology investigation into global communications, data mining and warehousing, and data fusion technologies by focusing on techniques and methodologies that support twenty first century military distributed collaboration. Advancement of these technologies is vitally important if military decision makers are to have the right data, in the right format, at the right time and place to support making the right decisions within available timelines. A quantitative understanding of individual and combinational effects arising from the application of technologies within a framework is presently far too complex to evaluate at more than a cursory depth. In order to facilitate quantitative analysis under these circumstances, the Distributed Information Enterprise Modeling and Simulation (DIEMS) team was formed to apply modeling and simulation (M&S) techniques to help in addressing JBI analysis challenges. The DIEMS team has been tasked utilizing collaborative distributed M&S architectures to quantitatively evaluate JBI technologies and tradeoffs. This paper first presents a high level view of the DIEMS project. Once this approach has been established, a more concentrated view of the detailed communications simulation techniques used in generating the underlying support data sets is presented.

Team Training through Communications Control

DTIC Science & Technology

1982-02-01

training * operational environment * team training research issues * training approach * team communications * models of operator beharior e...on the market soon, it certainly would be investigated carefully for its applicability to the team training problem. ce A text-to-speech voice...generation system. Votrax has recently marketed such a device, and others may soon follow suit. ’ d. A speech replay system designed to produce speech from

The Methodological Illumination of a Blind Spot: Information and Communication Technology and International Research Team Dynamics in a Higher Education Research Program

ERIC Educational Resources Information Center

Hoffman, David M.; Blasi, Brigida; Culum, Bojana; Dragšic, Žarko; Ewen, Amy; Horta, Hugo; Nokkala, Terhi; Rios-Aguilar, Cecilia

2014-01-01

This "self-ethnography" complements the other articles in this special issue by spotlighting a set of key challenges facing international research teams. The study is focused on the relationship between information and communication technology (ICT)-based collaboration and research team dynamics. Our diverse team, drawn from researchers…

Improving discharge planning communication between hospitals and patients.

PubMed

New, P W; McDougall, K E; Scroggie, C P R

2016-01-01

A potential barrier to patient discharge from hospital is communication problems between the treating team and the patient or family regarding discharge planning. To determine if a bedside 'Leaving Hospital Information Sheet' increases patient and family's knowledge of discharge date and destination and the name of the key clinician primarily responsible for team-patient communication. This article is a 'before-after' study of patients, their families and the interdisciplinary ward-based clinical team. Outcomes assessed pre-implementation and post-implementation of a bedside 'Leaving Hospital Information Sheet' containing discharge information for patients and families. Patients and families were asked if they knew the key clinician for team-patient communication and the proposed discharge date and discharge destination. Responses were compared with those set by the team. Staff were surveyed regarding their perceptions of patient awareness of discharge plans and the benefit of the 'Leaving Hospital Information Sheet'. Significant improvement occurred regarding patients' knowledge of their key clinician for team-patient communication (31% vs 75%; P = 0.0001), correctly identifying who they were (47% vs 79%; P = 0.02), and correctly reporting their anticipated discharge date (54% vs 86%; P = 0.004). There was significant improvement in the family's knowledge of the anticipated discharge date (78% vs 96%; P = 0.04). Staff reported the 'Leaving Hospital Information Sheet' assisted with communication regarding anticipated discharge date and destination (very helpful n = 11, 39%; a little bit helpful n = 11, 39%). A bedside 'Leaving Hospital Information Sheet' can potentially improve communication between patients, families and their treating team. © 2016 Royal Australasian College of Physicians.

Differences in end-of-life communication for children with advanced cancer who were referred to a palliative care team.

PubMed

Kassam, Alisha; Skiadaresis, Julia; Alexander, Sarah; Wolfe, Joanne

2015-08-01

There is a general consensus that involving a specialized palliative care team in the care of children with advanced cancer can help optimize end-of-life communication; however, how this compares to standard oncology care is still unknown. We aimed to determine whether there was an association between specialist palliative care involvement and improved end-of-life communication for children with advanced cancer and their families. We administered questionnaires to 75 bereaved parents (response rate 54%). Outcome measures were presence or absence of 11 elements related to end-of-life communication. Parents were significantly more likely to receive five communication elements if their child was referred to a palliative care team. These elements are: discussion of death and dying with parents by the healthcare team (P<0.01); discussion of death and dying with child by the healthcare team when appropriate (P < 0.01); providing parents with guidance on how to talk to their child about death and dying when appropriate (P < 0.01); preparing parents for medical aspects surrounding death (P = 0.02) and sibling support (P = 0.02). Children were less likely to be referred to a palliative care team if they had a hematologic malignancy. Children who receive standard oncology care are at higher risk of not receiving critical communication elements at end of life. Strategies to optimize end-of-life communication for children who are not referred to a palliative care team are needed. © 2015 Wiley Periodicals, Inc.

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)

The Use of Visual Thinking Strategies and Art to Help Nurses Find Their Voices.

PubMed

Moorman, Margaret

2017-08-01

Health care is increasingly complex, as nurses navigate working in teams and conveying critical information to others. Clear communication and accuracy are critical for nurses because they communicate to patients and other members of the health care team. Art, and more specifically, Visual Thinking Strategies (VTS), are ways for nurses to practice communication and clear articulation of ideas. VTS also allows nurses to explore finding their voices and working with others to provide safe and effective communication among the team, including patients and their families.

Is it possible to improve communication around radiotherapy delivery: A randomized study to assess the efficacy of team training?

PubMed

Liénard, Aurore; Delevallez, France; Razavi, Darius; Gibon, Anne-Sophie; Libert, Yves; Delvaux, Nicole; Marchal, Serge; Etienne, Anne-Marie; Bragard, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Durieux, Jean-François; Farvacques, Christine; Scalliet, Pierre; Van Houtte, Paul; Coucke, Philippe; Merckaert, Isabelle

2016-05-01

The aim of this study was to assess the efficacy of a 38-h communication skills training program designed for multidisciplinary radiotherapy teams. Four radiotherapy teams were randomly assigned to a training program or to a waiting list. Assessments were scheduled at baseline (T1) and then after the training was completed or four months later (T2), respectively. Communication around radiotherapy delivery was assessed based on audio recordings of the first and last radiotherapy sessions in order to assess team members' communication skills and the expression of concerns by breast cancer patients (analyzed with content analysis software LaComm). 198 radiotherapy sessions were recorded. During the first radiotherapy sessions, members of the trained teams exhibited more assessment skills (p=0.048), provided more setting information (p<0.001), and used more social words (p=0.019) compared to the members of the untrained teams. During the last radiotherapy session, members of the trained teams used more assessment skills (p=0.004) and patients interacting with members of the trained teams expressed more sadness words (p=0.023). Training of multidisciplinary teams has the potential to transfer skills that affect the short exchanges that take place around radiotherapy delivery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members.

PubMed

Wauben, L S G L; Dekker-van Doorn, C M; van Wijngaarden, J D H; Goossens, R H M; Huijsman, R; Klein, J; Lange, J F

2011-04-01

To assess surgical team members' differences in perception of non-technical skills. Questionnaire design. Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT. Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P < 0.001). Finally, 72-90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate. This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

Professionals’ views on interprofessional stroke team functioning

PubMed Central

Cramm, Jane M; Nieboer, Anna P

2011-01-01

Introduction The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals’ perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members. Methods We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39%) completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1) nested in 34 teams (level 2). Results Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion. Discussion and conclusion Our findings suggest that interventions to improve team members’ social well-being, communication, and role understanding will improve teams’ performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals’ interpersonal skills and interprofessional education. PMID:23390409

The role of healthcare communications agencies in maintaining compliance when working with the pharmaceutical industry and healthcare professionals.

PubMed

Cairns, Angela; Yarker, Yvonne E

2008-05-01

Relationships between the pharmaceutical industry and healthcare professionals continue to drive discussion about the potential for conflicts of interest. Despite greater regulation and oversight, there are still calls for increased transparency and further restrictions on these relationships. Regulatory authorities, the pharmaceutical industry, professional societies, and other interested parties have responded by developing robust guidelines for interactions between the pharmaceutical industry and healthcare professionals. This, in turn, is driving change in the way that healthcare communications agencies work, increasing the need for them to visibly demonstrate processes that ensure their employees comply with relevant laws, regulations, and guidelines. In our group of healthcare communications agencies we have established an internal compliance program and developed a policy that reflects the services we provide, and we recommend that other agencies adopt a similar program. Compliance training, implemented by a nominated compliance team, can be enforced by including compulsory tests for employees who interact with the pharmaceutical industry and healthcare professionals, with annual reassessment. The compliance team also has an important role to play in ensuring ongoing communication and staff education, including awareness of new legal and best practice developments. Management of the compliance program is essential, with clear mechanisms for auditing and evaluation, and the inclusion of compliance adherence in staff performance objectives. A visible framework for handling potential compliance issues should also be developed, with clear definitions of different levels of noncompliance and potential associated consequences. Compliance programs may also include other elements, such as terminology and documentation guidance, so that the program becomes an integral tool used by employees on a daily basis. With a robust internal compliance program, healthcare communication agencies can play a significant role in helping maintain appropriate pharmaceutical industry-healthcare professional relationships in an increasingly regulated and scrutinized environment.

Communication between anesthesiologists, patients and the anesthesia team: a descriptive study of induction and emergence.

PubMed

Smith, Andrew F; Pope, Catherine; Goodwin, Dawn; Mort, Maggie

2005-11-01

Although the importance of communication skills in anesthetic practice is increasingly recognized, formal communication skills training has hitherto dealt only with limited aspects of this professional activity. We aimed to document and analyze the informally-learned communication that takes place between anesthesia personnel and patients at induction of and emergence from general anesthesia. We adopted an ethnographic approach based principally on observation of anesthesia personnel at work in the operating theatres with subsequent analysis of observation transcripts. We noted three main styles of communication on induction, commonly combined in a single induction. In order of frequency, these were: (1) descriptive, where the anesthesiologists explained to the patient what he/she might expect to feel; (2) functional, which seemed designed to help anesthesiologists maintain physiological stability or assess the changing depth of anesthesia and (3) evocative, which referred to images or metaphors. Although the talk we have described is nominally directed at the patient, it also signifies to other members of the anesthetic team how induction is progressing. The team may also contribute to the communication behaviour depending on the context. Communication on emergence usually focused on establishing that the patient was awake. Communication at induction and emergence tends to fall into specific patterns with different emphases but similar functions. This communication work is shared across the anesthetic team. Further work could usefully explore the relationship between communication styles and team performance or indicators of patient safety or well-being.

Optimizing Patient Surgical Management Using WhatsApp Application in the Italian Healthcare System.

PubMed

Nardo, Bruno; Cannistrà, Marco; Diaco, Vincenzo; Naso, Agostino; Novello, Matteo; Zullo, Alessandra; Ruggiero, Michele; Grande, Raffaele; Sacco, Rosario

2016-09-01

Smartphones changed the method by which doctors communicate with each other, offer modern functionalities sensitive to the context of use, and can represent a valuable ally in the healthcare system. Studies have shown that WhatsApp™ application can facilitate communication within the healthcare team and provide the attending physician a constant oversight of activities performed by junior team members. The aim of the study was to use WhatsApp between two distant surgical teams involved in a program of elective surgery to verify if it facilitates communication, enhances learning, and improves patient care preserving their privacy. We conducted a focused group of surgeons over a 28-month period (from March 2013 to July 2015), and from September 2014 to July 2015, a group of selected specialists communicated healthcare matters through the newly founded "WhatsApp Surgery Group." Each patient enrolled in the study signed a consent form to let the team communicate his/her clinical data using WhatsApp. Communication between team members, response times, and types of messages were evaluated. Forty six (n = 46) patients were enrolled in the study. A total of 1,053 images were used with an average of 78 images for each patient (range 41-143). 125 h of communication were recorded, generating 354 communication events. The expert surgeon had received the highest number of questions (P, 0.001), while the residents asked clinical questions (P, 0.001) and were the fastest responders to communications (P, 0.001). Our study investigated how two distant clinical teams may exploit such a communication system and quantifies both the direction and type of communication between surgeons. WhatsApp is a low cost, secure, and fast technology and it offers the opportunity to facilitate clinical and nonclinical communications, enhance learning, and improve patient care preserving their privacy.

Interprofessional Team Training at the Prelicensure Level: A Review of the Literature.

PubMed

Nelson, Sioban; White, Catriona F; Hodges, Brian D; Tassone, Maria

2017-05-01

The authors undertook a descriptive analysis review to gain a better understanding of the various approaches to and outcomes of team training initiatives in prelicensure curricula since 2000. In July and August 2014, the authors searched the MEDLINE, PsycINFO, Embase, Business Source Premier, and CINAHL databases to identify evaluative studies of team training programs' effects on the team knowledge, communication, and skills of prelicensure students published from 2000 to August 2014. The authors identified 2,568 articles, with 17 studies meeting the selection criteria for full text review. The most common study designs were single-group, pre/posttest studies (n = 7), followed by randomized controlled or comparison trials (n = 6). The Situation, Background, Assessment, Recommendation communication tool (n = 5); crisis resource management principles (n = 6); and high-fidelity simulation (n = 4) were the most common curriculum bases used. Over half of the studies (n = 9) performed training with students from more than one health professions program. All but three used team performance assessments, with most (n = 8) using observed behavior checklists created for that specific study. The majority of studies (n = 16) found improvements in team knowledge, communication, and skills. Team training appears effective in improving team knowledge, communication, and skills in prelicensure learners. Continued exploration of the best method of team training is necessary to determine the most effective way to move forward in prelicensure interprofessional team education.

Virtual Team Effectiveness: An Empirical Study Using SEM

ERIC Educational Resources Information Center

Bhat, Swati Kaul; Pande, Neerja; Ahuja, Vandana

2016-01-01

Advances in communication and information technology create new opportunities for organizations to build and manage virtual teams. Virtual teams have become a norm for organizations whose members work across disparate geographical locations, relying primarily or exclusively, on the usage of Information and Communications Technology (ICT) for the…

Examination of wireless technology to improve nurse communication, response time to bed alarms, and patient safety.

PubMed

Guarascio-Howard, Linda

2011-01-01

A medical-surgical unit in a southwestern United States hospital examined the results of adding wireless communication technology to assist nurses in identifying patient bed status changes and enhancing team communication. Following the addition of wireless communication, response time to patient calls and the number of nurse-initiated communications were compared to pre-wireless calls and response time sampling period. In the baseline study, nurse-initiated communications and response time to patient calls were investigated for a team nursing model (Guarascio-Howard & Malloch, 2007). At this time, technology consisted of a nurse call system and telephones located at each decentralized nurse station and health unit coordinator (HUC) station. For this follow-up study, a wireless device was given to nurses and their team members following training on device use and privacy issues. Four registered nurses (RNs) were shadowed for 8 hours (32 hours total) before and after the introduction of the wireless devices. Data were collected regarding patient room visits, number of patient calls, bed status calls, response time to calls, and the initiator of the communication episodes. Follow-up study response time to calls significantly decreased (t-test p = .03). RNs and licensed practical nurses responded to bed status calls in less than 1 minute-62% of the 37 calls. Communication results indicated a significant shift (One Proportion Z Test) in RN-initiated communications, suggesting an enhanced ability to communicate with team members and to assist in monitoring patient status. Patient falls trended downward, although not significantly (p > .05), for a 6-month period of wireless technology use compared to the same period the previous year. The addition of a wireless device has advantages in team nursing, namely increasing communication with staff members and decreasing response time to patient and bed status calls. Limitations of the study included a change in caregiver team members and issues regarding wireless device and locator badge compliance. Administrative issues that arose during this field study included bed and cable maintenance, device battery charging, and the training of new and floating team members.

Enhancing Student Team Effectiveness: Application of Myers-Briggs Personality Assessment in Business Courses

ERIC Educational Resources Information Center

Amato, Christie H.; Amato, Louis H.

2005-01-01

This article examines the relationship between student perceptions of team learning experience and communication style. Student group learning perceptions were evaluated and team communication style was measured using dyads derived from Myers-Briggs personality profiles. Groups containing similar personalities were classified as compatible,…

Effectiveness of Teamwork in an Integrated Care Setting for Patients with COPD: Development and Testing of a Self-Evaluation Instrument for Interprofessional Teams.

PubMed

Van Dijk-de Vries, Anneke N; Duimel-Peeters, Inge G P; Muris, Jean W; Wesseling, Geertjan J; Beusmans, George H M I; Vrijhoef, Hubertus J M

2016-04-08

Teamwork between healthcare providers is conditional for the delivery of integrated care. This study aimed to assess the usefulness of the conceptual framework Integrated Team Effectiveness Model for developing and testing of the Integrated Team Effectiveness Instrument. Focus groups with healthcare providers in an integrated care setting for people with chronic obstructive pulmonary disease (COPD) were conducted to examine the recognisability of the conceptual framework and to explore critical success factors for collaborative COPD practice out of this framework. The resulting items were transposed into a pilot instrument. This was reviewed by expert opinion and completed 153 times by healthcare providers. The underlying structure and internal consistency of the instrument were verified by factor analysis and Cronbach's alpha. The conceptual framework turned out to be comprehensible for discussing teamwork effectiveness. The pilot instrument measures 25 relevant aspects of teamwork in integrated COPD care. Factor analysis suggested three reliable components: teamwork effectiveness, team processes and team psychosocial traits (Cronbach's alpha between 0.76 and 0.81). The conceptual framework Integrated Team Effectiveness Model is relevant in developing a practical full-spectrum instrument to facilitate discussing teamwork effectiveness. The Integrated Team Effectiveness Instrument provides a well-founded basis to self-evaluate teamwork effectiveness in integrated COPD care by healthcare providers. Recommendations are provided for the improvement of the instrument.

ALFA: The new ALICE-FAIR software framework

NASA Astrophysics Data System (ADS)

Al-Turany, M.; Buncic, P.; Hristov, P.; Kollegger, T.; Kouzinopoulos, C.; Lebedev, A.; Lindenstruth, V.; Manafov, A.; Richter, M.; Rybalchenko, A.; Vande Vyvre, P.; Winckler, N.

2015-12-01

The commonalities between the ALICE and FAIR experiments and their computing requirements led to the development of large parts of a common software framework in an experiment independent way. The FairRoot project has already shown the feasibility of such an approach for the FAIR experiments and extending it beyond FAIR to experiments at other facilities[1, 2]. The ALFA framework is a joint development between ALICE Online- Offline (O2) and FairRoot teams. ALFA is designed as a flexible, elastic system, which balances reliability and ease of development with performance using multi-processing and multithreading. A message- based approach has been adopted; such an approach will support the use of the software on different hardware platforms, including heterogeneous systems. Each process in ALFA assumes limited communication and reliance on other processes. Such a design will add horizontal scaling (multiple processes) to vertical scaling provided by multiple threads to meet computing and throughput demands. ALFA does not dictate any application protocols. Potentially, any content-based processor or any source can change the application protocol. The framework supports different serialization standards for data exchange between different hardware and software languages.

Virtual reality as a tool for cross-cultural communication: an example from military team training

NASA Astrophysics Data System (ADS)

Downes-Martin, Stephen; Long, Mark; Alexander, Joanna R.

1992-06-01

A major problem with communication across cultures, whether professional or national, is that simple language translation if often insufficient to communicate the concepts. This is especially true when the communicators come from highly specialized fields of knowledge or from national cultures with long histories of divergence. This problem becomes critical when the goal of the communication is national negotiation dealing with such high risk items as arms negotiation or trade wars. Virtual Reality technology has considerable potential for facilitating communication across cultures, by immersing the communicators within multiple visual representations of the concepts, and providing control over those representations. Military distributed team training provides a model for virtual reality suitable for cross cultural communication such as negotiation. In both team training and negotiation, the participants must cooperate, agree on a set of goals, and achieve mastery over the concepts being negotiated. Team training technologies suitable for supporting cross cultural negotiation exist (branch wargaming, computer image generation and visualization, distributed simulation), and have developed along different lines than traditional virtual reality technology. Team training de-emphasizes the realism of physiological interfaces between the human and the virtual reality, and emphasizes the interaction of humans with each other and with intelligent simulated agents within the virtual reality. This approach to virtual reality is suggested as being more fruitful for future work.

Criteria for successful multiprofessional cooperation in palliative care teams.

PubMed

Jünger, S; Pestinger, M; Elsner, F; Krumm, N; Radbruch, L

2007-06-01

Team work is considered a central component of palliative care. Within this comparatively young field of medicine, the emergence of new institutions (eg, palliative care units) highlights the challenge of establishing a completely new team. This study focuses on the factors, which enhance both the success and outcome criteria of good team work from the perception of team members in a palliative care unit. The palliative care team at the University Hospital of Aachen (n = 19) was interviewed 1 year after the unit's startup by the means of semistructured interviews. Interview texts were analysed using qualitative content analysis. Factors crucial to cooperation in the team members' views were close communication, team philosophy, good interpersonal relationships, high team commitment, autonomy and the ability to deal with death and dying. Moreover, close communication was by far the most frequently mentioned criteria for cooperation. Team performance, good coordination of workflow and mutual trust underpin the evaluation of efficient team work. Inefficient team work is associated with the absence of clear goals, tasks and role delegation, as well as a lack of team commitment. In a new team, close communication is particularly important for staff as they reorientate themselves to the dynamics of a new peer group. The results confirm the overwhelming importance of clarity, commitment and close, positive exchange among team members for successful team work.

Building Collective Communication Competence in Interdisciplinary Research Teams

ERIC Educational Resources Information Center

Thompson, Jessica Leigh

2009-01-01

Using a grounded theory approach, this investigation addresses how an interdisciplinary research (IDR) team negotiates meaning and struggles to establish and sustain a sense of collective communication competence (CCC). Certain communication processes were foundational to building CCC, such as spending time together, practicing trust, discussing…

Patient and team communication in the iPad era - a practical appraisal.

PubMed

Imburgia, Mario

2014-01-01

Communication with the patient and within the team is a critical factor that can influence the treatment outcome, especially in complex and multidisciplinary dental treatments. Indeed, effective communication, not focused on marketing but on proper information of the patient's intraoral situation, can encourage greater acceptance of treatment and also greater treatment satisfaction. Better communication within the dental team is also a very important factor to improve the final result and reduce the time needed to reach it. Thanks to new technological devices widely available, such as tablets, we can use visual communication and interaction with the clinical images of the patient in order to improve communication with the patient, and especially within the dental team. The use of this method allows us to obtain a facial, dentolabial and dental esthetic analysis of the patient that can be used in various clinical steps, improving the predictability of the esthetic outcome and at the same time reducing the number of clinical sessions usually required.

Performance implications of leader briefings and team-interaction training for team adaptation to novel environments.

PubMed

Marks, M A; Zaccaro, S J; Mathieu, J E

2000-12-01

The authors examined how leader briefings and team-interaction training influence team members' knowledge structures concerning processes related to effective performance in both routine and novel environments. Two-hundred thirty-seven undergraduates from a large mid-Atlantic university formed 79 three-member tank platoon teams and participated in a low-fidelity tank simulation. Team-interaction training, leader briefings, and novelty of performance environment were manipulated. Findings indicated that both leader briefings and team-interaction training affected the development of mental models, which in turn positively influenced team communication processes and team performance. Mental models and communication processes predicted performance more strongly in novel than in routine environments. Implications for the role of team-interaction training, leader briefings, and mental models as mechanisms for team adaptation are discussed.

Mobile Real-time Tracking of Acute Stroke Patients and Instant, Secure Inter-team Communication - the Join App.

PubMed

Munich, Stephan A; Tan, Lee A; Nogueira, Danilo M; Keigher, Kiffon M; Chen, Michael; Crowley, R Webster; Conners, James J; Lopes, Demetrius K

2017-09-01

The primary correlate to survival and preservation of neurologic function in patients suffering from an acute ischemic stroke is time from symptom onset to initiation of therapy and reperfusion. Communication and coordination among members of the stroke team are essential to maximizing efficiency and subsequently early reperfusion. In this work, we aim to describe our preliminary experience using the Join mobile application as a means to improve interdisciplinary team communication and efficiency. We describe our pilot experience with the initiation of the Join mobile application between July 2015 and July 2016. With this application, a mobile beacon is transported with the patient on the ambulance. Transportation milestone timestamps and geographic coordinates are transmitted to the treating facility and instantly communicated to all treatment team members. The transport team / patient can be tracked en route to the treating facility. During our pilot study, 62 patients were triaged and managed using the Join application. Automated time-stamping of critical events, geographic tracking of patient transport and summary documents were obtained for all patients. Treatment team members had an overall favorable impression of the Join application and recommended its continued use. The Join application is one of several components of a multi-institutional, interdisciplinary effort to improve the treatment of patients with acute ischemic stroke. The ability of the treatment team to track patient transport and communicate with the transporting team may improve reperfusion time and, therefore, improve neurologic outcomes.

Exclusion of Residents From Surgery-Intensive Care Team Communication: A Qualitative Study.

PubMed

Gotlib Conn, Lesley; Haas, Barbara; Rubenfeld, Gordon D; Scales, Damon C; Amaral, Andre C; Ferguson, Niall D; Nathens, Avery B

2016-01-01

Communication competency is an important aspect of postgraduate training and patient care delivery in all specialties and clinical domains. This study explored staff surgeon and intensivist perceptions of and experiences with residents' communication with a view toward fostering high quality interspecialty team communication in the surgical intensive care unit. A qualitative study using semistructured interviews. Data were analyzed iteratively and inductively as per standard qualitative thematic approach. University of Toronto, Toronto, Canada. A total of 15 staff surgeons and intensivists who collaborate in patient care in the surgical intensive care unit. The phenomenon of "resident bypass" emerged, resulting from staff surgeon and intensivist perceptions that residents threaten the quality of interspecialty team communication. Clear patterns and preferences for resident exclusion from this communication were present. A total of 5 interrelated drivers of resident bypass were discovered: lack of trust, lack of specialized knowledge, poor system design, need for timely communication, and residents' inadequate contribution to decision-making. Surgical and intensive care staff were dissatisfied with the structure of residents' roles in interspecialty team communication. Concerns about communication gaps, patient care continuity, and patient safety were expressed. Surgical and intensive care staff exclude residents from interspecialty team communication for the benefit of patient safety and care continuity, but this limits opportunities for residents to develop communication skill and competence. Efforts are needed to effectively integrate surgery and intensive care residents in interspecialty attending-resident communication in ways that are meaningful for both patient care and postgraduate training. The implications for medical education are discussed. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Developing Team Skills through a Collaborative Writing Assignment

ERIC Educational Resources Information Center

Thomas, Theda Ann

2014-01-01

Employers want students who are able to work effectively as members of a team, and expect universities to develop this ability in their graduates. This paper proposes a framework for a collaborative writing assignment that specifically develops students' ability to work in teams. The framework has been tested using two iterations of an action…

Building Student and Family-Centered Care Coordination Through Ongoing Delivery System Design.

PubMed

Baker, Dian; Anderson, Lori; Johnson, Jody

2017-01-01

In 2016 the National Association of School Nurses released an updated framework for school nurse practice. One highlight of the new framework is 21st century care coordination. That is, moving beyond basic case management to a systems-level approach for delivery of school health services. The framework broadly applies the term care coordination to include direct care and communication across systems. School nurses are often engaged in efforts to create school health care homes that serve as an axis of coordination for students and families between primary care offices and the schools. Effective care coordination requires that the school nurses not only know the principles of traditional case management but also understand complex systems that drive effective care coordination. The outcome of a system-level approach is enhanced access to services in an integrated health care delivery system that includes the school nurse as an integral member of the school's health care team. This article presents a comprehensive, system-level model of care coordination for school nurse leadership and practice.

Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.

PubMed

Montesano, Vicki L; Sivec, Harry J; Munetz, Mark R; Pelton, Jeremy R; Turkington, Douglas

2014-03-01

The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

The effect of a nurse team leader on communication and leadership in major trauma resuscitations.

PubMed

Clements, Alana; Curtis, Kate; Horvat, Leanne; Shaban, Ramon Z

2015-01-01

Effective assessment and resuscitation of trauma patients requires an organised, multidisciplinary team. Literature evaluating leadership roles of nurses in trauma resuscitation and their effect on team performance is scarce. To assess the effect of allocating the most senior nurse as team leader of trauma patient assessment and resuscitation on communication, documentation and perceptions of leadership within an Australian emergency department. The study design was a pre-post-test survey of emergency nursing staff (working at resuscitation room level) perceptions of leadership, communication, and documentation before and after the implementation of a nurse leader role. Patient records were audited focussing on initial resuscitation assessment, treatment, and nursing clinical entry. Descriptive statistical analyses were performed. Communication trended towards improvement. All (100%) respondents post-test stated they had a good to excellent understanding of their role, compared to 93.2% pre-study. A decrease (58.1-12.5%) in 'intimidating personality' as a negative aspect of communication. Nursing leadership had a 6.7% increase in the proportion of those who reported nursing leadership to be good to excellent. Accuracy of clinical documentation improved (P = 0.025). Trauma nurse team leaders improve some aspects of communication and leadership. Development of trauma nurse leaders should be encouraged within trauma team training programmes. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Soldier-Robot Teaming: Effects of Multimodal Collaboration on Team Communication for Robot Reconnaissance

DTIC Science & Technology

2010-10-01

of the modes of communication and target types central to the experimental tasks, as well as a task demonstration. The Soldier then practiced the...experimental tasks with each communication modality on a separate training course with targets. Practice was structured such that a communication... practice structure across all three communication conditions. Radio was always introduced first, then chat, and lastly tactor. The exception to this

Partners | Integrated Energy Solutions | NREL

Science.gov Websites

Develops Off-Grid Energy Access through Quality Assurance Framework for Mini-Grids NREL has teamed with the Africa to develop a Quality Assurance Framework for isolated mini-grids. NREL Enhances Energy Resiliency Partnership Develops Off-Grid Energy Access through Quality Assurance Framework for Mini-Grids NREL has teamed

Making sense of health information technology implementation: A qualitative study protocol.

PubMed

Kitzmiller, Rebecca R; Anderson, Ruth A; McDaniel, Reuben R

2010-11-29

Implementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing care in hospitals. Thus, HIT implementation may occur slowly as staff members observe and make sense of unexpected disruptions in care. As a critical organizational function, sensemaking, defined as the social process of searching for answers and meaning which drive action, leads to unified understanding, learning, and effective problem solving -- strategies that studies have linked to successful change. Project teamwork is a change strategy increasingly used by hospitals that facilitates sensemaking by providing a formal mechanism for team members to share ideas, construct the meaning of events, and take next actions. In this longitudinal case study, we aim to examine project teams' sensemaking and action as the team prepares to implement new information technology in a tiertiary care hospital. Based on management and healthcare literature on HIT implementation and project teamwork, we chose sensemaking as an alternative to traditional models for understanding organizational change and teamwork. Our methods choices are derived from this conceptual framework. Data on project team interactions will be prospectively collected through direct observation and organizational document review. Through qualitative methods, we will identify sensemaking patterns and explore variation in sensemaking across teams. Participant demographics will be used to explore variation in sensemaking patterns. Outcomes of this research will be new knowledge about sensemaking patterns of project teams, such as: the antecedents and consequences of the ongoing, evolutionary, social process of implementing HIT; the internal and external factors that influence the project team, including team composition, team member interaction, and interaction between the project team and the larger organization; the ways in which internal and external factors influence project team processes; and the ways in which project team processes facilitate team task accomplishment. These findings will lead to new methods of implementing HIT in hospitals.

Making sense of health information technology implementation: A qualitative study protocol

PubMed Central

2010-01-01

Background Implementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing care in hospitals. Thus, HIT implementation may occur slowly as staff members observe and make sense of unexpected disruptions in care. As a critical organizational function, sensemaking, defined as the social process of searching for answers and meaning which drive action, leads to unified understanding, learning, and effective problem solving -- strategies that studies have linked to successful change. Project teamwork is a change strategy increasingly used by hospitals that facilitates sensemaking by providing a formal mechanism for team members to share ideas, construct the meaning of events, and take next actions. Methods In this longitudinal case study, we aim to examine project teams' sensemaking and action as the team prepares to implement new information technology in a tiertiary care hospital. Based on management and healthcare literature on HIT implementation and project teamwork, we chose sensemaking as an alternative to traditional models for understanding organizational change and teamwork. Our methods choices are derived from this conceptual framework. Data on project team interactions will be prospectively collected through direct observation and organizational document review. Through qualitative methods, we will identify sensemaking patterns and explore variation in sensemaking across teams. Participant demographics will be used to explore variation in sensemaking patterns. Discussion Outcomes of this research will be new knowledge about sensemaking patterns of project teams, such as: the antecedents and consequences of the ongoing, evolutionary, social process of implementing HIT; the internal and external factors that influence the project team, including team composition, team member interaction, and interaction between the project team and the larger organization; the ways in which internal and external factors influence project team processes; and the ways in which project team processes facilitate team task accomplishment. These findings will lead to new methods of implementing HIT in hospitals. PMID:21114860

The outcome competency framework for practitioners in infection prevention and control: use of the outcome logic model for evaluation.

PubMed

Burnett, E; Curran, E; Loveday, H P; Kiernan, M A; Tannahill, M

2014-01-01

Healthcare is delivered in a dynamic environment with frequent changes in populations, methods, equipment and settings. Infection prevention and control practitioners (IPCPs) must ensure that they are competent in addressing the challenges they face and are equipped to develop infection prevention and control (IPC) services in line with a changing world of healthcare provision. A multifaceted Framework was developed to assist IPCPs to enhance competence at an individual, team and organisational level to enable quality performance and improved quality of care. However, if these aspirations are to be met, it is vital that competency frameworks are fit for purpose or they risk being ignored. The aim of this unique study was to evaluate short and medium term outcomes as set out in the Outcome Logic Model to assist with the evaluation of the impact and success of the Framework. This study found that while the Framework is being used effectively in some areas, it is not being used as much or in the ways that were anticipated. The findings will enable future work on revision, communication and dissemination, and will provide intelligence to those initiating education and training in the utilisation of the competences.

The outcome competency framework for practitioners in infection prevention and control: use of the outcome logic model for evaluation

PubMed Central

Curran, E; Loveday, HP; Kiernan, MA; Tannahill, M

2013-01-01

Healthcare is delivered in a dynamic environment with frequent changes in populations, methods, equipment and settings. Infection prevention and control practitioners (IPCPs) must ensure that they are competent in addressing the challenges they face and are equipped to develop infection prevention and control (IPC) services in line with a changing world of healthcare provision. A multifaceted Framework was developed to assist IPCPs to enhance competence at an individual, team and organisational level to enable quality performance and improved quality of care. However, if these aspirations are to be met, it is vital that competency frameworks are fit for purpose or they risk being ignored. The aim of this unique study was to evaluate short and medium term outcomes as set out in the Outcome Logic Model to assist with the evaluation of the impact and success of the Framework. This study found that while the Framework is being used effectively in some areas, it is not being used as much or in the ways that were anticipated. The findings will enable future work on revision, communication and dissemination, and will provide intelligence to those initiating education and training in the utilisation of the competences. PMID:28989348

Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond

PubMed Central

Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie

2016-01-01

Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434

Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond.

PubMed

Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie

2016-07-01

Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature.

The TEDxLSU Student Creative Communications Team: Integrating High-Impact Practices to Increase Engagement, Facilitate Deep Learning, and Advance Communication Skills

ERIC Educational Resources Information Center

Burdette, Rebecca; Galeucia, Annemarie; Liggett, Sarah; Thompson, Melissa

2016-01-01

This article provides background on Louisiana State University's Communication across the Curriculum (CxC) program and details the history and logistics of its experiential learning and community outreach event--TEDxLSU. In particular, the authors provide details on the Student Creative Communications Team (SCCT) which conceptualizes, plans, and…

Moving Toward Improved Teamwork in Cancer Care: The Role of Psychological Safety in Team Communication.

PubMed

Jain, Anshu K; Fennell, Mary L; Chagpar, Anees B; Connolly, Hannah K; Nembhard, Ingrid M

2016-11-01

Effective communication is a requirement in the teamwork necessary for improved coordination to deliver patient-centered, value-based cancer care. Communication is particularly important when care providers are geographically distributed or work across organizations. We review organizational and teams research on communication to highlight psychological safety as a key determinant of high-quality communication within teams. We first present the concept of psychological safety, findings about its communication effects for teamwork, and factors that affect it. We focus on five factors applicable to cancer care delivery: familiarity, clinical hierarchy-related status differences, geographic dispersion, boundary spanning, and leader behavior. To illustrate how these factors facilitate or hinder psychologically safe communication and teamwork in cancer care, we review the case of a patient as she experiences the treatment-planning process for early-stage breast cancer in a community setting. Our analysis is summarized in a key principle: Teamwork in cancer care requires high-quality communication, which depends on psychological safety for all team members, clinicians and patients alike. We conclude with a discussion of the implications of psychological safety in clinical care and suggestions for future research.

Communication between the elderly person and the family health team: is there integrality?

PubMed

de Almeida, Rita Tereza; Ciosak, Suely Itsuko

2013-01-01

to verify the forms of communication used in four Primary Health Units with Family Health Program teams in Porto Feliz, São Paulo, and how they impact in the care and control of the health of elderly people. this qualitative study sought to capture the communication between elderly people and healthcare professionals. Interviews were conducted with 20 elderly people of both sexes. from the discourses and observations, assertive communication and blocked communication emerged as the central analysis themes, the verbal and nonverbal elements of which, unveiled subjectivity of the communication process, of the local culture and of the psychosocial factors positively and negatively contributing to the healthcare for elderly people. The nursing teams of the Family Health Strategy showed forms of communication that favored the adherence of the elderly people to the care and control of their health. Negatives aspects did not have completely prejudicial consequences, however, should be avoided, in order to facilitate integral care to elderly people. it is worth reinforcing the need for improvement of the nursing team and other healthcare professionals regarding health communication as an innovative technology, bringing credibility to the health promotion and prevention programs with elderly users.

Enhancing Intercultural Communication and Understanding: Team Translation Project as a Student Engagement Learning Approach

ERIC Educational Resources Information Center

Yang, Ping

2015-01-01

This paper reflects on a team translation project on Aboriginal culture designed to enhance university students' intercultural communication competence and understanding through engaging in an interactive team translation project funded by the Australia-China Council. A selected group of Chinese speaking translation students participated in the…

Colonel Mustard in the Library with the Knife...Experiencing Virtual Teaming.

ERIC Educational Resources Information Center

Roebuck, Deborah Britt

Virtual teaming has come to stay in the fast developing world of communication as it brings more value to customers, saves costs, accelerates competence, and leverages organizational learning. Therefore, students need to be educated about this new type of team and the tools that are available to facilitate communication and to enhance…

Teams communicating through STEPPS.

PubMed

Stead, Karen; Kumar, Saravana; Schultz, Timothy J; Tiver, Sue; Pirone, Christy J; Adams, Robert J; Wareham, Conrad A

2009-06-01

To evaluate the effectiveness of the implementation of a TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) program at an Australian mental health facility. TeamSTEPPS is an evidence-based teamwork training system developed in the United States. Five health care sites in South Australia implemented TeamSTEPPS using a train-the-trainer model over an 8-month intervention period commencing January 2008 and concluding September 2008. A team of senior clinical staff was formed at each site to drive the improvement process. Independent researchers used direct observation and questionnaire surveys to evaluate the effectiveness of the implementation in three outcome areas: observed team behaviours; staff attitudes and opinions; and clinical performance and outcome. The results reported here focus on one site, an inpatient mental health facility. Team knowledge, skills and attitudes; patient safety culture; incident reporting rates; seclusion rates; observation for the frequency of use of TeamSTEPPS tools. Outcomes included restructuring of multidisciplinary meetings and the introduction of structured communication tools. The evaluation of patient safety culture and of staff knowledge, skills and attitudes (KSA) to teamwork and communication indicated a significant improvement in two dimensions of patient safety culture (frequency of event reporting, and organisational learning) and a 6.8% increase in the total KSA score. Clinical outcomes included reduced rates of seclusion. TeamSTEPPS implementation had a substantial impact on patient safety culture, teamwork and communication at an Australian mental health facility. It encouraged a culture of learning from patient safety incidents and making continuous improvements.

Using Hourly Time-Outs and a Standardized Tool to Promote Team Communication, Medical Record Documentation, and Patient Satisfaction During Second-Stage Labor.

PubMed

Wood, Jessica; Stevenson, Eleanor

2018-04-12

During labor, effective communication and collaboration among the healthcare team is critical for patient safety; however, there is currently no standard for communication and documentation of the plan of care as agreed upon by healthcare team members and the woman in labor. The goal of this project was to increase consistency in communication and collaboration between clinicians and laboring women during secondstage labor. An hourly "time-out" meeting of all healthcare team members was initiated for all women during second-stage labor. A documentation tool was implemented to ensure regular and clear communication between the clinical team and laboring women. Data were collected via medical review of cases of second-stage labor lasting more than 2 hours (n = 21 in the pre-implementation group; n = 39 for 3 months postimplementation; and n = 468 patients for 2 years post-implementation). Surveys were conducted of the clinical team (n = 40) and patients (n = 28). Following implementation, documented agreement of the plan of care increased from 14.3% before the project to 82.1% 3 months after implementation and remained at 81.6% 2 years after implementation. All nurses who participated in the survey reported a clear understanding of how and when to complete necessary medical record documentation during secondstage labor. The providers viewed the project favorably. Most women (92.9%) reported satisfaction with their experience. This project enhanced collaborative communication between members of the clinical team and laboring women and improved patient satisfaction. The improvements were sustainable over a 2-year period.

Validity, Reliability and Acceptability of the Team Standardized Assessment of Clinical Encounter Report*

PubMed Central

Wong, Camilla L.; Norris, Mireille; Sinha, Samir S.; Zorzitto, Maria L.; Madala, Sushma; Hamid, Jemila S.

2016-01-01

Background The Team Standardized Assessment of a Clinical Encounter Report (StACER) was designed for use in Geriatric Medicine residency programs to evaluate Communicator and Collaborator competencies. Methods The Team StACER was completed by two geriatricians and interdisciplinary team members based on observations during a geriatric medicine team meeting. Postgraduate trainees were recruited from July 2010–November 2013. Inter-rater reliability between two geriatricians and between all team members was determined. Internal consistency of items for the constructs Communicator and Collaborator competencies was calculated. Raters completed a survey previously administered to Canadian geriatricians to assess face validity. Trainees completed a survey to determine the usefulness of this instrument as a feedback tool. Results Thirty postgraduate trainees participated. The prevalence-adjusted bias-adjusted kappa range inter-rater reliability for Communicator and Collaborator items were 0.87–1.00 and 0.86–1.00, respectively. The Cronbach’s alpha coefficient for Communicator and Collaborator items was 0.997 (95% CI: 0.993–1.00) and 0.997 (95% CI: 0.997–1.00), respectively. The instrument lacked discriminatory power, as all trainees scored “meets requirements” in the overall assessment. Niney-three per cent and 86% of trainees found feedback useful for developing Communicator and Collaborator competencies, respectively. Conclusions The Team StACER has adequate inter-rater reliability and internal consistency. Poor discriminatory power and face validity challenge the merit of using this evaluation tool. Trainees felt the tool provided useful feedback on Collaborator and Communicator competencies. PMID:28050222

76 FR 27019 - Interagency Ocean Observation Committee, Meeting of the Data Management and Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... Observation Committee, Meeting of the Data Management and Communications Steering Team AGENCY: National Ocean...). ACTION: Notice of open meeting. SUMMARY: NOAA's Integrated Ocean Observing System (IOOS) Program... meeting of the IOOC's Data Management and Communications Steering Team (DMAC-ST). The DMAC-ST membership...

FAA and NASA UTM Research Transition Team: Communications and Navigation (CN) Working Group (WCG) Kickoff Meeting

NASA Technical Reports Server (NTRS)

Jung, Jaewoo; Larrow, Jarrett

2017-01-01

This is NASA FAA UTM Research Transition Team Communications and Navigation working group kick off meeting presentation that addresses the followings. Objectives overview Overall timeline and scope Outcomes and expectations Communication method and frequency of meetings Upcoming evaluation Next steps.

Enhancing communication in surgery through team training interventions: a systematic literature review.

PubMed

Gillespie, Brigid M; Chaboyer, Wendy; Murray, Patrick

2010-12-01

In surgery, up to 70% of adverse events are attributable to failures in communication. The purpose of this systematic literature review was to critically assess the results of team training interventions used in the OR. In the 12 studies that met the inclusion criteria, there were statistically significant before-and-after improvements in teamwork practices and in some secondary outcomes such as complication rates. Our findings suggest that team training interventions have utility in enhancing team communication and cohesion. Team training interventions that are developed in response to the nuances of the context are more likely to become embedded in clinical practice. The introduction of more complex interventions has implications for resources and staffing. Further research is needed to identify and evaluate strategies that address the sustainability of complex team training interventions across multiple OR contexts. Published by Elsevier Inc. All rights reserved.

[Investigation of team processes that enhance team performance in business organization].

PubMed

Nawata, Kengo; Yamaguchi, Hiroyuki; Hatano, Toru; Aoshima, Mika

2015-02-01

Many researchers have suggested team processes that enhance team performance. However, past team process models were based on crew team, whose all team members perform an indivisible temporary task. These models may be inapplicable business teams, whose individual members perform middle- and long-term tasks assigned to individual members. This study modified the teamwork model of Dickinson and McIntyre (1997) and aimed to demonstrate a whole team process that enhances the performance of business teams. We surveyed five companies (member N = 1,400, team N = 161) and investigated team-level-processes. Results showed that there were two sides of team processes: "communication" and "collaboration to achieve a goal." Team processes in which communication enhanced collaboration improved team performance with regard to all aspects of the quantitative objective index (e.g., current income and number of sales), supervisor rating, and self-rating measurements. On the basis of these results, we discuss the entire process by which teamwork enhances team performance in business organizations.

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.

Effectiveness of Teamwork in an Integrated Care Setting for Patients with COPD: Development and Testing of a Self-Evaluation Instrument for Interprofessional Teams

PubMed Central

Van Dijk-de Vries, Anneke N.; Duimel-Peeters, Inge G. P.; Muris, Jean W.; Wesseling, Geertjan J.; Beusmans, George H. M. I.

2016-01-01

Introduction: Teamwork between healthcare providers is conditional for the delivery of integrated care. This study aimed to assess the usefulness of the conceptual framework Integrated Team Effectiveness Model for developing and testing of the Integrated Team Effectiveness Instrument. Theory and methods: Focus groups with healthcare providers in an integrated care setting for people with chronic obstructive pulmonary disease (COPD) were conducted to examine the recognisability of the conceptual framework and to explore critical success factors for collaborative COPD practice out of this framework. The resulting items were transposed into a pilot instrument. This was reviewed by expert opinion and completed 153 times by healthcare providers. The underlying structure and internal consistency of the instrument were verified by factor analysis and Cronbach’s alpha. Results: The conceptual framework turned out to be comprehensible for discussing teamwork effectiveness. The pilot instrument measures 25 relevant aspects of teamwork in integrated COPD care. Factor analysis suggested three reliable components: teamwork effectiveness, team processes and team psychosocial traits (Cronbach’s alpha between 0.76 and 0.81). Conclusions and discussion: The conceptual framework Integrated Team Effectiveness Model is relevant in developing a practical full-spectrum instrument to facilitate discussing teamwork effectiveness. The Integrated Team Effectiveness Instrument provides a well-founded basis to self-evaluate teamwork effectiveness in integrated COPD care by healthcare providers. Recommendations are provided for the improvement of the instrument. PMID:27616953

Theory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teams.

PubMed

Clark, Phillip G; Cott, Cheryl; Drinka, Theresa J K

2007-12-01

Interprofessional teamwork is an essential and expanding form of health care practice. While moral issues arising in teamwork relative to the patient have been explored, the analysis of ethical issues regarding the function of the team itself is limited. This paper develops a conceptual framework for organizing and analyzing the different types of ethical issues in interprofessional teamwork. This framework is a matrix that maps the elements of principles, structures, and processes against individual, team, and organizational levels. A case study is presented that illustrates different dimensions of these topics, based on the application of this framework. Finally, a set of conclusions and recommendations is presented to summarize the integration of theory and practice in interprofessional ethics, including: (i) importance of a framework, (ii) interprofessional ethics discourse, and (iii) interprofessional ethics as an emerging field. The goal of this paper is to begin a dialogue and discussion on the ethical issues confronting interprofessional teams and to lay the foundation for an expanding discourse on interprofessional ethics.

Relationships between Communication Variables and Scores in Team Training Exercises.

DTIC Science & Technology

1982-01-01

against instructor grades for individuals, subteams, and teams. Communication .- rates on the intership circuit tended to be negatively...communications because communications are essential to ASW operations and are of high frequency. In earlier work in this project, Bell (in press) identified...giving these variables an arbitrarily high weight in the factor analysis. A more appropriate analysis is needed to identify useful categories of ASW

Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.

PubMed

Ward, Marcia M; Baloh, Jure; Zhu, Xi; Stewart, Greg L

A particularly useful model for examining implementation of quality improvement interventions in health care settings is the PARIHS (Promoting Action on Research Implementation in Health Services) framework developed by Kitson and colleagues. The PARIHS framework proposes three elements (evidence, context, and facilitation) that are related to successful implementation. An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by the Agency for Healthcare Research and Quality, but research is needed to better understand its implementation. We apply the PARIHS framework in studying TeamSTEPPS implementation to identify elements that are most closely related to successful implementation. Quarterly interviews were conducted over a 9-month period in 13 small rural hospitals that implemented TeamSTEPPS. Interview quotes that were related to each of the PARIHS elements were identified using directed content analysis. Transcripts were also scored quantitatively, and bivariate regression analysis was employed to explore relationships between PARIHS elements and successful implementation related to planning activities. The current findings provide support for the PARIHS framework and identified two of the three PARIHS elements (context and facilitation) as important contributors to successful implementation. This study applies the PARIHS framework to TeamSTEPPS, a widely used quality initiative focused on improving health care quality and patient safety. By focusing on small rural hospitals that undertook this quality improvement activity of their own accord, our findings represent effectiveness research in an understudied segment of the health care delivery system. By identifying context and facilitation as the most important contributors to successful implementation, these analyses provide a focus for efficient and effective sustainment of TeamSTEPPS efforts.

How Communication Among Members of the Health Care Team Affects Maternal Morbidity and Mortality.

PubMed

Brennan, Rita Allen; Keohane, Carol Ann

In the United States, rates of severe maternal morbidity and mortality have escalated in the past decade. Communication failure among members of the health care team is one associated factor that can be modified. Nurses can promote effective communication. We provide strategies that incorporate team training principles and structured communication processes for use by providers and health care systems to improve the quality and safety of patient care and reduce the incidence of maternal mortality and morbidity. Copyright © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Teamwork, Communication, Formula-One Racing and the Outcomes of Cardiac Surgery

PubMed Central

Merry, Alan F.; Weller, Jennifer; Mitchell, Simon J.

2014-01-01

Abstract: Most cardiac units achieve excellent results today, but the risk of cardiac surgery is still relatively high, and avoidable harm is common. The story of the Green Lane Cardiothoracic Unit provides an exemplar of excellence, but also illustrates the challenges associated with changes over time and with increases in the size of a unit and the complexity of practice today. The ultimate aim of cardiac surgery should be the best outcomes for (often very sick) patients rather than an undue focus on the prevention of error or adverse events. Measurement is fundamental to improving quality in health care, and the framework of structure, process, and outcome is helpful in considering how best to achieve this. A combination of outcomes (including some indicators of important morbidity) with key measures of process is advocated. There is substantial evidence that failures in teamwork and communication contribute to inefficiency and avoidable harm in cardiac surgery. Minor events are as important as major ones. Six approaches to improving teamwork (and hence outcomes) in cardiac surgery are suggested. These are: 1) subspecialize and replace tribes with teams; 2) sort out the leadership while flattening the gradients of authority; 3) introduce explicit training in effective communication; 4) use checklists, briefings, and debriefings and engage in the process; 5) promote a culture of respect alongside a commitment to excellence and a focus on patients; 6) focus on the performance of the team, not on individuals. PMID:24779113

Teamwork, communication, formula-one racing and the outcomes of cardiac surgery.

PubMed

Merry, Alan F; Weller, Jennifer; Mitchell, Simon J

2014-03-01

Most cardiac units achieve excellent results today, but the risk of cardiac surgery is still relatively high, and avoidable harm is common. The story of the Green Lane Cardiothoracic Unit provides an exemplar of excellence, but also illustrates the challenges associated with changes over time and with increases in the size of a unit and the complexity of practice today. The ultimate aim of cardiac surgery should be the best outcomes for (often very sick) patients rather than an undue focus on the prevention of error or adverse events. Measurement is fundamental to improving quality in health care, and the framework of structure, process, and outcome is helpful in considering how best to achieve this. A combination of outcomes (including some indicators of important morbidity) with key measures of process is advocated. There is substantial evidence that failures in teamwork and communication contribute to inefficiency and avoidable harm in cardiac surgery. Minor events are as important as major ones. Six approaches to improving teamwork (and hence outcomes) in cardiac surgery are suggested. These are: 1) subspecialize and replace tribes with teams; 2) sort out the leadership while flattening the gradients of authority; 3) introduce explicit training in effective communication; 4) use checklists, briefings, and debriefings and engage in the process; 5) promote a culture of respect alongside a commitment to excellence and a focus on patients; 6) focus on the performance of the team, not on individuals.

Achieving Agility and Stability in Large-Scale Software Development

DTIC Science & Technology

2013-01-16

temporary team is assigned to prepare layers and frameworks for future feature teams. Presentation Layer Domain Layer Data Access Layer Framework...http://www.sei.cmu.edu/training/ elearning ~ Software Engineering Institute CarnegieMellon

Cancer: communicating in the team game.

PubMed

Boyle, Frances M; Robinson, Emma; Heinrich, Paul; Dunn, Stewart M

2004-06-01

There is increasing evidence that effective communication is a critical means by which surgeons can assist their patients to achieve the best outcomes. This paper examines the processes and outcomes of effective communication by surgeons in cancer teams, and includes: (i). strategies that promote collaborative relationships with patients and lead to more effective treatment; (ii). strategies to improve multidisciplinary team performance; and (iii). methods to minimize the risk of error and litigation. The experience of a cancer diagnosis involves radical changes in patients' lives, somewhat akin to suddenly finding yourself in the middle of a rugby scrum for the first time. The analogy of rugby throws fresh light on such critical factors in communication as prematch preparation, orientation to the game and the team, a good kick off, sizing up the opposition, creative plays and optimizing teamwork to promote quality of life and survival.

Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan.

PubMed

Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu

2014-08-11

The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.

Integrating team resource management program into staff training improves staff’s perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan

PubMed Central

2014-01-01

Background The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. Methods We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. Results During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Conclusion Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation. PMID:25115403

Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

PubMed

Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

2016-05-01

In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Development and Validation of Performance Assessment Tools for Interprofessional Communication and Teamwork (PACT)

ERIC Educational Resources Information Center

Chiu, Chia-Ju

2014-01-01

Background: Medical errors caused by breakdowns in teamwork and interprofessional communication contribute to many deaths in the United States each year. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) is an evidence-based teamwork system developed to improve communication and teamwork skills among health care…

Teaching Business Communication on the Production Line: A Case Study.

ERIC Educational Resources Information Center

Moore, Richard W.

1993-01-01

Analyzes the communication training received by over 4,000 workers as part of an effort to implement a team concept production system at a General Motors plant. Presents an overview of the team concept training. Discusses five barriers to effective training, four successful instructional methods, and implications for business communication. (RS)

78 FR 64918 - Interagency Ocean Observation Committee, Meeting of the Data Management and Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... Observation Committee, Meeting of the Data Management and Communications Steering Team AGENCY: National Ocean... meeting of the IOOC's Data Management and Communications Steering Team (DMAC-ST). The DMAC-ST membership... conference telephone call. Public access is available at the Consortium for Ocean Leadership, 1201 New York...

SYMLOG in the Communication Classroom: Applications for Small Group Communication Behavior Awareness.

ERIC Educational Resources Information Center

Hillmer, Barbara Hoehn; Blubaugh, Jon A.

The development of skills for group evaluation and facilitation in today's team environment is an essential component of the learning process for the student of communication. Until recently there has been no integrated model for the consideration of small groups and teams that incorporated findings from psychology, social psychology, management…

Political Science and Speech Communication--A Team Approach to Teaching Political Communication.

ERIC Educational Resources Information Center

Blatt, Stephen J.; Fogel, Norman

This paper proposes making speech communication more interdisciplinary and, in particular, combining political science and speech in a team-taught course in election campaigning. The goals, materials, activities, and plan of such a course are discussed. The goals include: (1) gaining new insights into the process of contemporary campaigns and…

Alex Lemke | NREL

Science.gov Websites

electric power professionals. Prior to that, Alex spent 15 years with Crain Communications' RCR Wireless @nrel.gov | 303-384-7018 As the Wind and Water Power Program Communications Team Lead, Alex serves as the primary interface to the Wind and Water Power Program management team to develop communication strategies

Facebook as a tool for communication, collaboration, and informal knowledge exchange among members of a multisite family health team.

PubMed

Lofters, Aisha K; Slater, Morgan B; Nicholas Angl, Emily; Leung, Fok-Han

2016-01-01

To implement and evaluate a private Facebook group for members of a large Ontario multisite Family Health Team (FHT) to facilitate improved communication and collaboration. Program implementation and subsequent survey of team members. A large multisite FHT in Toronto, Ontario. Health professionals of the FHT. Usage patterns and self-reported perceptions of the Facebook group by team members. At the time of the evaluation survey, the Facebook group had 43 members (37.4% of all FHT members). Activity in the group was never high, and posts by team members who were not among the researchers were infrequent throughout the study period. The content of posts fell into two broad categories: 1) information that might be useful to various team members and 2) questions posed by team members that others might be able to answer. Of the 26 team members (22.6%) who completed the evaluation survey, many reported that they never logged into the Facebook page (16 respondents), and never used it to communicate with team members outside of their own site of practice (19 respondents). Only six respondents reported no concerns with using Facebook as a professional communication tool; the most frequent concerns were regarding personal and patient privacy. The use of social media by health care practitioners is becoming ubiquitous. However, the issues of privacy concerns and determining how to use social media without adding to provider workload must be addressed to make it a useful tool in health care.

A Problem Based Learning Project Analyzing Rubrics Used to Evaluate Elementary STEM Immersion Programs

NASA Astrophysics Data System (ADS)

Pearson, Roxanne N.

In 2010, the President's Council of Advisors on Science and Technology recommended that eight hundred new STEM focused elementary and middle schools be established. Unfortunately, districts may be slow to implement STEM at the elementary level because they do not understand how to do so effectively (Zimny, 2017). School administrators need a framework for decision-making and supervisory feedback related to the process of managing these programs (Zimny, 2017). To support administrators in implementing elementary STEM immersion programs, this project explored three questions: What criteria are common among existing STEM immersion program rubrics? What criteria should be included in a comprehensive rubric for managing elementary STEM immersion programs at the district level? What do district documents show about how elementary STEM immersion programs develop, implement, and evaluate those programs? The team developed a comprehensive STEM program review instrument including criteria for effective elementary STEM curriculum and the professional development and administrative support necessary to implement such curriculum. These criteria were organized into three stages, including the planning and development of elementary STEM immersion programs, the implementation of these programs, and the evaluation of these programs after they had been implemented for a significant period of time. The team synthesized best practice indicators relevant to elementary STEM programs from existing K-12 guides, then validated those indicators against current best practice research and feedback from STEM education experts. District documents from seven elementary STEM immersion programs in Missouri and Colorado were examined using the team's rubric. Scores were higher in the areas of program planning, content alignment, and ongoing refinement of curriculum, and lower in the areas of professional development for professional skills and STEM-specific pedagogy, two-way communication with stakeholders, and data collection for program refinement. Scores were lowest for those schools with inadequate documentation of their program management processes. The team recommended districts institute a more rigorous documentation process for managing innovative programs such as STEM immersion. Communication plans should include procedures for two-way communication with all stakeholders. Data collection and refinement efforts should increase, as should professional development opportunities related to professional skills and STEM-specific pedagogy; this should include administrators.

Unleashing Expert Judgment in the IPCC's Fifth Assessment Report

NASA Astrophysics Data System (ADS)

Freeman, P. T.; Mach, K. J.; Mastrandrea, M.; Field, C. B.

2016-12-01

IPCC assessments are critical vehicles for evaluating and synthesizing existing knowledge about climate change, its impacts, and potential options for adaptation and mitigation. In these assessments, rigorous expert judgment is essential for characterizing current scientific understanding including persistent and complex uncertainties related to climate change. Over its history the IPCC has iteratively developed frameworks for evaluating and communicating what is known and what is not known about climate change science. In this presentation, we explore advances and challenges in approaches to evaluating and communicating expert judgment in the Intergovernmental Panel on Climate Change's Fifth Assessment Report (IPCC AR5). We present an analysis of the frequency of the use of calibrated degree-of-certainty terms in the policymaker summaries from the IPCC's AR5 and Fourth Assessment Report (AR4). We find that revised guidance for IPCC author teams in the AR5 improved the development of balanced judgments on scientific evidence across disciplines. Overall, degree-of-certainty terms are more abundant in the AR5 policymaker summaries compared to those of the AR4, demonstrating an increased commitment to extensively and transparently characterizing expert judgments underpinning report conclusions. This analysis also shows that while working groups still favor different degree-of-certainty scales in the AR5, authors employed a wider array of degree-of-certainty scales to communicate expert judgment supporting report findings compared to the policymaker summaries of the AR4. Finally, our analysis reveals greater inclusion of lower-certainty findings in the AR5 as compared to the AR4, critical for communicating a fuller range of possible climate change impacts and response options. Building on our findings we propose a simpler, more transparent, and more rigorous framework for developing and communicating expert judgments in future climate and environmental assessments.

Team Formation and Communication Restrictions in Collectives

NASA Technical Reports Server (NTRS)

Agogino, Adrian K.; Turner, Kagan

2003-01-01

A collective of agents often needs to maximize a "world utility" function which rates the performance of an entire system, while subject to communication restrictions among the agents. Such communication restrictions make it difficult for agents which try to pursue their own "private" utilities to take actions that also help optimize the world utility. Team formation presents a solution to this problem, where by joining other agents, an agent can significantly increase its knowledge about the environment and improve its chances of both optimizing its own utility and that its doing so will contribute to the world utility. In this article we show how utilities that have been previously shown to be effective in collectives can be modified to be more effective in domains with moderate communication restrictions resulting in performance improvements of up to 75%. Additionally we show that even severe communication constraints can be overcome by forming teams where each agent of a team shares the same utility, increasing performance an additional 25%. We show that utilities and team sizes can be manipulated to form the best compromise between how "aligned" an agent s utility is with the world utility and how easily an agent can learn that utility.

Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME.

PubMed

Vanderbilt, Allison A; Pappada, Scott M; Stein, Howard; Harper, David; Papadimos, Thomas J

2017-01-01

Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one's knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum.

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

Introductory Biology Courses: A Framework To Support Active Learning in Large Enrollment Introductory Science Courses

PubMed Central

2005-01-01

Active learning and research-oriented activities have been increasingly used in smaller, specialized science courses. Application of this type of scientific teaching to large enrollment introductory courses has been, however, a major challenge. The general microbiology lecture/laboratory course described has been designed to incorporate published active-learning methods. Three major case studies are used as platforms for active learning. Themes from case studies are integrated into lectures and laboratory experiments, and in class and online discussions and assignments. Students are stimulated to apply facts to problem-solving and to learn research skills such as data analysis, writing, and working in teams. This course is feasible only because of its organizational framework that makes use of teaching teams (made up of faculty, graduate assistants, and undergraduate assistants) and Web-based technology. Technology is a mode of communication, but also a system of course management. The relevance of this model to other biology courses led to assessment and evaluation, including an analysis of student responses to the new course, class performance, a university course evaluation, and retention of course learning. The results are indicative of an increase in student engagement in research-oriented activities and an appreciation of real-world context by students. PMID:15917873

Adaptive awareness for personal and small group decision making.

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

Perano, Kenneth J.; Tucker, Steve; Pancerella, Carmen M.

2003-12-01

Many situations call for the use of sensors monitoring physiological and environmental data. In order to use the large amounts of sensor data to affect decision making, we are coupling heterogeneous sensors with small, light-weight processors, other powerful computers, wireless communications, and embedded intelligent software. The result is an adaptive awareness and warning tool, which provides both situation awareness and personal awareness to individuals and teams. Central to this tool is a sensor-independent architecture, which combines both software agents and a reusable core software framework that manages the available hardware resources and provides services to the agents. Agents can recognizemore » cues from the data, warn humans about situations, and act as decision-making aids. Within the agents, self-organizing maps (SOMs) are used to process physiological data in order to provide personal awareness. We have employed a novel clustering algorithm to train the SOM to discern individual body states and activities. This awareness tool has broad applicability to emergency teams, military squads, military medics, individual exercise and fitness monitoring, health monitoring for sick and elderly persons, and environmental monitoring in public places. This report discusses our hardware decisions, software framework, and a pilot awareness tool, which has been developed at Sandia National Laboratories.« less

When teams shift among processes: insights from simulation and optimization.

PubMed

Kennedy, Deanna M; McComb, Sara A

2014-09-01

This article introduces process shifts to study the temporal interplay among transition and action processes espoused in the recurring phase model proposed by Marks, Mathieu, and Zacarro (2001). Process shifts are those points in time when teams complete a focal process and change to another process. By using team communication patterns to measure process shifts, this research explores (a) when teams shift among different transition processes and initiate action processes and (b) the potential of different interventions, such as communication directives, to manipulate process shift timing and order and, ultimately, team performance. Virtual experiments are employed to compare data from observed laboratory teams not receiving interventions, simulated teams receiving interventions, and optimal simulated teams generated using genetic algorithm procedures. Our results offer insights about the potential for different interventions to affect team performance. Moreover, certain interventions may promote discussions about key issues (e.g., tactical strategies) and facilitate shifting among transition processes in a manner that emulates optimal simulated teams' communication patterns. Thus, we contribute to theory regarding team processes in 2 important ways. First, we present process shifts as a way to explore the timing of when teams shift from transition to action processes. Second, we use virtual experimentation to identify those interventions with the greatest potential to affect performance by changing when teams shift among processes. Additionally, we employ computational methods including neural networks, simulation, and optimization, thereby demonstrating their applicability in conducting team research. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A Wireless Text Messaging System Improves Communication for Neonatal Resuscitation.

PubMed

Hughes Driscoll, Colleen A; Schub, Jamie A; Pollard, Kristi; El-Metwally, Dina

Handoffs for neonatal resuscitation involve communicating critical delivery information (CDI). The authors sought to achieve ≥95% communication of CDI during resuscitation team requests. CDI included name of caller, urgency of request, location of delivery, gestation of fetus, status of amniotic fluid, and indication for presence of the resuscitation team. Three interventions were implemented: verbal scripted handoff, Spök text messaging, and Engage text messaging. Percentages of CDI communications were analyzed using statistical process control. Following implementation of Engage, the communication of all CDI, except for indication, was ≥95%; communication of indication occurred 93% of the time. Control limits for most CDI were narrower with Engage, indicating greater reliability of communication compared to the verbal handoff and Spök. Delayed resuscitation team arrival, a countermeasure, was not higher with text messaging compared to verbal handoff ( P = 1.00). Text messaging improved communication during high-risk deliveries, and it may represent an effective tool for other delivery centers.

Virtual Teams and E-Collaboration Technology: A Case Study Investigating the Dynamics of Virtual Team Communication

ERIC Educational Resources Information Center

Mattison, Theresa

2011-01-01

The purpose of this study was to determine to what extent the use of e-collaboration tools when used as a primary channel of communication affected virtual team members' trust and motivation, in a spatially dispersed environment. Structured interviews were conducted with 18 project managers, who were responsible for leading virtual projects…

Problem-Solving Phase Transitions During Team Collaboration.

PubMed

Wiltshire, Travis J; Butner, Jonathan E; Fiore, Stephen M

2018-01-01

Multiple theories of problem-solving hypothesize that there are distinct qualitative phases exhibited during effective problem-solving. However, limited research has attempted to identify when transitions between phases occur. We integrate theory on collaborative problem-solving (CPS) with dynamical systems theory suggesting that when a system is undergoing a phase transition it should exhibit a peak in entropy and that entropy levels should also relate to team performance. Communications from 40 teams that collaborated on a complex problem were coded for occurrence of problem-solving processes. We applied a sliding window entropy technique to each team's communications and specified criteria for (a) identifying data points that qualify as peaks and (b) determining which peaks were robust. We used multilevel modeling, and provide a qualitative example, to evaluate whether phases exhibit distinct distributions of communication processes. We also tested whether there was a relationship between entropy values at transition points and CPS performance. We found that a proportion of entropy peaks was robust and that the relative occurrence of communication codes varied significantly across phases. Peaks in entropy thus corresponded to qualitative shifts in teams' CPS communications, providing empirical evidence that teams exhibit phase transitions during CPS. Also, lower average levels of entropy at the phase transition points predicted better CPS performance. We specify future directions to improve understanding of phase transitions during CPS, and collaborative cognition, more broadly. Copyright © 2017 Cognitive Science Society, Inc.

Non-Critical-Care Nurses' Perceptions of Facilitators and Barriers to Rapid Response Team Activation.

PubMed

Jenkins, Sheryl Henry; Astroth, Kim Schafer; Woith, Wendy Mann

2015-01-01

Rapid response teams can save lives but are only effective when activated. We surveyed 50 nurses for their perceptions of facilitators and barriers to activation. Findings showed that participants need more education on their role and when to activate the rapid response team. Nurses who comprise the team need help building their communication skills. We recommend nursing professional development specialists increase the frequency of offerings and expand the focus on roles, activation criteria, and communication skills.

Distributed framework for dyanmic telescope and instrument control

NASA Astrophysics Data System (ADS)

Ames, Troy J.; Case, Lynne

2003-02-01

Traditionally, instrument command and control systems have been developed specifically for a single instrument. Such solutions are frequently expensive and are inflexible to support the next instrument development effort. NASA Goddard Space Flight Center is developing an extensible framework, known as Instrument Remote Control (IRC) that applies to any kind of instrument that can be controlled by a computer. IRC combines the platform independent processing capabilities of Java with the power of the Extensible Markup Language (XML). A key aspect of the architecture is software that is driven by an instrument description, written using the Instrument Markup Language (IML). IML is an XML dialect used to describe graphical user interfaces to control and monitor the instrument, command sets and command formats, data streams, communication mechanisms, and data processing algorithms. The IRC framework provides the ability to communicate to components anywhere on a network using the JXTA protocol for dynamic discovery of distributed components. JXTA (see http://www.jxta.org) is a generalized protocol that allows any devices connected by a network to communicate in a peer-to-peer manner. IRC uses JXTA to advertise a devices IML and discover devices of interest on the network. Devices can join or leave the network and thus join or leave the instrument control environment of IRC. Currently, several astronomical instruments are working with the IRC development team to develop custom components for IRC to control their instruments. These instruments include: High resolution Airborne Wideband Camera (HAWC), a first light instrument for the Stratospheric Observatory for Infrared Astronomy (SOFIA); Submillimeter And Far Infrared Experiment (SAFIRE), a Principal Investigator instrument for SOFIA; and Fabry-Perot Interferometer Bolometer Research Experiment (FIBRE), a prototype of the SAFIRE instrument, used at the Caltech Submillimeter Observatory (CSO). Most recently, we have been working with the Submillimetre High

Office of Space Science: Integrated technology strategy

NASA Technical Reports Server (NTRS)

Huntress, Wesley T., Jr.; Reck, Gregory M.

1994-01-01

This document outlines the strategy by which the Office of Space Science, in collaboration with the Office of Advanced Concepts and Technology and the Office of Space Communications, will meet the challenge of the national technology thrust. The document: highlights the legislative framework within which OSS must operate; evaluates the relationship between OSS and its principal stakeholders; outlines a vision of a successful OSS integrated technology strategy; establishes four goals in support of this vision; provides an assessment of how OSS is currently positioned to respond to the goals; formulates strategic objectives to meet the goals; introduces policies for implementing the strategy; and identifies metrics for measuring success. The OSS Integrated Technology Strategy establishes the framework through which OSS will satisfy stakeholder expectations by teaming with partners in NASA and industry to develop the critical technologies required to: enhance space exploration, expand our knowledge of the universe, and ensure continued national scientific, technical and economic leadership.

NASA strategic plan

NASA Technical Reports Server (NTRS)

1994-01-01

The NASA Strategic Plan is a living document. It provides far-reaching goals and objectives to create stability for NASA's efforts. The Plan presents NASA's top-level strategy: it articulates what NASA does and for whom; it differentiates between ends and means; it states where NASA is going and what NASA intends to do to get there. This Plan is not a budget document, nor does it present priorities for current or future programs. Rather, it establishes a framework for shaping NASA's activities and developing a balanced set of priorities across the Agency. Such priorities will then be reflected in the NASA budget. The document includes vision, mission, and goals; external environment; conceptual framework; strategic enterprises (Mission to Planet Earth, aeronautics, human exploration and development of space, scientific research, space technology, and synergy); strategic functions (transportation to space, space communications, human resources, and physical resources); values and operating principles; implementing strategy; and senior management team concurrence.

Combining Chemical Information Literacy, Communication Skills, Career Preparation, Ethics, and Peer Review in a Team-Taught Chemistry Course

ERIC Educational Resources Information Center

Jones, Mary Lou Baker; Seybold, Paul G.

2016-01-01

The widely acknowledged need to include chemical information competencies and communication skills in the undergraduate chemistry curriculum can be accommodated in a variety of ways. We describe a team-taught, semester-length course at Wright State University which combines chemical information literacy, written and oral communication skills,…

Communications Specialist | Center for Cancer Research

Cancer.gov

Be part of our mission to support research against cancer. We have an exciting opportunity for a talented communicator to join our team and be part of the effort to find cures for cancer. We are looking for a creative, team-oriented communications professional, with strong writing skills to publicize our research advances, employment and training opportunities and clinical

Use of a Surgical Safety Checklist to Improve Team Communication.

PubMed

Cabral, Richard A; Eggenberger, Terry; Keller, Kathryn; Gallison, Barry S; Newman, David

2016-09-01

To improve surgical team communication, a team at Broward Health Imperial Point Hospital, Ft Lauderdale, Florida, implemented a program for process improvement using a locally adapted World Health Organization Surgical Safety Checklist. This program included a standardized, comprehensive time out and a briefing/debriefing process. Postimplementation responses to the Safety Attitudes Questionnaire revealed a significant increase in the surgical team's perception of communication compared with that reported on the pretest (6% improvement resulting in t79 = -1.72, P < .05, d = 0.39). Perceptions of communication increased significantly for nurses (12% increase, P = .002), although the increase for surgeons and surgical technologists was lower (4% for surgeons, P = .15 and 2.3% for surgical technologists, P = .06). As a result of this program, we have observed improved surgical teamwork behaviors and an enhanced culture of safety in the OR. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

[A new attempt to promote home medical care in Kashiwa city-usefulness of information and communication technology with seamless multidisciplinary cooperation].

PubMed

Iijima, Katsuya; Yoshie, Satoru; Kimata, Mari; Ihori, Mikio; Yamamoto, Takuma; Goto, Jun; Fujita, Shinsuke; Takabayashi, Katsuhiko; Kamata, Minoru; Tsuji, Tetsuo

2012-12-01

Due to the rapidly increasing super-aging society, medical policy in Japan should be redefined. Therefore, the medical and nursing home care system should now be revised greatly. We need to change the current principle that is based on cure only. The patients should receive hospitable care closely connected with their life in their home-town(region)throughout their lifetime. This is termed as "home medical care system". Here, we promote patient-centered medical home care, which implements the chronic and/or End-Of-Life care models, in Kashiwa city, Chiba prefecture. This system is a promising framework for primary care transformation. There is a need for a multidisciplinary team-based care system using information and communication technology(ICT)with smooth and seamless cooperation. However, increased awareness among the workers engaged in home medical care is first required.

Marital crises in oncology patients. An approach to initial intervention by primary clinicians.

PubMed

Peteet, J; Greenberg, B

1995-05-01

Life-threatening illnesses such as cancer may precipitate marital crises in vulnerable relationships, and oncology clinicians often feel uncertain about how to approach them. This paper presents a framework for initial intervention based on the nature of the principal threat to the relationship. Immature relationships need distance and support for their identity as a couple; hostile dependent couples need to find consensus in order to structure communication; physically abusive relationships require monitoring in order to promote safety; and estranged couples need help in understanding their disappointment and identifying available support. Clinicians working in oncology can help couples in crisis by promoting a realistic balance of independence and dependence, clarifying the complexity of factors contributing to the crisis, considering referral for couples treatment, communicating with the team while respecting patients' confidences, and by choosing clear and compatible clinical roles. Primary clinicians can stabilize and treat marital crises, but need access to medically knowledgeable couples' therapists.

Collaboration, Communication and Co-ordination in Agile Software Development Practice

NASA Astrophysics Data System (ADS)

Robinson, Hugh; Sharp, Helen

This chapter analyses the results of a series of observational studies of agile software developmentagile software development teams, identifying commonalities in collaboration, co-ordination and communication activities. Pairing and customer collaborationcustomer collaboration are focussed on to illustrate the nature of collaboration and communication, as are two simple physical artefacts that emerged through analysis as being an information-rich focal point for the co-ordination of collaboration and communication activities. The analysis shows that pairingpairing has common characteristics across all teams, while customer collaboration differs between the teams depending on the application and organisational context of development.

Ebola, team communication, and shame: but shame on whom?

PubMed

Shannon, Sarah E

2015-01-01

Examined as an isolated situation, and through the lens of a rare and feared disease, Mr. Duncan's case seems ripe for second-guessing the physicians and nurses who cared for him. But viewed from the perspective of what we know about errors and team communication, his case is all too common. Nearly 440,000 patient deaths in the U.S. each year may be attributable to medical errors. Breakdowns in communication among health care teams contribute in the majority of these errors. The culture of health care does not seem to foster functional, effective communication between and among professionals. Why? And more importantly, why do we not do something about it?

Within-team Patterns of Communication and Referral in Multimodal Treatment of Chronic Low Back Pain Patients by an Integrative Care Team.

PubMed

O'Connor, Bonnie B; Eisenberg, David M; Buring, Julie E; Liang, Catherine L; Osypiuk, Kamila; Levy, Donald B; Wayne, Peter M

2015-03-01

Nonspecific chronic low back pain (CLBP) is a highly prevalent and costly public health problem with few treatment options that provide consistent and greater than modest benefits. Treatment of CLBP is shifting from unimodal to multimodal and multidisciplinary approaches, including biopsychosocially-based complementary and integrative care. Multidisciplinary approaches require unique levels of communication and coordination amongst clinicians; however, to date few studies have evaluated patterns of communication and decision making amongst clinicians collaborating in the care of challenging patients with CLBP. As part of an observational study evaluating the effectiveness and cost-effectiveness of an integrative, team-based care model for the treatment of CLBP, we used multiple qualitative research methods to characterize within-team cross-referral and communication amongst jointly-trained practitioners representing diverse biomedical and complementary disciplines. Patterns of communication and coordinated care are summarized for 3 cases of CLBP treated by multiple members (≥3) of an integrative medical team embedded within an academic hospital. Patients were aged from 36 to 88 years with varied comorbidities. Qualitative content analysis revealed 5 emergent themes regarding integrative patient care and treatment decision in this clinic: (1) the fundamental importance of the clinic's formal teamwork training; (2) the critical communicative and collaborative function of regular team meetings; (3) the importance to patient care goals of having the varied disciplines practicing "under one roof"; (4) a universal commitment to understanding and treating patients as whole persons; and (5) a shared philosophy of helping patients to help themselves. These key themes are all interconnected and form the foundation of the clinic's culture. Our qualitative findings provide context for current trends in enhancing patient-centered, coordinated, and team-based care; efforts towards better understanding interprofessional communication; overcoming barriers to successful collaboration; and identifying best practices for fostering clinical teamwork and a strong team identity. Our findings also support the need for further qualitative research, in combination with quantitative research, for evaluating the effectiveness and cost-effectiveness of resource-intensive integrative models for the treatment of chronic conditions.

Speaking from the Inside: Challenges Faced by Communication Researchers Investigating Disease-Related Issues in a Hospital Setting.

PubMed

Bourquin, Céline; Stiefel, Friedrich; Singy, Pascal

2015-09-01

This commentary came from within the framework of integrating the humanities in medicine and from accompanying research on disease-related issues by teams involving clinicians and researchers in medical humanities. The purpose is to reflect on the challenges faced by researchers when conducting emotionally laden research and on how they impact observations and subsequent research findings. This commentary is furthermore a call to action since it promotes the institutionalization of a supportive context for medical humanities researchers who have not been trained to cope with sensitive medical topics in research. To that end, concrete recommendations regarding training and supervision were formulated.

An electronic patient risk communication board.

PubMed

Ohashi, Kumiko; Caligtan, Christine A; Benoit, Angela N; Breydo, Eugene M; Carroll, Diane L; Keohane, Carol A; Bates, David W; Dykes, John S; Dykes, Patricia C

2012-01-01

Communication failures have been identified as the root cause of the majority of medical malpractice claims and patient safety violations. We believe it is essential to share key patient risk information with healthcare team members at the patient's bedside. In this study, we developed an electronic Patient Risk Communication Board (ePRCB) to assist in bridging the communication gap between all health care team members. The goal of the ePRCB is to effectively communicate the patient's key risk factors, such as a fall risk or risk of aspiration, to the healthcare team and to reduce adverse events caused by communication failures. The ePRCB will transmit patient risk information and tailored interventions with easy-to-understand icons on an LCD screen at the point of care. A set of patient risk reminder icons was developed and validated by focus groups. We used the results of the evaluation to refine the icons for the ePRCB.

An Electronic Patient Risk Communication Board

PubMed Central

Ohashi, Kumiko; Caligtan, Christine A.; Benoit, Angela N.; Breydo, Eugene M.; Carroll, Diane L.; Keohane, Carol A.; Bates, David W.; Dykes, John S.; Dykes, Patricia C.

2012-01-01

Communication failures have been identified as the root cause of the majority of medical malpractice claims and patient safety violations. We believe it is essential to share key patient risk information with healthcare team members at the patient’s bedside. In this study, we developed an electronic Patient Risk Communication Board (ePRCB) to assist in bridging the communication gap between all health care team members. The goal of the ePRCB is to effectively communicate the patient’s key risk factors, such as a fall risk or risk of aspiration, to the healthcare team and to reduce adverse events caused by communication failures. The ePRCB will transmit patient risk information and tailored interventions with easy-to-understand icons on an LCD screen at the point of care. A set of patient risk reminder icons was developed and validated by focus groups. We used the results of the evaluation to refine the icons for the ePRCB. PMID:24199109

Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes

PubMed Central

Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

2017-01-01

Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students’ attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students’ performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students’ performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills. PMID:28289305

Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes.

PubMed

Kirwin, Jennifer; Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

2017-02-25

Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students' attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students' performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students' performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills.

Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow.

PubMed

Przybylo, Jennifer A; Wang, Ange; Loftus, Pooja; Evans, Kambria H; Chu, Isabella; Shieh, Lisa

2014-09-01

Though current hospital paging systems are neither efficient (callbacks disrupt workflow), nor secure (pagers are not Health Insurance Portability and Accountability Act [HIPAA]-compliant), they are routinely used to communicate patient information. Smartphone-based text messaging is a potentially more convenient and efficient mobile alternative; however, commercial cellular networks are also not secure. To determine if augmenting one-way pagers with Medigram, a secure, HIPAA-compliant group messaging (HCGM) application for smartphones, could improve hospital team communication. Eight-week prospective, cluster-randomized, controlled trial Stanford Hospital Three inpatient medicine teams used the HCGM application in addition to paging, while two inpatient medicine teams used paging only for intra-team communication. Baseline and post-study surveys were collected from 22 control and 41 HCGM team members. When compared with paging, HCGM was rated significantly (P < 0.05) more effective in: (1) allowing users to communicate thoughts clearly (P = 0.010) and efficiently (P = 0.009) and (2) integrating into workflow during rounds (P = 0.018) and patient discharge (P = 0.012). Overall satisfaction with HCGM was significantly higher (P = 0.003). 85% of HCGM team respondents said they would recommend using an HCGM system on the wards. Smartphone-based, HIPAA-compliant group messaging applications improve provider perception of in-hospital communication, while providing the information security that paging and commercial cellular networks do not. © 2014 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.

Teamwork and Electronic Health Record Implementation: A Case Study of Preserving Effective Communication and Mutual Trust in a Changing Environment.

PubMed

Gross, Anne H; Leib, Ryan K; Tonachel, Anne; Tonachel, Richard; Bowers, Danielle M; Burnard, Rachel A; Rhinehart, Catherine A; Valentim, Rahila; Bunnell, Craig A

2016-11-01

This article describes how trust among team members and in the technology supporting them was eroded during implementation of an electronic health record (EHR) in an adult outpatient oncology practice at a comprehensive cancer center. Delays in care of a 38-year-old woman with high-risk breast cancer occurred because of ineffective team communication and are illustrated in a case study. The case explores how the patient's trust and mutual trust between team members were disrupted because of inaccurate assumptions about the functionality of the EHR's communication tool, resultant miscommunications between team members and the patient, and the eventual recognition that care was not being effectively coordinated, as it had been previously. Despite a well-established, team-based culture and significant preparation for the EHR implementation, the challenges that occurred point to underlying human and system failures from which other organizations going through a similar process may learn. Through an analysis and evaluation of events that transpired before and during the EHR rollout, suggested interventions for preventing this experience are offered, which include: a thorough crosswalk between old and new communication mechanisms before implementation; understanding and mitigation of gaps in the communication tool's functionality; more robust training for staff, clinicians, and patients; greater consideration given to the pace of change expected of individuals; and development of models of collaboration between EHR users and vendors in developing products that support high-quality, team-based care in the oncology setting. These interventions are transferable to any organizational or system change that threatens mutual trust and effective communication.

Integration of Slack, a cloud-based team collaboration application, into research coordination.

PubMed

Gofine, Miriam; Clark, Sunday

2017-06-30

Practitioners of epidemiology require efficient real-time communication and shared access to numerous documents in order to effectively manage a study. Much of this communication involves study logistics and does not require use of Protected Health Information. Slack is a team collaboration app; it archives all direct messages and group conversations, hosts documents internally, and integrates with the Google Docs application. Slack has both desktop and mobile applications, allowing users to communicate in real-time without the need to find email addresses or phone numbers or create contact lists. METHOD: We piloted the integration of Slack into our research team of one faculty member, one research coordinator, and approximately 20 research assistants. Statistics describing the app's usage were calculated twelve months after its implementation. RESULTS: Results indicating heavy usage by both research professionals and assistants are presented. Our Slack group included a cumulative 51 users. Between October 2015 and November 2016, approximately 10,600 messages were sent through Slack; 53% were sent by RA's and 47% were sent by us. Of the 106 files stored on Slack, 82% were uploaded by research staff. In a January 2016 survey, 100% of RA's agreed or strongly agreed that Slack improved communication within the team. CONCLUSION: We demonstrate a model for integration of communication technology into academic activities by research teams. Slack is easily integrated into the workflow at an urban, academic medical center and is adopted by users as a highly effective tool for meeting research teams' communication and document management needs.

Hamline/3M Project: Liaison for Curricular Change

NASA Astrophysics Data System (ADS)

Rundquist, Andy

2002-03-01

This project was designed to catalyze curricular changes to better prepare students for the workplace. Industrial managers provided a list of 16 characteristics valued in the workplace: most were NOT related to science course content. The project formed 5 teams each including 3M professionals and students. Each team developed curricular changes in one of the 16 areas. Team goals were to improve skills in communication, data analysis, business/economics, team problem solving, and culture competency. Curricular changes realized include communication skill activities embodied in science courses and faculty communication teaching skill seminars, self learning tools in data analysis, statistics and model building, a new course developed with assistance from 3M personnel focussing on topics directly related to technological industries, high performance team problem solving training/coaching for faculty and workshops for students and faculty relative to importance of cultural competencies in the workplace, and a new course focusing on culture, team problem solving and conflict resolution in the technical workplace. Process for developing and content of curricular changes will be reported.

Family caregiver participation in hospice interdisciplinary team meetings: How does it affect the nature and content of communication?

PubMed Central

Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Kruse, Robin L.; Demiris, George; Gage, L. A.; Wagner, Ken

2012-01-01

Collaboration between family caregivers and healthcare providers is necessary to ensure patient-centered care, especially for hospice patients. During hospice care, interdisciplinary team members meet bi-weekly to collaborate and develop holistic care plans that address the physical, spiritual, psychological, and social needs of patients and families. The purpose of this study was to explore team communication when video-conferencing is used to facilitate the family caregiver’s participation in a hospice team meeting. Video-recorded team meetings with and without family caregiver participation were analyzed for communication patterns using the Roter Interaction Analysis System. Standard meetings that did not include caregivers were shorter in duration and task-focused, with little participation from social workers and chaplains. Meetings that included caregivers revealed an emphasis on biomedical education and relationship-building between participants, little psychosocial counseling, and increased socio-emotional talk from social workers and chaplains. Implications for family participation in hospice team meetings are highlighted. PMID:22435889

Philosophy and conceptual framework: collectively structuring nursing care systematization.

PubMed

Schmitz, Eudinéia Luz; Gelbcke, Francine Lima; Bruggmann, Mario Sérgio; Luz, Susian Cássia Liz

2017-03-30

To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution's nurses. Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. As a contribution, it brought the construction of the institutions' nursing philosophy and conceptual framework, and the definition of a nursing theory.

Flexible and Trusted Autonomy in Weapons

DTIC Science & Technology

2017-03-01

not translate to relevant insights into communication strategies for human team members. In addition, the study did not specifically explore implicit...specifications, or other data does not license the holder or any other person or corporation ; or convey any rights or permission to manufacture, use, or sell any...communication strategies for anticipatory information sharing during team performance of tasks with varying degrees of complexity. The strategies used by teams

Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management.

PubMed

Turner, Kea; Samuel, Cleo A; Donovan, Heidi As; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

2017-04-01

Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street's (2007) Framework for Patient-Centered Communication in Cancer Care. The findings of this study suggest providers' communication behaviors including managing survivors' uncertainty, responding to survivors' emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers' discipline. There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers' roles in symptom assessment, and determine best practices for AET symptom communication.

Factors affecting the implementation of childhood vaccination communication strategies in Nigeria: a qualitative study.

PubMed

Oku, Afiong; Oyo-Ita, Angela; Glenton, Claire; Fretheim, Atle; Eteng, Glory; Ames, Heather; Muloliwa, Artur; Kaufman, Jessica; Hill, Sophie; Cliff, Julie; Cartier, Yuri; Bosch-Capblanch, Xavier; Rada, Gabriel; Lewin, Simon

2017-02-15

The role of health communication in vaccination programmes cannot be overemphasized: it has contributed significantly to creating and sustaining demand for vaccination services and improving vaccination coverage. In Nigeria, numerous communication approaches have been deployed but these interventions are not without challenges. We therefore aimed to explore factors affecting the delivery of vaccination communication in Nigeria. We used a qualitative approach and conducted the study in two states: Bauchi and Cross River States in northern and southern Nigeria respectively. We identified factors affecting the implementation of communication interventions through interviews with relevant stakeholders involved in vaccination communication in the health services. We also reviewed relevant documents. Data generated were transcribed verbatim and analysed using thematic analysis. We used the SURE framework to organise the identified factors (barriers and facilitators) affecting vaccination communication delivery. We then grouped these into health systems and community level factors. Some of the commonly reported health system barriers amongst stakeholders interviewed included: funding constraints, human resource factors (health worker shortages, training deficiencies, poor attitude of health workers and vaccination teams), inadequate infrastructure and equipment and weak political will. Community level factors included the attitudes of community stakeholders and of parents and caregivers. We also identified factors that appeared to facilitate communication activities. These included political support, engagement of traditional and religious institutions and the use of organised communication committees. Communication activities are a crucial element of immunization programmes. It is therefore important for policy makers and programme managers to understand the barriers and facilitators affecting the delivery of vaccination communication so as to be able to implement communication interventions more effectively.

Noise peaks influence communication in the operating room. An observational study.

PubMed

Keller, Sandra; Tschan, Franziska; Beldi, Guido; Kurmann, Anita; Candinas, Daniel; Semmer, Norbert K

2016-12-01

Noise peaks are powerful distractors. This study focuses on the impact of noise peaks on surgical teams' communication during 109 long abdominal surgeries. We related measured noise peaks during 5-min intervals to the amount of observed communication during the same interval. Results show that noise peaks are associated with less case-relevant communication; this effect is moderated by the level of surgical experience; case-relevant communications decrease under high noise peak conditions among junior, but not among senior surgeons. However, case-irrelevant communication did not decrease under high noise level conditions, rather there was a trend to more case-irrelevant communication under high noise peaks. The results support the hypothesis that noise peaks impair communication because they draw on attentional resources rather than impairing understanding of communication. As case-relevant communication is important for surgical performance, exposure to high noise peaks in the OR should be minimised especially for less experienced surgeons. Practitioner Summary: This study investigated whether noise during surgeries influenced the communication within surgical teams. During abdominal surgeries, noise levels were measured and communication was observed. Results showed that high noise peaks reduced the frequency of patient-related communication, but did not reduce patient-irrelevant communication. Noise may negatively affect team coordination in surgeries.

UK dental laboratory technicians' views on the efficacy and teaching of clinical-laboratory communication.

PubMed

Juszczyk, A S; Clark, R K F; Radford, D R

2009-05-23

The General Dental Council states that 'good dental care is delivered by a team' and restorative treatment is enhanced by communication between team members. Commercial dental laboratories are ideally placed to comment on effective communication. To investigate contemporary attitudes and communication between dentist and dental technician from the technician's perspective. Eight hundred and three dental laboratories were invited to take part in a postal survey covering dentist/laboratory communication and the dentist's understanding of technical procedures. Forty percent of laboratories responded. Only 9% scored communication as very good, 48% scored communication with newly qualified dentists better than with established dentists but only 26% considered that dental students were taught to communicate with dental laboratories effectively. The free comments that the respondents were invited to make identified three distinct themes, 'recognition within the dental team', 'effective communication between dentist and dental technician' and 'dentists lack of technical knowledge'. Effective communication between dentist and dental technician is often poor. It was the view of the dental technicians who responded that newly qualified dentists do not have an appropriate understanding of technical techniques. Dental schools are still not preparing new graduates to communicate effectively with dental laboratories.

Theoretically-Driven Infrastructure for Supporting Healthcare Teams Training at a Military Treatment Facility

NASA Technical Reports Server (NTRS)

Turner, Robert T.; Parodi, Andrea V.

2011-01-01

The Team Resource Center (TRC) at Naval Medical Center Portsmouth (NMCP) currently hosts a tri-service healthcare teams training course three times annually . The course consists of didactic learning coupled with simulation exercises to provide an interactive educational experience for healthcare professionals. The course is also the foundation of a research program designed to explore the use of simulation technologies for enhancing team training and evaluation. The TRC has adopted theoretical frameworks for evaluating training readiness and efficacy, and is using these frameworks to guide a systematic reconfiguration of the infrastructure supporting healthcare teams training and research initiatives at NMCP.

Team-based Service Delivery for Students with Disabilities: Practice Options and Guidelines for Success.

ERIC Educational Resources Information Center

Ogletree, Billy T.; Bull, Jeannette; Drew, Ruby; Lunnen, Karen Y.

2001-01-01

This article reviews the assessment procedures, treatment procedures, and the advantages and disadvantages of three professional-family team models: multidisciplinary teams, interdisciplinary teams, and transdisciplinary teams. Guidelines for optimal team participation are provided. The importance of mission statements, communication, trust,…

Psychologists' views of inter-disciplinary psychosocial communication within the cancer care team.

PubMed

Thewes, B; Butow, P; Davis, E; Turner, J; Mason, C

2014-12-01

Little is known about how psychologists working in cancer care centres communicate clinical information to other members of the multidisciplinary team or what information is communicated. This study surveyed Australian cancer care psychologists regarding their communication practices and their views on barriers to and facilitators of effective inter-disciplinary communication. Psychologists were invited to complete an online survey containing purpose-designed items that addressed study aims. Forty-four psychologists completed the survey. Psychologists' most common method of recording initial consultations was in patient medical records, with 69 % of respondents recording notes in either most of the time or all of the time. Twenty-two percent of psychologists said they did not regularly feedback the results of an initial assessment to a referrer and more than 40 % used verbal and e-mail communication to do so. This study provides data that will assist in the development of guidelines for inter-professional communication between psychologists and other members of the cancer care team.

Themes and Reform of Primary Health Care (RCAPS) in the city of Rio de Janeiro, Brazil.

PubMed

Soranz, Daniel; Pinto, Luiz Felipe; Penna, Gerson Oliveira

2016-05-01

During the period of 1990-2000, Rio de Janeiro was characterized by a limited supply of public and universal primary care services. In 2008, family health team coverage corresponded to 3.5% of the population, the lowest among capital cities. At the end of 2013, coverage reached more than 40% of Rio residents with teams comprised of doctors, nurses, practical nurses, community health agents, and health surveillance agents, in addition to oral health teams. This article describes and analyzes the main components of the Reform in Primary Health Care (RCAPS) implemented since 2009, focusing on three lines of action: administrative reform, organizational model, and model of care. A new organizational chart of the Municipal Health Secretary and a legal framework for a new results-based model were created. As for the model of care, the standardization of procedures and health activities for all units and the monthly assessment of clinical indicators of results of implanted electronic medical records were created. Experience has shown the feasibility of RCAPS, pointing to new challenges that will allow consolidation of the expansion of access, training of human resources, health communication, and a shift to a managerial results-driven model.

Optimal Reward Functions in Distributed Reinforcement Learning

NASA Technical Reports Server (NTRS)

Wolpert, David H.; Tumer, Kagan

2000-01-01

We consider the design of multi-agent systems so as to optimize an overall world utility function when (1) those systems lack centralized communication and control, and (2) each agents runs a distinct Reinforcement Learning (RL) algorithm. A crucial issue in such design problems is to initialize/update each agent's private utility function, so as to induce best possible world utility. Traditional 'team game' solutions to this problem sidestep this issue and simply assign to each agent the world utility as its private utility function. In previous work we used the 'Collective Intelligence' framework to derive a better choice of private utility functions, one that results in world utility performance up to orders of magnitude superior to that ensuing from use of the team game utility. In this paper we extend these results. We derive the general class of private utility functions that both are easy for the individual agents to learn and that, if learned well, result in high world utility. We demonstrate experimentally that using these new utility functions can result in significantly improved performance over that of our previously proposed utility, over and above that previous utility's superiority to the conventional team game utility.

Your Media Speak So Loud I Can't Hear a Word You're Saying: Impact of Media and Media Selection on Performance

ERIC Educational Resources Information Center

Hassell, Martin

2013-01-01

With the proliferation of communication media and technologies available, it is important for teams to understand the influence of these media on the performance of their communications. Additionally, it is important for researchers to understand how teams choose and use media. Literature on communication media impacts and communication…

A Framework for Modeling Workflow Execution by an Interdisciplinary Healthcare Team.

PubMed

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

2015-01-01

The use of business workflow models in healthcare is limited because of insufficient capture of complexities associated with behavior of interdisciplinary healthcare teams that execute healthcare workflows. In this paper we present a novel framework that builds on the well-founded business workflow model formalism and related infrastructures and introduces a formal semantic layer that describes selected aspects of team dynamics and supports their real-time operationalization.

Interdisciplinary team communication among forensic nurses and rape victim advocates.

PubMed

Patterson, Debra

2014-01-01

Victim advocates and forensic nurses provide integrated care to address the complex legal, medical, and mental health needs of rape survivors. Research suggests that conflict exists between nurses and advocates, but it remains unknown how their communication patterns contribute to or resolve these conflicts. Utilizing a qualitative case study approach, the current study interviewed 24 nurses and advocates from a Midwest organization to better understand team communication patterns when addressing conflicts. The findings suggest that most nurses communicate concerns directly while advocates avoid direct communication. Factors that influenced direct and indirect communication and their implications for practice will be discussed.

Monitoring and accountability for the Pacific response to the non-communicable diseases crisis.

PubMed

Tolley, Hilary; Snowdon, Wendy; Wate, Jillian; Durand, A Mark; Vivili, Paula; McCool, Judith; Novotny, Rachel; Dewes, Ofa; Hoy, Damian; Bell, Colin; Richards, Nicola; Swinburn, Boyd

2016-09-10

Non-communicable diseases (NCD) are the leading cause of premature death and disability in the Pacific. In 2011, Pacific Forum Leaders declared "a human, social and economic crisis" due to the significant and growing burden of NCDs in the region. In 2013, Pacific Health Ministers' commitment to 'whole of government' strategy prompted calls for the development of a robust, sustainable, collaborative NCD monitoring and accountability system to track, review and propose remedial action to ensure progress towards the NCD goals and targets. The purpose of this paper is to describe a regional, collaborative framework for coordination, innovation and application of NCD monitoring activities at scale, and to show how they can strengthen accountability for action on NCDs in the Pacific. A key component is the Dashboard for NCD Action which aims to strengthen mutual accountability by demonstrating national and regional progress towards agreed NCD policies and actions. The framework for the Pacific Monitoring Alliance for NCD Action (MANA) draws together core country-level components of NCD monitoring data (mortality, morbidity, risk factors, health system responses, environments, and policies) and identifies key cross-cutting issues for strengthening national and regional monitoring systems. These include: capacity building; a regional knowledge exchange hub; innovations (monitoring childhood obesity and food environments); and a robust regional accountability system. The MANA framework is governed by the Heads of Health and operationalised by a multi-agency technical Coordination Team. Alliance membership is voluntary and non-conditional, and aims to support the 22 Pacific Island countries and territories to improve the quality of NCD monitoring data across the region. In establishing a common vision for NCD monitoring, the framework combines data collected under the WHO Global Framework for NCDs with a set of action-orientated indicators captured in a NCD Dashboard for Action. Viewing NCD monitoring as a multi-component system and providing a robust, transparent mutual accountability mechanism helps align agendas, roles and responsibilities of countries and support organisations. The dashboard provides a succinct communication tool for reporting progress on implementation of agreed policies and actions and its flexible methodology can be easily expanded, or adapted for other regions.

Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams.

PubMed

Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John

2009-04-01

The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

Teaming for Speech and Auditory Training.

ERIC Educational Resources Information Center

Nussbaum, Debra B.; Waddy-Smith, Bettie

1985-01-01

The article suggests three strategies for the audiologist and speech/communication specialist to use in assisting the preschool teacher to implement student's individualized education program: (1) demonstration teaming, (2) dual teaming; and (3) rotation teaming. (CL)

Five challenges to ethical communication for interprofessional paediatric practice: A social work perspective.

PubMed

Delany, Clare; Richards, Angela; Stewart, Helen; Kosta, Lauren

2017-07-01

In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.

The impact of organisational and individual factors on team communication in surgery: a qualitative study.

PubMed

Gillespie, Brigid M; Chaboyer, Wendy; Longbottom, Paula; Wallis, Marianne

2010-06-01

Effective teamwork and communication is a crucial determinant of patient safety in the operating room. Communication failures are often underpinned by the inherent differences in professional practices across disciplines, and the ways in which they collaborate. Despite the overwhelming international support to improve team communication, progress has been slow. The aim of this paper is to extend understanding of the organisational and individual factors that influence teamwork in surgery. This qualitative study used a grounded theory approach to generate a theoretical model to explain the relations between organisational and individual factors that influence interdisciplinary communication in surgery. A purposive sample of 16 participants including surgeons, anaesthetists, and nurses who worked in an operating room of a large metropolitan hospital in south east Queensland, Australia, were selected. Participants were interviewed during 2008 using semi-structured individual and group interviews. All interviews were recorded and transcribed. Using a combination of inductive and deductive approaches, thematic analyses uncovered individual experiences in association with teamwork in surgery. Analysis generated three themes that identified and described causal patterns of interdisciplinary teamwork practices; interdisciplinary diversity in teams contributes to complex interpersonal relations, the pervasive influence of the organisation on team cohesion, and, education is the panacea to improving team communications. The development of shared mental models has the potential to improve teamwork in surgery, and thus enhance patient safety. This insight presents a critical first step towards the development teambuilding interventions in the operating room that would specifically address communication practices in surgery. (c) 2009 Elsevier Ltd. All rights reserved.

Collegial relationship breakdown: a qualitative exploration of nurses in acute care settings.

PubMed

Cowin, Leanne S

2013-01-01

Poor collegial relations can cause communication breakdown, staff attrition and difficulties attracting new nursing staff. Underestimating the potential power of nursing team relationships means that opportunities to create better working environments and increase the quality of nursing care can be missed. Previous research on improving collegiality indicates that professionalism and work satisfaction increases and that staff attrition decreases. This study explores challenges, strengths and strategies used in nursing team communication in order to build collegial relationships. A qualitative approach was employed to gather nurses experiences and discussion of communication within their nursing teams and a constant comparison method was utilised for data analysis. A convenience sampling technique was employed to access both Registered Nurses and Enrolled Nurses to partake in six focus groups. Thirty mostly female nurses (ratio of 5:1) participated in the study. Inclusion criteria consisted of being a nurse currently working in acute care settings and the exclusion criteria included nursing staff currently working in closed specialty units (i.e. intensive care units). Results revealed three main themes: (1) externalisation and internalisation of nursing team communication breakdown, (2) the importance of collegiality for retention of nurses and (3) loss of respect, and civility across the healthcare workplace. A clear division between hierarchies of nurses was apparent in how nursing team communication was delivered and managed. Open, respectful and collegial communication is essential in today's dynamic and complex health environments. The nurses in this study highlighted how important nursing communication can be to work motivation and how leadership fosters teamwork.

Team Attributes, Processes, and Values: A Pedagogical Framework

ERIC Educational Resources Information Center

Keyton, Joann; Beck, Stephenson J.

2008-01-01

This article proposes a pedagogical framework to help students analyze their group and team interactions. Intersecting five fundamental group attributes (group size, group goal, group member interdependence, group structure, and group identity) with three overarching group processes (leadership, decision making, and conflict management) creates an…

Technology-Enhanced Learning in Science (TELS)

NASA Astrophysics Data System (ADS)

Linn, Marcia

2006-12-01

The overall research question addressed by the NSF-funded echnologyEnhanced Learning in Science (TELS) Center is whether interactive scientific visualizations embedded in high quality instructional units can be used to increase pre-college student learning in science. The research draws on the knowledge integration framework to guide the design of instructional modules, professional development activities, and assessment activities. This talk reports on results from the first year where 50 teachers taught one of the 12 TELS modules in over 200 classes in 16 diverse schools. Assessments scored with the knowledge integration rubric showed that students made progress in learning complex physics topics such as electricity, mechanics, and thermodynamics. Teachers encountered primarily technological obstacles that the research team was able to address prior to implementation. Powerful scientific visualizations required extensive instructional supports to communicate to students. Currently, TELS is refining the modules, professional development, and assessments based on evidence from the first year. Preliminary design principles intended to help research teams build on the findings will be presented for audience feedback and discussion.

Enhancing pediatric clinical competency with high-fidelity simulation.

PubMed

Birkhoff, Susan D; Donner, Carol

2010-09-01

In today's tertiary pediatric hospital setting, the increased complexity of patient care demands seamless coordination and collaboration among multidisciplinary team members. In an effort to enhance patient safety, clinical competence, and teamwork, simulation-based learning has become increasingly integrated into pediatric clinical practice as an innovative educational strategy. The simulated setting provides a risk-free environment where learners can incorporate cognitive, psychomotor, and affective skill acquisition without fear of harming patients. One pediatric university hospital in Southeastern Pennsylvania has enhanced the traditional American Heart Association (AHA) Pediatric Advanced Life Support (PALS) course by integrating high-fidelity simulation into skill acquisition, while still functioning within the guidelines and framework of the AHA educational standards. However, very little research with reliable standardized testing methods has been done to measure the effect of simulation-based learning. This article discusses the AHA guidelines for PALS, evaluation of PALS and nursing clinical competencies, communication among a multidisciplinary team, advantages and disadvantages of simulation, incorporation of high-fidelity simulation into pediatric practice, and suggestions for future practice. Copyright 2010, SLACK Incorporated.

Public health incident management: Logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

The early intervention safeguarding nurse pilot: an integrated model of working.

PubMed

Fifield, Lucille; Blake, Susan

2011-11-01

Some of the most vulnerable children will need co-ordinated help from health, children's services and other agencies. Co-ordinated and joint working hinges on effective communication at all levels. Evidence shows that direct verbal communication is a more effective way to share concerns and that this should be followed up by written information. Yet barriers persist that prevent this from happening. Integrated health and social care teams are purported to break down professional and communication barriers. This paper reports on the evaluation of a pilot integrated model of health and social care in the North West of England. Such models can work and produce positive outcomes for children and families, but require full commitment from all parties. There are principles that need to be in place for this integrated model to achieve its aims and objectives, such as a robust governance framework that specifies the roles and responsibilities of each agency, managers and practitioners. Despite the model achieving its aim, the project was not as efficient as it could have been due to the lack of an integrated information technology system.

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.

Survey of North American Multidisciplinary Cleft Palate and Craniofacial Team Clinic Administration.

PubMed

Pfeifauf, Kristin D; Patel, Kamlesh B; Snyder-Warwick, Alison; Skolnick, Gary B; Scheve, Sibyl; Naidoo, Sybill D

2018-01-01

This study aims to provide an understanding of the ways cleft palate (CP) and craniofacial teams address billing, administration, communication of clinical recommendations, appointment scheduling, and diagnosis-specific protocols. An online clinic administration survey was developed using data from an open-ended telephone questionnaire. The online survey was distributed by e-mail to the American Cleft Palate-Craniofacial Association (ACPA) nurse coordinator electronic mailing list, used regularly by the ACPA and its members to communicate with teams. The response was 34.1% (42/123). Two incomplete records were excluded, as were any inconsistent responses of 3 teams submitting duplicate records. Six (15.8%) of 38 teams do not charge for clinic visits. For all other teams, some or all providers bill individually for services (68.4%) or a single lump sum applies (10.5%). Patients of 34 (89.5%) of 38 teams occasionally or often neglect to schedule or attend follow-up appointments. Twenty-six (66.7%) of 39 team directors were plastic surgeons. Phone is a common method of contacting families for scheduling (60.0%) and appointment reminders (82.5%). Most teams' providers (90.0%) routinely communicate findings to each other during postclinical conference. Most teams saw patients with isolated cleft lip (43.6%), cleft lip and palate (64.1%), or isolated CP (59.0%) annually. The breadth of strategies team clinic administration strategies warrants further exploration of the variations and their effects on patient-centered outcomes including the quality of life, satisfaction, cost, and resource utilization.

The surgical prebrief as part of a five-point comprehensive approach to improving pediatric cardiac surgical team communication.

PubMed

Hoganson, David M; Boston, Umar S; Manning, Peter B; Eghtesady, Pirooz

2014-10-01

Communication is essential to the safe conduct of any critical task including cardiac surgery. After inspiration by airline crew resource management training, a communication system for the care plans of pediatric cardiac patients was developed and refined over time that encompasses the entire heart center team. Five distinct communication points are used to ensure preoperative, intraoperative, and postoperative care, which is transitioned efficiently and maintained at the highest level. © The Author(s) 2014.

Development and Initial Validation of the Caregiver Perceptions About Communication With Clinical Team Members (CAPACITY) Measure.

PubMed

Van Houtven, Courtney Harold; Miller, Katherine E M; O'Brien, Emily C; Wolff, Jennifer L; Lindquist, Jennifer; Kabat, Margaret; Campbell-Kotler, Margaret; Henius, Jennifer; Voils, Corrine I

2017-12-01

Despite the important role that family caregivers play managing the care of persons with complex health needs, little is known about how caregivers perceive themselves to be recognized and valued by health care professionals. Our objective was to develop and validate a novel measure, the CAregiver Perceptions About Commun Ication with Clinical Team members (CAPACITY) instrument. Questions focus on perceived quality of communication with the health care team and the extent to which caregivers believe that the health care team considers their capacity and preferences in decision making. A confirmatory factor analysis supported a two-factor solution addressing communication and capacity. Internal consistency reliability was .90 for the communication domain and .93 for the capacity domain. Correlations between these two subscales and individual difference measures provided evidence of convergent and discriminant validity. The CAPACITY instrument may be a useful performance measure that quantifies the extent to which caregivers' experience person- and family-centered health care.

Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in the Emergency Department.

PubMed

Martin, Heather A; Ciurzynski, Susan M

2015-11-01

Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework. To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented. Data were gathered from 32 nurses and 2 nurse practitioners using structured observation and pre- and post-implementation surveys. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction. Eighty-three percent of patient encounters included a joint evaluation. A huddle structured with SBAR was conducted 86% of the time. Registered nurses and nurse practitioners verbalized patients' treatment plans in 89% of cases and 97% of cases, respectively. Improved teamwork, communication, and nursing satisfaction scores were demonstrated among the nurse practitioners and registered nurses. This project showed the feasibility of a simple and inexpensive joint nurse practitioner-registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

The effect of simulation-based crew resource management training on measurable teamwork and communication among interprofessional teams caring for postoperative patients.

PubMed

Paull, Douglas E; Deleeuw, Lori D; Wolk, Seth; Paige, John T; Neily, Julia; Mills, Peter D

2013-11-01

Many adverse events in health care are caused by teamwork and communication breakdown. This study was conducted to investigate the effect of a point-of-care simulation-based team training curriculum on measurable teamwork and communication skills in staff caring for postoperative patients. Twelve facilities involving 334 perioperative surgical staff underwent simulation-based training. Pretest and posttest self-report data included the Self-Efficacy of Teamwork Competencies Scale. Observational data were captured with the Clinical Teamwork Scale. Teamwork scores (measured on a five-point Likert scale) improved for all eight survey questions by an average of 18% (3.7 to 4.4, p < .05). The observed communication rating (scale of 1 to 10) increased by 16% (5.6 to 6.4, p < .05). Simulation-based team training for staff caring for perioperative patients is associated with measurable improvements in teamwork and communication. Copyright 2013, SLACK Incorporated.

Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication.

PubMed

Mayo, Anna T; Woolley, Anita Williams

2016-09-01

Teams offer the potential to achieve more than any person could achieve working alone; yet, particularly in teams that span professional boundaries, it is critical to capitalize on the variety of knowledge, skills, and abilities available. This article reviews research from the field of organizational behavior to shed light on what makes for a collectively intelligent team. In doing so, we highlight the importance of moving beyond simply including smart people on a team to thinking about how those people can effectively coordinate and collaborate. In particular, we review the importance of two communication processes: ensuring that team members with relevant knowledge (1) speak up when one's expertise can be helpful and (2) influence the team's work so that the team does its collective best for the patient. © 2016 American Medical Association. All Rights Reserved.

An academic hospitalist model to improve healthcare worker communication and learner education: Results from a quasi-experimental study at a veterans affairs medical center

PubMed Central

Saint, Sanjay; Fowler, Karen E; Krein, Sarah L; Flanders, Scott A; Bodnar, Timothy W; Young, Eric; Moseley, Richard H

2013-01-01

BACKGROUND Although hospitalists may improve efficiency and quality of inpatient care, their effect on healthcare-worker communication and education has been less well-studied. OBJECTIVE To test various approaches to improving healthcare-worker communication and learner education within the context of a newly designed academic hospital medicine program. DESIGN Before-and-after design with concurrent control group. SETTING A Midwestern Veterans Affairs medical center. INTERVENTION Multimodal systems redesign of 1 of 4 medical teams (Gold team) that included clinical modifications (change in rounding structure, with inclusion of nurses, a Clinical Care Coordinator, and a pharmacist) and educational interventions (providing explicit expectations of learners and providing a reading list for both learners and attending physicians). MEASUREMENTS Number of admissions, length of stay, readmissions, house officer and medical student ratings of attendings' teaching, medical student internal medicine National Board of Medical Examiners Subject Examination (“shelf” exam) scores, and clinical staff surveys. RESULTS Length of stay was reduced by about 0.3 days on all teams after the initiative began (P = 0.004), with no significant differences between Gold and non-Gold teams. The majority of physicians (83%) and nurses (68%) felt that including nurses during rounds improved healthcare-worker communication; significantly more nurses were satisfied with communication with the Gold team than with the other teams (71% vs 53%; P = 0.02). Gold attendings generally received higher teaching scores compared with non-Gold attendings, and third-year medical students on the Gold team scored significantly higher on the shelf exam compared with non–Gold team students (84 vs 82; P = 0.006). CONCLUSIONS Academic hospitalists working within a systems redesign intervention were able to improve healthcare-worker communication and enhance learner education without increasing patient length of stay or readmission rates. Journal of Hospital Medicine 2013;8:702–710. 2013 The Authors. Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine PMID:24249096

Hamline/3M Corp. Project: Liason for Curricular Change*

NASA Astrophysics Data System (ADS)

Artz, Jerry L.

2002-04-01

This project was designed to catalyze curricular changes to better prepare students for the workplace. Industrial managers provided a list of 16 characteristics valued in the workplace; most were NOT related to science course content. The project formed 5 teams each including 3M professionals and students. Each team developed curricular changes in one of the 16 areas. Team goals were to improve skills in communication, data analysis, business/economics, team problem solving, and cultural competency. Curricular changes realized include communication skill activities embodied in science courses and faculty communication teaching skill seminars; self learning tools in data analysis, statistics and model building; a new course developed with assistance from 3M personnel focusing on topics directly related to technological industries; high performance team problem solving training/coaching for faculty; workshops for students and faculty relative to importance of cultural competencies in the workplace; and a new course focusing on culture, team problem solving and conflict resolution in the technical workplace. Process for developing and content of curricular changes will be reported. *Thanks to: NSF GOALI CHE-99010782

Engaging in Collaboration: A Team of Teams Approach

ERIC Educational Resources Information Center

Young, Carol; Hill, Rachel; Morris, Greg; Woods, Fabiola

2016-01-01

Adapting a Team of Teams model to a school environment provides a framework for a collaborative team culture based on trust, common vision, purposeful conversations, and interconnectivity. School leaders facilitate collaboration by modeling teamwork, as well as transparency and adaptability, to create a positive school culture and thereby improve…

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members

PubMed Central

Wauben, L.S.G.L.; Dekker-van Doorn, C.M.; van Wijngaarden, J.D.H.; Goossens, R.H.M.; Huijsman, R.; Klein, J.; Lange, J.F.

2011-01-01

Objective To assess surgical team members’ differences in perception of non-technical skills. Design Questionnaire design. Setting Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Participants Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. Methods All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT. Results Ratings for ‘communication’ were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for ‘teamwork’ differed significantly between all team members (P ≤ 0.005). Within ‘situation awareness’ significant differences were mainly observed for ‘gathering information’ between surgeons and other team members (P < 0.001). Finally, 72–90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate. Conclusions This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system. PMID:21242160

Using Network-Based Language Analysis to Bridge Expertise and Cultivate Sensitivity to Differentiated Language Use in Interdisciplinary Geoscience Research

NASA Astrophysics Data System (ADS)

Hannah, M. A.; Simeone, M.

2017-12-01

On interdisciplinary teams, expertise is varied, as is evidenced by differences in team members' language use. Developing strategies to combine that expertise and bridge differentiated language practices is especially difficult between geoscience subdisciplines as researchers assume they use a shared language—vocabulary, jargon, codes, linguistic styles. In our paper, we discuss a network-based approach used to identify varied expertise and language practices between geoscientists (n=29) on a NSF team funded to study how deep and surface Earth processes worked together to give rise to the Great Oxygenation Event. We describe how we modeled the team's expertise from a language corpus consisting of 220 oxygen-related terms frequently used by team members and then compared their understanding of the terms to develop interventions to bridge the team's expertise. Corpus terms were identified via team member interviews, observations of members' interactions at research meetings, and discourse analysis of members' publications. Comparisons of members' language use were based on a Likert scale survey that asked members to assess how they understood a term; how frequently they used a term; and whether they conceptualized a term as an object or process. Rather than use our method as a communication audit tool (Zwijze-Koning & de Jong, 2015), teams can proactively use it in a project's early stages to assess the contours of the team's differentiated expertise and show where specialized knowledge resides in the team, where latent or non-obvious expertise exists, where expertise overlaps, and where gaps are in the team's knowledge. With this information, teams can make evidence based recommendations to forward their work such as allocating resources; identifying and empowering members to serve as connectors and lead cross-functional project initiatives; and developing strategies to avoid communication barriers. The method also generates models for teaching language sensitivity to subdisciplinary colleagues by making visible the nuanced ways they use language to organize and communicate their research. Ultimately, understanding the impact of differentiated language use is an unmet need in Earth science research, and our method offers a unique way to visualize and understand how such use impacts team communication.

Teaming Up for Performance Support: A Model of Roles, Skills, and Competencies.

ERIC Educational Resources Information Center

Huber, Burt; Lippincott, Jenifer; McMahon, Cathie; Witt, Catherine

1999-01-01

Discusses roles, skills, and competencies that comprise a development team engaged in creating electronic performance support systems (EPSS). Explains intrinsic, extrinsic, and external EPSS, presents case studies for each type, and suggests effective team strategies that include team formation and team-client communication. (LRW)

Minding the gap: Interprofessional communication during inpatient and post discharge chasm care.

PubMed

Scotten, Mitzi; Manos, Eva LaVerne; Malicoat, Allison; Paolo, Anthony M

2015-07-01

Poor communication is cited as a main cause of poor patient outcomes and errors in healthcare, and clear communication can be especially critical during transitions such as discharge. In this project, communication was standardized for clarity, and techniques were implemented to continue care from inpatient, to discharge, across the post-discharge chasm, to hand-off with the primary care provider (PCP). The interprofessional (IP) quality improvement initiative included: (1) evidence-based teamwork system; (2) in situ simulation; (3) creation of an IP model of care; and (4) innovations in use of telehealth technology to continue care post-discharge. Measures inpatient/parent satisfaction and the attitudes of the care team have improved. Traditional methods of communication and transition do not meet patient or healthcare provider needs. Communication must be standardized to be understandable and be used by the IP team. Care must continue post-discharge by utilizing technology to increase quality and continuity of care. Improving and practicing communication skills may lead to reductions in healthcare errors and readmissions, and may decrease the length of stay and improve satisfaction of care teams. Published by Elsevier Ireland Ltd.

Building the team for team science

USGS Publications Warehouse

Read, Emily K.; O'Rourke, M.; Hong, G. S.; Hanson, P. C.; Winslow, Luke A.; Crowley, S.; Brewer, C. A.; Weathers, K. C.

2016-01-01

The ability to effectively exchange information and develop trusting, collaborative relationships across disciplinary boundaries is essential for 21st century scientists charged with solving complex and large-scale societal and environmental challenges, yet these communication skills are rarely taught. Here, we describe an adaptable training program designed to increase the capacity of scientists to engage in information exchange and relationship development in team science settings. A pilot of the program, developed by a leader in ecological network science, the Global Lake Ecological Observatory Network (GLEON), indicates that the training program resulted in improvement in early career scientists’ confidence in team-based network science collaborations within and outside of the program. Fellows in the program navigated human-network challenges, expanded communication skills, and improved their ability to build professional relationships, all in the context of producing collaborative scientific outcomes. Here, we describe the rationale for key communication training elements and provide evidence that such training is effective in building essential team science skills.

Team interaction during surgery: a systematic review of communication coding schemes.

PubMed

Tiferes, Judith; Bisantz, Ann M; Guru, Khurshid A

2015-05-15

Communication problems have been systematically linked to human errors in surgery and a deep understanding of the underlying processes is essential. Although a number of tools exist to assess nontechnical skills, methods to study communication and other team-related processes are far from being standardized, making comparisons challenging. We conducted a systematic review to analyze methods used to study events in the operating room (OR) and to develop a synthesized coding scheme for OR team communication. Six electronic databases were accessed to search for articles that collected individual events during surgery and included detailed coding schemes. Additional articles were added based on cross-referencing. That collection was then classified based on type of events collected, environment type (real or simulated), number of procedures, type of surgical task, team characteristics, method of data collection, and coding scheme characteristics. All dimensions within each coding scheme were grouped based on emergent content similarity. Categories drawn from articles, which focused on communication events, were further analyzed and synthesized into one common coding scheme. A total of 34 of 949 articles met the inclusion criteria. The methodological characteristics and coding dimensions of the articles were summarized. A priori coding was used in nine studies. The synthesized coding scheme for OR communication included six dimensions as follows: information flow, period, statement type, topic, communication breakdown, and effects of communication breakdown. The coding scheme provides a standardized coding method for OR communication, which can be used to develop a priori codes for future studies especially in comparative effectiveness research. Copyright © 2015 Elsevier Inc. All rights reserved.

Emergency department team communication with the patient: the patient's perspective.

PubMed

McCarthy, Danielle M; Ellison, Emily P; Venkatesh, Arjun K; Engel, Kirsten G; Cameron, Kenzie A; Makoul, Gregory; Adams, James G

2013-08-01

Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication. The objective of this study was to determine patients' perceptions of their ED team's communication skills. This was a cross-sectional study in an urban, academic ED. Patients completed the Communication Assessment Tool for Teams (CAT-T) survey upon ED exit. The CAT-T was adapted from the psychometrically validated Communication Assessment Tool (CAT) to measure patient perceptions of communication with a medical team. The 14 core CAT-T items are associated with a 5-point scale (5 = excellent); results are reported as the percent of participants who responded "excellent." Responses were analyzed for differences based on age, sex, race, and operational metrics (wait time, ED daily census). There were 346 patients identified; the final sample for analysis was 226 patients (53.5% female, 48.2% Caucasian), representing a response rate of 65.3%. The scores on CAT-T items (reported as % "excellent") ranged from 50.0% to 76.1%. The highest-scoring items were "let me talk without interruptions" (76.1%), "talked in terms I could understand" (75.2%), and "treated me with respect" (74.3%). The lowest-scoring item was "encouraged me to ask questions" (50.0%). No differences were noted based on patient sex, race, age, wait time, or daily census of the ED. The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions. Copyright © 2013 Elsevier Inc. All rights reserved.

Strengths and weaknesses in team communication processes in a UK emergency department setting: findings using the Communication Assessment Tool-Team.

PubMed

Graham, Blair; Smith, Jason E; Enki, Doyo

2017-12-01

Identifying weaknesses in emergency department (ED) communication may highlight areas where quality improvement may be beneficial. This study explores whether the Communication Assessment Tool-Team (CAT-T) survey can identify communication strengths and weaknesses in a UK setting. This study aimed to determine the frequency of patient responses for each item on the CAT-T survey and to compare the proportion of responses according to patient and operational characteristics. Adults presenting to the minors area of a semi-urban ED between April and May 2015 were included. Those lacking capacity or in custody were excluded. Multivariate analysis identified associations between responses and demographic/operational characteristics. A total of 407/526 eligible patients responded (77.3%). Respondents were mostly White British (93.9%), with a median age of 45 years. Most responses were obtained during daytime hours (84.2% between 08 : 00 and 18 : 00). The median reported times to triage, assessment and disposition were 15, 35 and 90 min, respectively. Items most frequently rated as 'very good'/'excellent' (strengths) were 'ambulance staff treated me with respect' (86.7%), ED staff 'let me talk without interruptions' (85%) and 'paid attention to me' (83.7%). Items most frequently rated as 'poor'/'fair' (weaknesses) were 'encouraged me to ask questions', 'reception treated me with respect' (10.4%) and 'staff showed an interest in my health' (6.8%). Arrival time, analgesia at triage and time to assessment were associated with significantly increased odds of positive perception of team communication for a range of items. The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.

A Cross-Disciplinary Literature Review: Examining Trust on Virtual Teams

ERIC Educational Resources Information Center

Berry, Gregory R.

2011-01-01

Effective and efficient teams communicate, collaborate, and perform, even if these teams are not co-located. Although much is known about enabling effectiveness on face-to-face teams, considerably less is known about similarly enabling effectiveness on virtual teams. Yet the use of virtual teams is common and will likely become more commonplace as…

Virtual Team Effectiveness: An Empirical Examination of the Use of Communication Technologies on Trust and Virtual Team Performance

ERIC Educational Resources Information Center

Thomas, Valerie Brown

2010-01-01

Ubiquitous technology and agile organizational structures have enabled a strategic response to increasingly competitive, complex, and unpredictable challenges faced by many organizations. Using cyberinfrastructure, which is primarily the network of information, computers, communication technologies, and people, traditional organizations have…

The Process of Creating Integrated Home Care in Lithuania: from Idea to Reality

PubMed Central

Jurkuvienė, Ramunė; Butkevičienė, Rūta; Gajdosikienė, Indrė

2016-01-01

Background: The article presents an analysis of the formulation and implementation of a social innovation: integrated home care (IHC) in post-soviet Lithuania. From 1998 a series of top-down orders to implement IHC were issued, however, home nursing did not start. In 2011 the Ministry of Social Security and Labour began a process to develop integrated home care using new, collaborative processes. The result was 21 pilot projects with well-conceptualized IHC services. Method: Using data from focus groups, interviews, and recorded observations, the research team systematically documented the innovation process, including themes and deviations, employing Smale’s Innovation Trinity framework to organize the larger picture. Results: In the Lithuanian post-totalitarian context, top-down communication was found to be prevalent. Not only IHC, but also openness to change and dialogue at high levels were innovations. Patient-centered practice at local levels could only occur when a new attitude of mind was reached through dialogue with officials at higher levels and between peers. Conclusions: The enactment, rather than the mask of dialogue, participatory program development were critical in the success of IHC innovation. This is difficult to achieve in the light of antiquated public bureaucracies, but in this case, the Ministry team, rather than avoiding the expectation of top-down communication, made it into an asset through promotion of collaboration. PMID:28435419

The perspectives of adults with aphasia and their team members regarding the importance of nine life areas for rehabilitation: a pilot investigation.

PubMed

Pettit, Lauren K; Tönsing, Kerstin M; Dada, Shakila

2017-03-01

Client-centred rehabilitation implies that persons with aphasia and their significant others are actively involved in all decisions regarding rehabilitation, including the setting of rehabilitation priorities and goals. This study aimed to describe and compare the perspectives of adults with aphasia, their significant others and their speech-language pathologists (SLPs) regarding the importance of nine life areas for the rehabilitation of adults with aphasia. A total of 15 adults with expressive aphasia rated the importance of nine life areas using the Talking Mats™ framework. A questionnaire was used to obtain the ratings of 15 of their significant others and the 15 SLPs treating them. Most life areas were rated as important to work on in rehabilitation by most participants. The adults with aphasia rated the areas as important more frequently than their significant others and SLPs. All participants rated Communication as important. Statistically significant differences were noted for three of the nine life areas. The life areas which the participants were questioned about seem to provide a good starting point for rehabilitation teams to find common ground for collaborative goal setting. The Talking Mats™ approach allowed adults with aphasia to participate in the process. It can be a useful tool to promote client-centred rehabilitation for adults with expressive communication difficulties.

Addressing dysfunctional relations among healthcare teams: improving team cooperation through applied organizational theories.

PubMed

Horwitz, Sujin K; Horwitz, Irwin B; Barshes, Neal R

2011-01-01

Previous research has demonstrated that communication failure and interpersonal conflicts are significant impediments among health-care teams to assess complex information and engage in the meaningful collaboration necessary for optimizing patient care. Despite the prolific research on the role of effective teamwork in accomplishing complex tasks, such findings have been traditionally applied to business organizations and not medical contexts. This chapter, therefore, reviews and applies four theories from the fields of organizational behavior (OB) and organization development (OD) as potential means for improving team interaction in health-care contexts. This study is unique in its approach as it addresses the long-standing problems that exist in team communication and cooperation in health-care teams by applying well-established theories from the organizational literature. The utilization and application of the theoretical constructs discussed in this work offer valuable means by which the efficacy of team work can be greatly improved in health-care organizations.

Cooperation, Coordination, and Trust in Virtual Teams: Insights from Virtual Games

NASA Astrophysics Data System (ADS)

Korsgaard, M. Audrey; Picot, Arnold; Wigand, Rolf T.; Welpe, Isabelle M.; Assmann, Jakob J.

This chapter considers fundamental concepts of effective virtual teams, illustrated by research on Travian, a massively multiplayer online strategy game wherein players seek to build empires. Team inputs are the resources that enable individuals to work interdependently toward a common goal, including individual and collective capabilities, shared knowledge structures, and leadership style. Team processes, notably coordination and cooperation, transform team inputs to desired collective outcomes. Because the members of virtual teams are geographically dispersed, relying on information and communication technology, three theories are especially relevant for understanding how they can function effectively: social presence theory, media richness theory, and media synchronicity theory. Research in settings like Travian can inform our understanding of structures, processes, and performance of virtual teams. Such research could provide valuable insight into the emergence and persistence of trust and cooperation, as well as the impact of different communication media for coordination and information management in virtual organizations.

Evaluating Academic Scientists Collaborating in Team-Based Research: A Proposed Framework

PubMed Central

Mazumdar, Madhu; Messinger, Shari; Finkelstein, Dianne M.; Goldberg, Judith D.; Lindsell, Christopher J.; Morton, Sally C.; Pollock, Brad H.; Rahbar, Mohammad H.; Welty, Leah J.; Parker, Robert A.

2015-01-01

Criteria for evaluating faculty are traditionally based on a triad of scholarship, teaching, and service. Research scholarship is often measured by first or senior authorship on peer-reviewed scientific publications and being principal investigator on extramural grants. Yet scientific innovation increasingly requires collective rather than individual creativity, which traditional measures of achievement were not designed to capture and, thus, devalue. The authors propose a simple, flexible framework for evaluating team scientists that includes both quantitative and qualitative assessments. An approach for documenting contributions of team scientists in team-based scholarship, non-traditional education, and specialized service activities is also outlined. While biostatisticians are used for illustration, the approach is generalizable to team scientists in other disciplines. PMID:25993282

[Communication within the health care team: doctors and nurses].

PubMed

Kollár, János

2016-04-24

Proper communication within the health care team is especially important in terms of creating safe emotional and professional conditions for the team members and for quality healing. The aim of the study is to explore the factors that hinder appropriate communication between doctors and nurses and thus to make the effective elimination of the communication disturbances possible. Investigation in main medical databases and general search engines were used for analysing the phenomenon. It was revealed that communication between doctors and nurses is restrained by factors that can be observed on individual, professional and system levels as well. Role confusion, lack of trust, communication barriers arising from hierarchical inequalities, leadership problems, differences in qualifications, burnout and organizational problems can equally be found amongst them. The effectiveness of communication between nurses and doctors in Hungary is especially strongly influenced by the fear of losing jobs, the financial problems arising from different degree of gratuity and the phenomenon of burnout. Changes on individual, professional and system levels are equally important for significant improvement in the communication between doctors and nurses. Joint trainings based on strong organizational development skills and joint conferences could promote significantly better flow of information, mutual appreciation and harmonization.

Conflicts and communication gaps in the intensive care unit.

PubMed

Fassier, Thomas; Azoulay, Elie

2010-12-01

Conflicts occur frequently in the ICU. Research on ICU conflicts is an emerging field, with only few recent studies being available on intrateam and team-family conflicts. Research on communication in the ICU is developing at a faster pace. Recent findings come from one multinational epidemiological survey on intrateam conflicts and one qualitative study on the causes and consequences of conflicts. Advances in research on communication with families in the ICU have improved our understanding of team-family and intrateam conflicts, thus suggesting targets for improvement. Data about ICU conflicts depend on conflict definition, study designs (qualitative versus quantitative), patient case-mix, and detection bias. Conflicts perceived by caregivers are frequent and consist mainly in intrateam conflicts. The two main sources of conflicts in the ICU are end-of-life decisions and communication issues. Conflicts negatively impact patient safety, patient/family-centered care, and team welfare and cohesion. They generate staff burnout and increase healthcare costs. Further qualitative studies rooted in social-science theories about workplace conflicts are needed to better understand the typology of ICU conflicts (sources and consequences) and to address complex ICU conflicts that involve systems as opposed to people. Conflict prevention and resolution are complex issues requiring multimodal interventions. Clinical research in this field is insufficiently developed, and no guidelines are available so far. Prevention strategies need to be developed along two axes: improved understanding of family experience, preferences, and values, as well as evidence-based communication may reduce team-family conflicts and organizational measures including restoring leadership, multidisciplinary teamwork, and improved communication within the team may prevent intrateam conflicts in the ICU.

The Effects of Multimodal Mobile Communications on Cooperative Team Interactions Executing Distributed Tasks

DTIC Science & Technology

2013-07-01

AFRL-RH-WP-TP-2013-0046 The Effects of Multimodal Mobile Communications on Cooperative Team Interactions Executing Distributed Tasks Gregory...3. DATES COVERED (From - To) 31-07-13 Interim 01 August 2011 – 01 August 2013 4. TITLE AND SUBTITLE The Effects of Multimodal Mobile... multimodal communication capabilities can con- tribute to the effectiveness and efficiency of real-time, task outcome and per- formance. In this paper, we

Timely Digital Patient-Clinician Communication in Specialist Clinical Services for Young People: A Mixed-Methods Study (The LYNC Study)

PubMed Central

Bryce, Carol; Cave, Jonathan; Dritsaki, Melina; Fraser, Joseph; Hamilton, Kathryn; Huxley, Caroline; Ignatowicz, Agnieszka; Kim, Sung Wook; Kimani, Peter K; Madan, Jason; Slowther, Anne-Marie; Sujan, Mark; Sturt, Jackie

2017-01-01

Background Young people (aged 16-24 years) with long-term health conditions can disengage from health services, resulting in poor health outcomes, but clinicians in the UK National Health Service (NHS) are using digital communication to try to improve engagement. Evidence of effectiveness of this digital communication is equivocal. There are gaps in evidence as to how it might work, its cost, and ethical and safety issues. Objective Our objective was to understand how the use of digital communication between young people with long-term conditions and their NHS specialist clinicians changes engagement of the young people with their health care; and to identify costs and necessary safeguards. Methods We conducted mixed-methods case studies of 20 NHS specialist clinical teams from across England and Wales and their practice providing care for 13 different long-term physical or mental health conditions. We observed 79 clinical team members and interviewed 165 young people aged 16-24 years with a long-term health condition recruited via case study clinical teams, 173 clinical team members, and 16 information governance specialists from study NHS Trusts. We conducted a thematic analysis of how digital communication works, and analyzed ethics, safety and governance, and annual direct costs. Results Young people and their clinical teams variously used mobile phone calls, text messages, email, and voice over Internet protocol. Length of clinician use of digital communication varied from 1 to 13 years in 17 case studies, and was being considered in 3. Digital communication enables timely access for young people to the right clinician at the time when it can make a difference to how they manage their health condition. This is valued as an addition to traditional clinic appointments and can engage those otherwise disengaged, particularly at times of change for young people. It can enhance patient autonomy, empowerment and activation. It challenges the nature and boundaries of therapeutic relationships but can improve trust. The clinical teams studied had not themselves formally evaluated the impact of their intervention. Staff time is the main cost driver, but offsetting savings are likely elsewhere in the health service. Risks include increased dependence on clinicians, inadvertent disclosure of confidential information, and communication failures, which are mostly mitigated by young people and clinicians using common-sense approaches. Conclusions As NHS policy prompts more widespread use of digital communication to improve the health care experience, our findings suggest that benefit is most likely, and harms are mitigated, when digital communication is used with patients who already have a relationship of trust with the clinical team, and where there is identifiable need for patients to have flexible access, such as when transitioning between services, treatments, or lived context. Clinical teams need a proactive approach to ethics, governance, and patient safety. PMID:28396301

From Crew Communication to Coordination: A Fundamental Means to an End

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.; Connors, Mary M. (Technical Monitor)

1998-01-01

This viewgraph presentation describes the purposes and contexts of communication, factors which affect the interpretation of communication, and the advantages of effective, systematic communication to and from crews. Communication accomplishes information transfer, team/task management, shared problem solving and decision making, and establishment of the interpersonal climate. These accomplishments support outcomes: Technical task performance; CRM (crew resource management); Procedures and ATC (air traffic control); and Work/team atmosphere. The presentation lists various types of management inefficiency which can result from a lack of each of the four accomplishments. Communication skills are used within the following contexts: physical; social and organizational; task and operational; and speech and linguistic. Crew communication can be evaluated through investigation (case study), research (experimentation), and training.

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review.

PubMed

O'Reilly, Pauline; Lee, Siew Hwa; O'Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne

2017-01-01

Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work. International Prospective Register of Systematic Reviews PROSPERO 2015: CRD42015019362.

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review

PubMed Central

O’Reilly, Pauline; Lee, Siew Hwa; O’Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne

2017-01-01

Background Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. Methods and findings An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. Conclusion A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work. Systematic review registration International Prospective Register of Systematic Reviews PROSPERO 2015: CRD42015019362. PMID:28545038

Education and Communication in an Interprofessional Antimicrobial Stewardship Program.

PubMed

Foral, Pamela A; Anthone, Jennifer M; Destache, Christopher J; Vivekanandan, Renuga; Preheim, Laurel C; Gorby, Gary L; Horne, John M; Dobronski, Leo A; Syed, Javeria J; Mindru, Cezarina; Ali, Mir A; Ali, Karim F; Neemann, Kari A; Bittner, Marvin J

2016-09-01

Interprofessional education/interprofessional practice (IPE/IPP) is an essential component in medical education and training. A collaborative interprofessional team environment ensures optimal patient-centered care. To describe the implementation of 2 interprofessional antimicrobial stewardship program (ASP) teams using IPE/IPP and to assess the acceptance rate by the primary medical and surgical teams of ASP recommendations for antimicrobial interventions. A business plan for the ASP was approved at 2 academic medical centers used for the present study. During a 3-year study period, 2 interprofessional ASP teams included an attending physician specializing in infectious disease (ID), an ID physician fellow, an ASP pharmacist, physician residents, medical students, pharmacy residents, and pharmacy students. Educational seminars were presented for all adult-admitting physicians to discuss the need for the ASP and the prospective audit and feedback process. Cases were presented for discussion during ASP/ID rounds and recommendations were agreed upon by the ASP team. A motivational interviewing face-to-face technique was frequently used to convey the ASP team recommendation to the primary medical or surgical team in a noncoercive and educational manner. The ASP team recommendations for ASP interventions were documented in the medical records. The overall acceptance rate of recommendations by the primary medical and surgical teams were greater than 90% (2051 of 2266). The most frequent interventions provided were streamline therapy (601), route of administration change (452), bug-drug mismatch (190), and discontinuation of therapy (179). Route of administration change was also the most frequently accepted intervention (96%). The motivational face-to-face communication technique was particularly useful in conveying ASP team member recommendations to the primary medical or surgical teams. Communicating recommendations as a multidisciplinary team in an educational manner seems to have resulted in to greater acceptance of recommendations.

Quality of Communication in Robotic Surgery and Surgical Outcomes.

PubMed

Schiff, Lauren; Tsafrir, Ziv; Aoun, Joelle; Taylor, Andrew; Theoharis, Evan; Eisenstein, David

2016-01-01

Robotic surgery has introduced unique challenges to surgical workflow. The association between quality of communication in robotic-assisted laparoscopic surgery and surgical outcomes was evaluated. After each gynecologic robotic surgery, the team members involved in the surgery completed a survey regarding the quality of communication. A composite quality-of-communication score was developed using principal component analysis. A higher composite quality-of-communication score signified poor communication. Objective parameters, such as operative time and estimated blood loss (EBL), were gathered from the patient's medical record and correlated with the composite quality-of-communication scores. Forty robotic cases from March through May 2013 were included. Thirty-two participants including surgeons, circulating nurses, and surgical technicians participated in the study. A higher composite quality-of-communication score was associated with greater EBL (P = .010) and longer operative time (P = .045), after adjustment for body mass index, prior major abdominal surgery, and uterine weight. Specifically, for every 1-SD increase in the perceived lack of communication, there was an additional 51 mL EBL and a 31-min increase in operative time. The most common reasons reported for poor communication in the operating room were noise level (28/36, 78%) and console-to-bedside communication problems (23/36, 64%). Our study demonstrates a significant association between poor intraoperative team communication and worse surgical outcomes in robotic gynecologic surgery. Employing strategies to decrease extraneous room noise, improve console-to-bedside communication and team training may have a positive impact on communication and related surgical outcomes.

Enhancing communication by using the Coordinated Care Classification System.

PubMed

O'Neal, P V; Kozeny, D K; Garland, P P; Gaunt, S M; Gordon, S C

1998-07-01

Because of the changes in our healthcare system, some clinical nurse specialists (CNSs) are having to expand their traditional roles of clinician, educator, consultant, leader, and researcher to include case management activities. The CNSs at Promina Gwinnett Health System in Lawrenceville, Georgia, have combined CNS and case manager activities and have adopted the title "CNS/Outcomes Coordinator." The CNS/Outcomes Coordinator is responsible for coordinating patient care, promoting team collaboration, and facilitating communication. To inform the healthcare team of the CNS/Outcomes Coordinator's patient responsibilities, the CNS/Outcomes Coordinators developed a Coordinated Care Classification System. This article describes how coordinating patient care, promoting team collaboration, and facilitating communication can be enhanced by the use of a classification system.

Team Knowledge Sharing Intervention Effects on Team Shared Mental Models and Student Performance in an Undergraduate Science Course

ERIC Educational Resources Information Center

Sikorski, Eric G.; Johnson, Tristan E.; Ruscher, Paul H.

2012-01-01

The purpose of this study was to examine the effects of a shared mental model (SMM) based intervention on student team mental model similarity and ultimately team performance in an undergraduate meteorology course. The team knowledge sharing (TKS) intervention was designed to promote team reflection, communication, and improvement planning.…

Knowledge Sharing within Virtual Teams: A Qualitative Case Study of the Role Technology Plays in Team Sharing Practices

ERIC Educational Resources Information Center

Parker, Denise L.

2017-01-01

Virtual teams are comprised of members from various locations who use Information and Communication Technology (ICT) for member interaction. Many organizations have accepted virtual teams as an alternative to face-to-face teams. With the acceptance comes many challenges, one of those challenges is supporting team sharing in the virtual…

Communication Among Incident Responders-A Study

DTIC Science & Technology

2012-09-01

Determine If More Teams Prefer Water or Coca - Cola 5 2.3.1 Description 5 2.3.2 Results 6 2.3.3 Analysis 7 2.4 Task #4: Complete Email Message...participating in this study: <REDACTED> Please determine whether more of these teams prefer Coca - Cola or Water to drink with dinner. Please...needs to express a preference for either water or Coca - Cola . We also did not describe how teams should communicate and tally votes in order to answer our

Interprofessional collaborative reasoning by residents and nurses in internal medicine: Evidence from a simulation study.

PubMed

Blondon, K S; Maître, F; Muller-Juge, V; Bochatay, N; Cullati, S; Hudelson, P; Vu, N V; Savoldelli, G L; Nendaz, M R

2017-04-01

Clinical reasoning has been studied in residents or nurses, using interviews or patient-provider encounters. Despite a growing interest in interprofessional collaboration, the notion of collaborative reasoning has not been well studied in clinical settings. Our study aims at exploring resident-nurse collaborative reasoning in a simulation setting. We enrolled 14 resident-nurse teams from a general internal medicine division in a mixed methods study. Teams each managed one of four acute case scenarios, followed by a stimulated-recall session. A qualitative, inductive analysis of the transcripts identified five dimensions of collaborative reasoning: diagnostic reasoning, patient management, patient monitoring, communication with the patient, and team communication. Three investigators (two senior physicians, one nurse) assessed individual and team performances using a five-point Likert scale, and further extracted elements supporting the collaborative reasoning process. Global assessment of the resident-nurse team was not simply an average of individual performances. Qualitative results underlined the need to improve situational awareness, particularly for task overload. Team communication helped team members stay abreast of each other's thoughts and improve their efficiency. Residents and nurses differed in their reasoning processes, and awareness of this difference may contribute to improving interprofessional collaboration. Understanding collaborative reasoning can provide an additional dimension to interprofessional education.

Tracking Team Dynamic Strategy Implemented in Sly Fox Mission 22

DTIC Science & Technology

communication between team members and track the overall status of the team social dynamic. This paper provides a detailed account of the need, methodology , results, benefits, and limitations of this strategy.

Does leader-affective presence influence communication of creative ideas within work teams?

PubMed

Madrid, Hector P; Totterdell, Peter; Niven, Karen

2016-09-01

Affective presence is a novel, emotion-related personality trait, supported in experimental studies, concerning the extent to which a person makes his or her interaction partners feel the same way (Eisenkraft & Elfenbein, 2010). Applying this concept to an applied teamwork context, we proposed that team-leader-affective presence would influence team members' communication of creative ideas. Multilevel modeling analysis of data from a survey study conducted with teams from a consultancy firm confirmed that team-leader-affective presence interacted with team-member creative idea generation to predict inhibition of voicing their ideas. Specifically, withholding of ideas was less likely when team members generated creative ideas and their team leader had higher positive affective presence or lower negative affective presence. These findings contribute to emotion research by showing affective presence as a trait with interpersonal meaning, which can shape how cognition is translated into social behavior in applied performance contexts, such as teamwork in organizations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Accounting for medical communication: parents' perceptions of communicative roles and responsibilities in the pediatric intensive care unit.

PubMed

Gordon, Cynthia; Barton, Ellen; Meert, Kathleen L; Eggly, Susan; Pollacks, Murray; Zimmerman, Jerry; Anand, K J S; Carcillo, Joseph; Newth, Christopher J L; Dean, J Michael; Willson, Douglas F; Nicholson, Carol

2009-01-01

Through discourse analysis of transcribed interviews conducted over the phone with parents whose child died in the Pediatric Intensive Care Unit (PICU) (n = 51), this study uncovers parents' perceptions of clinicians' and their own communicative roles and responsibilities in the context of team-based care. We examine parents' descriptions and narratives of communicative experiences they had with PICU clinicians, focusing on how parents use accounts to evaluate the communicative behaviors they report (n = 47). Findings indicate that parental perceptions of communicative responsibilities are more nuanced than assumed in previous research: Parents identified their own responsibilities as participating as part of the team of care, gathering information, interacting with appropriate affect, and working to understand complex and uncertain medical information. Complementarily, parents identified clinician responsibilities as communicating professionally, providing medical information clearly, managing parents' hope responsibly, and communicating with appropriate affect. Through the accounts they provide, parents evaluate both parental and clinician role-responsibilities as fulfilled and unfulfilled. Clinicians' management of prognostic uncertainty and parents' struggles to understand that uncertainty emerged as key, complementary themes with practical implications for incorporating parents into the PICU care team. The study also highlights insights retrospective interview data bring to the examination of medical communication.

Using Wikis to Investigate Communication, Collaboration and Engagement in Capstone Engineering Design Projects

ERIC Educational Resources Information Center

Berthoud, L.; Gliddon, J.

2018-01-01

In today's global Aerospace industry, virtual workspaces are commonly used for collaboration between geographically distributed multidisciplinary teams. This study investigated the use of wikis to look at communication, collaboration and engagement in 'Capstone' team design projects at the end of an engineering degree. Wikis were set up for teams…

Team Communication amongst Clinical Teachers in a Formal Meeting of Post Graduate Medical Training

ERIC Educational Resources Information Center

Slootweg, Irene A.; Scherpbier, Albert; van der Leeuw, Renée; Heineman, Maas Jan; van der Vleuten, Cees; Lombarts, Kiki M. J. M. H.

2016-01-01

The importance of team communication, or more specifically speaking up, for safeguarding quality of patient care is increasingly being endorsed in research findings. However, little is known about speaking up of clinical teachers in postgraduate medical training. In order to determine how clinical teachers demonstrate speaking up in formal…

Emotional Intelligence, Communication Competence, and Student Perceptions of Team Social Cohesion

ERIC Educational Resources Information Center

Troth, Ashlea C.; Jordan, Peter J.; Lawrence, Sandra A.

2012-01-01

Students generally report poor experiences of group work in university settings. This study examines whether individual student perceptions of team social cohesion are determined by their level of emotional intelligence (EI) and whether this relationship is mediated by their communication skills. Business students (N = 273) completed the 16-item…

Leadership Trust in Virtual Teams Using Communication Tools: A Quantitative Correlational Study

ERIC Educational Resources Information Center

Clark, Robert Lynn

2014-01-01

The purpose of this quantitative correlational study was to address leadership trust in virtual teams using communication tools in a small south-central, family-owned pharmaceutical organization, with multiple dispersed locations located in the United States. The results of the current research study could assist leaders to develop a communication…

Incorporating Interprofessional Teamwork and Communication into a Concept-Based Curriculum to Promote Transition to Practice

ERIC Educational Resources Information Center

Meekins, Eva M.

2016-01-01

Teamwork and communication are essential concepts for new graduate registered nurses working as members of the interprofessional team. Studies have shown the efficacy of applying these interprofessional education concepts by allowing student nurses to round with health teams before graduation. The innovative practice of rounding significantly…

Identifying collaborative care teams through electronic medical record utilization patterns.

PubMed

Chen, You; Lorenzi, Nancy M; Sandberg, Warren S; Wolgast, Kelly; Malin, Bradley A

2017-04-01

The goal of this investigation was to determine whether automated approaches can learn patient-oriented care teams via utilization of an electronic medical record (EMR) system. To perform this investigation, we designed a data-mining framework that relies on a combination of latent topic modeling and network analysis to infer patterns of collaborative teams. We applied the framework to the EMR utilization records of over 10 000 employees and 17 000 inpatients at a large academic medical center during a 4-month window in 2010. Next, we conducted an extrinsic evaluation of the patterns to determine the plausibility of the inferred care teams via surveys with knowledgeable experts. Finally, we conducted an intrinsic evaluation to contextualize each team in terms of collaboration strength (via a cluster coefficient) and clinical credibility (via associations between teams and patient comorbidities). The framework discovered 34 collaborative care teams, 27 (79.4%) of which were confirmed as administratively plausible. Of those, 26 teams depicted strong collaborations, with a cluster coefficient > 0.5. There were 119 diagnostic conditions associated with 34 care teams. Additionally, to provide clarity on how the survey respondents arrived at their determinations, we worked with several oncologists to develop an illustrative example of how a certain team functions in cancer care. Inferred collaborative teams are plausible; translating such patterns into optimized collaborative care will require administrative review and integration with management practices. EMR utilization records can be mined for collaborative care patterns in large complex medical centers. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Reducing the complexity of NASA's space communications infrastructure

NASA Technical Reports Server (NTRS)

Miller, Raymond E.; Liu, Hong; Song, Junehwa

1995-01-01

This report describes the range of activities performed during the annual reporting period in support of the NASA Code O Success Team - Lifecycle Effectiveness for Strategic Success (COST LESS) team. The overall goal of the COST LESS team is to redefine success in a constrained fiscal environment and reduce the cost of success for end-to-end mission operations. This goal is more encompassing than the original proposal made to NASA for reducing complexity of NASA's Space Communications Infrastructure. The COST LESS team approach for reengineering the space operations infrastructure has a focus on reversing the trend of engineering special solutions to similar problems.

Nursing leadership competencies: low-fidelity simulation as a teaching strategy.

PubMed

Pollard, Cheryl L; Wild, Carol

2014-11-01

Nurses must demonstrate leadership and followership competencies within complex adaptive team environments to ensure patient and staff safety, effective use of resources, and an adaptive health care system. These competencies are demonstrated through the use of communication strategies that are embedded within a relational practice. Health care professionals, regardless of formal position, need to assert their opinions and perspectives using a communication style that demonstrates value of all team members in open discussions about quality patient care, appropriate access, and stewardship. Challenges to effective communication and relational practice are the individual and organizational patterns of behavior, and the subsequent impact that these behaviors have on others. Students articulate situational awareness when they conduct a critical analysis of individual, team, and organizational functioning, and then use this information and evidence gained from a critical literature review to develop recommendations to improve individual, team, and/or organizational performance. Leadership and followership simulation exercises, inclusive of public feedback and debriefing, are used as a pedagogical/andragogical strategy in a nursing baccalaureate senior leadership course to facilitate learning of team communication skills and improve situational awareness. We view this strategy as an alternative to traditional classroom learning activities which provide little opportunity for recursive learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles.

PubMed

Lee, Soo-Hoon; Khanuja, Harpal S; Blanding, Renee J; Sedgwick, Jeanne; Pressimone, Kathleen; Ficke, James R; Jones, Lynne C

2017-10-30

Teamwork training improves short-term teamwork behaviors. However, improvements are often not sustained. The purpose of this study was to explore the extent to which teamwork reinforcement activities for orthopedic surgery teams lead to sustained teamwork behaviors. Seven months after 104 staff from an orthopedic surgical unit were trained in Team Strategies and Tools to Enhance Performance and Patient Safety principles, 4 reinforcement activities were implemented regarding leadership and communication: lectures with videos on leadership skills for nursing staff; an online self-paced learning program on communication skills for nursing staff; a 1-page summary on leadership skills e-mailed to surgical staff; and a 1-hour perioperative grand rounds on Team Strategies and Tools to Enhance Performance and Patient Safety principles for anesthesia staff and new staff. Twenty-four orthopedic surgical teams were evaluated on teamwork behaviors during surgery by 2 observers before and after the reinforcement period using the Observational Teamwork Assessment for Surgery tool. After reinforcement, leadership (P = 0.022) and communication (P = 0.044) behaviors improved compared with prereinforcement levels. Specifically, nursing staff improved in leadership (P = 0.016) and communication (P = 0.028) behaviors, surgical staff improved in leadership behaviors (P = 0.009), but anesthesia staff did not improve in any teamwork behaviors. Sustained improvement in teamwork behaviors requires reinforcement. Level III, prospective pre-post cohort study.

Team Proactivity as a Linking Mechanism between Team Creative Efficacy, Transformational Leadership, and Risk-Taking Norms and Team Creative Performance

ERIC Educational Resources Information Center

Shin, Yuhyung; Eom, Chanyoung

2014-01-01

Despite the growing body of research on creativity in team contexts, very few attempts have been made to explore the team-level antecedents and the mediating processes of team creative performance on the basis of a theoretical framework. To address this gap, drawing on Paulus and Dzindolet's (2008) group creativity model, this study proposed team…

Increasing the Translation of Evidence Into Practice, Policy, and Public Health Improvements: A Framework for Training Health Professionals in Implementation and Dissemination Science

PubMed Central

Gonzales, Ralph; Handley, Margaret A.; Ackerman, Sara; O’Sullivan, Patricia S.

2012-01-01

The authors describe a conceptual framework for implementation and dissemination science (IDS) and propose competencies for IDS training. Their framework is designed to facilitate the application of theories and methods from the distinct domains of clinical disciplines (e.g., medicine, public health), population sciences (e.g., biostatistics, epidemiology) and translational disciplines (e.g., social and behavioral sciences, business administration education). They explore three principles that guided the development of their conceptual framework: Behavior change among organizations and/or individuals (providers, patients) is inherent in the translation process; engagement of stakeholder organizations, health care delivery systems, and individuals is imperative to achieve effective translation and sustained improvements; and IDS research is iterative, benefiting from cycles and collaborative, bidirectional relationships. The authors propose seven domains for IDS training--team science, context identification, literature identification and assessment, community engagement, intervention design and research implementation, evaluation of effect of translational activity, behavioral change communication strategies--and define twelve IDS training competencies within these domains. As a model, they describe specific courses introduced at the University of California, San Francisco, which they designed to develop these competencies. The authors encourage other training programs and institutions to use (or adapt) the design principles, conceptual framework, And proposed competencies to evaluate their current IDS training needs and to support new program development. PMID:22373617

A web-based team-oriented medical error communication assessment tool: development, preliminary reliability, validity, and user ratings.

PubMed

Kim, Sara; Brock, Doug; Prouty, Carolyn D; Odegard, Peggy Soule; Shannon, Sarah E; Robins, Lynne; Boggs, Jim G; Clark, Fiona J; Gallagher, Thomas

2011-01-01

Multiple-choice exams are not well suited for assessing communication skills. Standardized patient assessments are costly and patient and peer assessments are often biased. Web-based assessment using video content offers the possibility of reliable, valid, and cost-efficient means for measuring complex communication skills, including interprofessional communication. We report development of the Web-based Team-Oriented Medical Error Communication Assessment Tool, which uses videotaped cases for assessing skills in error disclosure and team communication. Steps in development included (a) defining communication behaviors, (b) creating scenarios, (c) developing scripts, (d) filming video with professional actors, and (e) writing assessment questions targeting team communication during planning and error disclosure. Using valid data from 78 participants in the intervention group, coefficient alpha estimates of internal consistency were calculated based on the Likert-scale questions and ranged from α=.79 to α=.89 for each set of 7 Likert-type discussion/planning items and from α=.70 to α=.86 for each set of 8 Likert-type disclosure items. The preliminary test-retest Pearson correlation based on the scores of the intervention group was r=.59 for discussion/planning and r=.25 for error disclosure sections, respectively. Content validity was established through reliance on empirically driven published principles of effective disclosure as well as integration of expert views across all aspects of the development process. In addition, data from 122 medicine and surgical physicians and nurses showed high ratings for video quality (4.3 of 5.0), acting (4.3), and case content (4.5). Web assessment of communication skills appears promising. Physicians and nurses across specialties respond favorably to the tool.

Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction.

PubMed

Gausvik, Christian; Lautar, Ashley; Miller, Lisa; Pallerla, Harini; Schlaudecker, Jeffrey

2015-01-01

Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR) on an acute care for the elderly (ACE) unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer patient care. These results point to the interconnectedness and dual benefit to both job satisfaction and patient quality of care that can come from enhancements to team communication.

Human-Autonomy Teaming in a Flight Following Task

NASA Technical Reports Server (NTRS)

Shively, Robert J.

2017-01-01

The NATO HFM-247 Working Group is creating a summary report of the group's activities on human-autonomy teaming. This chapter is a summary of our at NASA Ames work toward developing a framework for human-autonomy teaming (HAT) in aviation. The purpose of this project was to demonstrate and evaluate proposed tenets of HAT. The HAT features were derived from three tenets and were built into an automated recommender system on a ground station. These tenets include bi-directional communication, automation transparency, and operator directed interface. This study focused primarily on interactions with one piece of automation, the Autonomous Constrained Flight Planner (ACFP). The ACFP is designed to support rapid diversion decisions for commercial pilots in off-nominal situations. Much effort has gone into enhancing this tool not only in capability but also in transparency. In this study, participants used the ACFP at a ground station designed to aid dispatchers in a flight following role to reroute aircraft in situations such as inclement weather, system failures and medical emergencies. Participants performed this task both with HAT features enabled and without and provided feedback. We examined subjective and behavioral indicators of HAT collaborations using a proof-of-concept demonstration of HAT tenets. The data collected suggest potential advantages and disadvantages of HAT.

NASA Work Breakdown Structure (WBS) Handbook

NASA Technical Reports Server (NTRS)

Fleming, Jon F.; Poole, Kenneth W.

2016-01-01

The purpose of this document is to provide program/project teams necessary instruction and guidance in the best practices for Work Breakdown Structure (WBS) and WBS dictionary development and use for project implementation and management control. This handbook can be used for all types of NASA projects and work activities including research, development, construction, test and evaluation, and operations. The products of these work efforts may be hardware, software, data, or service elements (alone or in combination). The aim of this document is to assist project teams in the development of effective work breakdown structures that provide a framework of common reference for all project elements. The WBS and WBS dictionary are effective management processes for planning, organizing, and administering NASA programs and projects. The guidance contained in this document is applicable to both in-house, NASA-led effort and contracted effort. It assists management teams from both entities in fulfilling necessary responsibilities for successful accomplishment of project cost, schedule, and technical goals. Benefits resulting from the use of an effective WBS include, but are not limited to: providing a basis for assigned project responsibilities, providing a basis for project schedule and budget development, simplifying a project by dividing the total work scope into manageable units, and providing a common reference for all project communication.

Work Breakdown Structure (WBS) Handbook

NASA Technical Reports Server (NTRS)

2010-01-01

The purpose of this document is to provide program/project teams necessary instruction and guidance in the best practices for Work Breakdown Structure (WBS) and WBS dictionary development and use for project implementation and management control. This handbook can be used for all types of NASA projects and work activities including research, development, construction, test and evaluation, and operations. The products of these work efforts may be hardware, software, data, or service elements (alone or in combination). The aim of this document is to assist project teams in the development of effective work breakdown structures that provide a framework of common reference for all project elements. The WBS and WBS dictionary are effective management processes for planning, organizing, and administering NASA programs and projects. The guidance contained in this document is applicable to both in-house, NASA-led effort and contracted effort. It assists management teams from both entities in fulfilling necessary responsibilities for successful accomplishment of project cost, schedule, and technical goals. Benefits resulting from the use of an effective WBS include, but are not limited to: providing a basis for assigned project responsibilities, providing a basis for project schedule development, simplifying a project by dividing the total work scope into manageable units, and providing a common reference for all project communication.

Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

PubMed

Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

2018-05-23

The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

Targeting communication interventions to decrease oncology family caregiver burden

PubMed Central

Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

2012-01-01

Objectives The goal of this paper was to articulate and describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Data Sources Case studies of oncology family caregivers and hospice patients were selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Conclusion Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. Implications for Nursing Practice By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid patient, family, and team to best optimize all quality of life domains for patient as well as the lead family caregiver. PMID:23107184

Entrepreneurial Thinking in Interdisciplinary Student Teams

ERIC Educational Resources Information Center

Neumeyer, Xaver; McKenna, Ann

2016-01-01

Our work investigates students' perception of collaborative expertise and the role of inquiry-based learning in the context of team-based entrepreneurship education. Specifically, we examine students' perception of communication, division of work, shared goals, team conflicts and leadership in their respective teams. In addition, we look at the…

Provider perceptions of knowledge exchange and communication in a multisite family health team

PubMed Central

Slater, Morgan; Nicholas, Emily; Leung, Fok-Han; Lofters, Aisha

2016-01-01

Abstract Objective To describe providers’ self-reported knowledge and use of family health team (FHT) services and to explore attitudes and perspectives about communication issues among health care professionals active within a large multisite FHT. Design Electronic questionnaire. Setting A multisite FHT in Toronto, Ont. Participants Health care professionals active within the FHT (N = 90). Main outcome measures The survey captured demographic characteristics, including the respondents’ roles and experience; knowledge about services available within the FHT; use of services; and perceived communication issues within the FHT. Results Forty-six health care professionals participated (51% response rate). While respondents were highly aware of the clinical resources and services offered at their own site of practice (95% agreed or strongly agreed), only 54% were aware of services offered at other sites within the FHT. Internal referrals for certain specialty services were high (ie, methadone management, obstetric care, intrauterine device insertion, and psychiatry), but less than 50% of other referrals (ie, sports medicine, joint injections, or tropical medicine) were to physicians within the FHT, despite physicians within the FHT offering services in these areas of expertise. Only 60% of respondents believed that patients had equal access to all of the services within the FHT, and 42% agreed or strongly agreed that patients were unlikely to travel between sites to access services. Roughly one-quarter of respondents believed that physicians were unlikely to refer patients to another site within the FHT to receive health care services. Most respondents agreed that the geographic distribution of the sites negatively affected communication within the FHT (68% agreed or strongly agreed). Conclusion Geographic dispersion of team members in a multisite FHT had a negative effect on provider knowledge of available services, perceived patient access to services, and communication within the team. As most FHTs are spread across multiple locations, finding ways to improve communication among team members will be key to maximizing the effectiveness of the patient care provided by these team-based models.

In the Loop: The Organization of Team-Based Communication in a Patient-Centered Clinical Collaboration System.

PubMed

Kurahashi, Allison M; Weinstein, Peter B; Jamieson, Trevor; Stinson, Jennifer N; Cafazzo, Joseph A; Lokuge, Bhadra; Morita, Plinio P; Cohen, Eyal; Rapoport, Adam; Bezjak, Andrea; Husain, Amna

2016-03-24

We describe the development and evaluation of a secure Web-based system for the purpose of collaborative care called Loop. Loop assembles the team of care with the patient as an integral member of the team in a secure space. The objectives of this paper are to present the iterative design of the separate views for health care providers (HCPs) within each patient's secure space and examine patients', caregivers', and HCPs' perspectives on this separate view for HCP-only communication. The overall research program includes cycles of ethnography, prototyping, usability testing, and pilot testing. This paper describes the usability testing phase that directly informed development. A descriptive qualitative approach was used to analyze participant perspectives that emerged during usability testing. During usability testing, we sampled 89 participants from three user groups: 23 patients, 19 caregivers, and 47 HCPs. Almost all perspectives from the three user groups supported the need for an HCP-only communication view. In an earlier prototype, the visual presentation caused confusion among HCPs when reading and composing messages about whether a message was visible to the patient. Usability testing guided us to design a more deliberate distinction between posting in the Patient and Team view and the Health Care Provider Only view at the time of composing a message, which once posted is distinguished by an icon. The team made a decision to incorporate an HCP-only communication view based on findings during earlier phases of work. During usability testing we tested the separate communication views, and all groups supported this partition. We spent considerable effort designing the partition; however, preliminary findings from the next phase of evaluation, pilot testing, show that the Patient and Team communication is predominantly being used. This demonstrates the importance of a subsequent phase of the clinical trial of Loop to validate the concept and design.

Assessing Team Learning in Technology-Mediated Collaboration: An Experimental Study

ERIC Educational Resources Information Center

Andres, Hayward P.; Akan, Obasi H.

2010-01-01

This study examined the effects of collaboration mode (collocated versus non-collocated videoconferencing-mediated) on team learning and team interaction quality in a team-based problem solving context. Situated learning theory and the theory of affordances are used to provide a framework that describes how technology-mediated collaboration…

Key Determinants of Student Satisfaction When Undertaking Group Work

ERIC Educational Resources Information Center

Pang, Elvy; Tong, Canon; Wong, Anthony

2011-01-01

The increasing popularity of team structures in business environment coupled with the common practice of including group projects/assignments in university curricula means that business schools should direct efforts towards maximizing team as well as personal results. Yet, most frameworks for studying teams center exclusively on team level…

Using systems thinking to support clinical system transformation.

PubMed

Best, Allan; Berland, Alex; Herbert, Carol; Bitz, Jennifer; van Dijk, Marlies W; Krause, Christina; Cochrane, Douglas; Noel, Kevin; Marsden, Julian; McKeown, Shari; Millar, John

2016-05-16

Purpose - The British Columbia Ministry of Health's Clinical Care Management initiative was used as a case study to better understand large-scale change (LSC) within BC's health system. Using a complex system framework, the purpose of this paper is to examine mechanisms that enable and constrain the implementation of clinical guidelines across various clinical settings. Design/methodology/approach - Researchers applied a general model of complex adaptive systems plus two specific conceptual frameworks (realist evaluation and system dynamics mapping) to define and study enablers and constraints. Focus group sessions and interviews with clinicians, executives, managers and board members were validated through an online survey. Findings - The functional themes for managing large-scale clinical change included: creating a context to prepare clinicians for health system transformation initiatives; promoting shared clinical leadership; strengthening knowledge management, strategic communications and opportunities for networking; and clearing pathways through the complexity of a multilevel, dynamic system. Research limitations/implications - The action research methodology was designed to guide continuing improvement of implementation. A sample of initiatives was selected; it was not intended to compare and contrast facilitators and barriers across all initiatives and regions. Similarly, evaluating the results or process of guideline implementation was outside the scope; the methods were designed to enable conversations at multiple levels - policy, management and practice - about how to improve implementation. The study is best seen as a case study of LSC, offering a possible model for replication by others and a tool to shape further dialogue. Practical implications - Recommended action-oriented strategies included engaging local champions; supporting local adaptation for implementation of clinical guidelines; strengthening local teams to guide implementation; reducing change fatigue; ensuring adequate resources; providing consistent communication especially for front-line care providers; and supporting local teams to demonstrate the clinical value of the guidelines to their colleagues. Originality/value - Bringing a complex systems perspective to clinical guideline implementation resulted in a clear understanding of the challenges involved in LSC.

Anchoring interprofessional education in undergraduate curricula: The Heidelberg story.

PubMed

Berger, Sarah; Goetz, Katja; Leowardi-Bauer, Christina; Schultz, Jobst-Hendrik; Szecsenyi, Joachim; Mahler, Cornelia

2017-03-01

The ability of health professionals to collaborate effectively has significant potential impact on patient safety and quality-care outcomes, especially given the increasingly complex and dynamic clinical practice environments of today. Educators of the health professions are faced with an immediate challenge to adapt curricula and traditional teaching methods to ensure graduates are equipped with the necessary interprofessional competencies and (inter)professional values for their future practice. The World Health Organization's "Framework for action in interprofessional education (IPE) and collaborative practice" promotes IPE as a key strategy to enhance patient outcomes by preparing a "collaborative practice-ready health workforce." Logistical and attitudinal barriers can hinder integration of IPE into curricula. Lessons learned through the implementation of a planned change to establish four interprofessional seminars (team communication, medical error communication, healthcare English, and small business management) at Heidelberg University Medical Faculty, Germany, are described. A key factor in successfully anchoring IPE seminars in the undergraduate curricula was the structured approach drawing on change management concepts.

The New NGSS Classroom: A Curriculum Framework for Project-Based Science Learning

ERIC Educational Resources Information Center

Holthuis, Nicole; Deutscher, Rebecca; Schultz, Susan E.; Jamshidi, Arash

2018-01-01

As schools work to implement the Next Generation Science Standards (NGSS), a team at Stanford University found that project-based learning is an effective framework for engaging students. The team used project-based learning, group activities, and performance-based assessments to design an effective, engaging curriculum. Over a three-year period,…

Grasping the Dynamic Complexity of Team Learning: An Integrative Model for Effective Team Learning in Organisations

ERIC Educational Resources Information Center

Decuyper, Stefan; Dochy, Filip; Van den Bossche, Piet

2010-01-01

In this article we present an integrative model of team learning. Literature shows that effective team learning requires the establishment of a dialogical space amongst team members, in which communicative behaviours such as "sharing", "co-construction" and "constructive conflict" are balanced. However, finding this balance is not enough.…

An integrated computer-based procedure for teamwork in digital nuclear power plants.

PubMed

Gao, Qin; Yu, Wenzhu; Jiang, Xiang; Song, Fei; Pan, Jiajie; Li, Zhizhong

2015-01-01

Computer-based procedures (CBPs) are expected to improve operator performance in nuclear power plants (NPPs), but they may reduce the openness of interaction between team members and harm teamwork consequently. To support teamwork in the main control room of an NPP, this study proposed a team-level integrated CBP that presents team members' operation status and execution histories to one another. Through a laboratory experiment, we compared the new integrated design and the existing individual CBP design. Sixty participants, randomly divided into twenty teams of three people each, were assigned to the two conditions to perform simulated emergency operating procedures. The results showed that compared with the existing CBP design, the integrated CBP reduced the effort of team communication and improved team transparency. The results suggest that this novel design is effective to optim team process, but its impact on the behavioural outcomes may be moderated by more factors, such as task duration. The study proposed and evaluated a team-level integrated computer-based procedure, which present team members' operation status and execution history to one another. The experimental results show that compared with the traditional procedure design, the integrated design reduces the effort of team communication and improves team transparency.

Multidisciplinary crisis simulations: the way forward for training surgical teams.

PubMed

Undre, Shabnam; Koutantji, Maria; Sevdalis, Nick; Gautama, Sanjay; Selvapatt, Nowlan; Williams, Samantha; Sains, Parvinderpal; McCulloch, Peter; Darzi, Ara; Vincent, Charles

2007-09-01

High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.

Patient Centeredness in Electronic Communication: Evaluation of Patient-to-Health Care Team Secure Messaging

PubMed Central

Luger, Tana M; Volkman, Julie E; Rocheleau, Mary; Mueller, Nora; Barker, Anna M; Nazi, Kim M; Houston, Thomas K; Bokhour, Barbara G

2018-01-01

Background As information and communication technology is becoming more widely implemented across health care organizations, patient-provider email or asynchronous electronic secure messaging has the potential to support patient-centered communication. Within the medical home model of the Veterans Health Administration (VA), secure messaging is envisioned as a means to enhance access and strengthen the relationships between veterans and their health care team members. However, despite previous studies that have examined the content of electronic messages exchanged between patients and health care providers, less research has focused on the socioemotional aspects of the communication enacted through those messages. Objective Recognizing the potential of secure messaging to facilitate the goals of patient-centered care, the objectives of this analysis were to not only understand why patients and health care team members exchange secure messages but also to examine the socioemotional tone engendered in these messages. Methods We conducted a cross-sectional coding evaluation of a corpus of secure messages exchanged between patients and health care team members over 6 months at 8 VA facilities. We identified patients whose medical records showed secure messaging threads containing at least 2 messages and compiled a random sample of these threads. Drawing on previous literature regarding the analysis of asynchronous, patient-provider electronic communication, we developed a coding scheme comprising a series of a priori patient and health care team member codes. Three team members tested the scheme on a subset of the messages and then independently coded the sample of messaging threads. Results Of the 711 messages coded from the 384 messaging threads, 52.5% (373/711) were sent by patients and 47.5% (338/711) by health care team members. Patient and health care team member messages included logistical content (82.6%, 308/373 vs 89.1%, 301/338), were neutral in tone (70.2%, 262/373 vs 82.0%, 277/338), and respectful in nature (25.7%, 96/373 vs 33.4%, 113/338). Secure messages from health care team members sometimes appeared hurried (25.4%, 86/338) but also displayed friendliness or warmth (18.9%, 64/338) and reassurance or encouragement (18.6%, 63/338). Most patient messages involved either providing or seeking information; however, the majority of health care team member messages involved information provision in response to patient questions. Conclusions This evaluation is an important step toward understanding the content and socioemotional tone that is part of the secure messaging exchanges between patients and health care team members. Our findings were encouraging; however, there are opportunities for improvement. As health care organizations seek to supplement traditional encounters with virtual care, they must reexamine their use of secure messaging, including the patient centeredness of the communication, and the potential for more proactive use by health care team members. PMID:29519774

Communication Research in Aviation and Space Operations: Symptoms and Strategies of Crew Coordination

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.; Hart, Sandra G. (Technical Monitor)

1994-01-01

The day-to-day operators of today's aerospace systems work under increasing pressures to accomplish more with less. They work in operational systems which are complex, technology-based, and high-risk; in which incidents and accidents have far-reaching and costly consequences. For these and other reasons, there is concern that the safety net formerly built upon redundant systems and abundant resources may become overburdened. Although we know that human ingenuity can overcome incredible odds, human nature can also fail in unpredictable ways. Over the last 20 years, a large percentage of aviation accidents and incidents have been attributed to human errors rather than hardware or environmental factors alone. A class of errors have been identified which are not due to a lack of individual, technical competencies. Rather, they are due to the failure of teams to utilize readily available resources or information in a timely fashion. These insights began a training revolution in the aviation industry called Cockpit Resource Management, which later became known as Crew Resource Management (CRM) as its concepts and applications extended to teams beyond the flightdeck. Then, as now, communication has been a cornerstone in CRM training since crew coordination and resource management largely resides within information transfer processes--both within flightcrews, and between flightcrews and the ground operations teams that support them. The research I will describe takes its roots in CRM history as we began to study communication processes in order to discover symptoms of crew coordination problems, as well as strategies of effective crew management. On the one hand, communication is often the means or the tool by which team members manage their resources, solve problems, maintain situational awareness and procedural discipline. Conversely, it is the lack of planning and resource management, loss of vigilance and situational awareness, and non-standard communications that are implicated in accidents and incidents. NASA/Ames Crew Factors researchers have been developing a model of effective crew coordination in order to understand the sources of performance breakdowns, and to develop effective solutions and interventions. Because communication is a primary mechanism by which information is received and transmitted, and because it is observable behavior, we focus on these group processes in order to identify patterns of communication that distinguish effective from less effective crew performance. Since a prime objective is to develop training recommendations for enhancing communication skills, we interpret our findings in the context of relevant task and environmental conditions, role and procedural constraints, and the normal real-time parameters of flight operations. Another research objective is to consider how communication and coordination can be enhanced through design. For example, flight deck and hardware design as well as procedural and software design may greatly influence the efficiency with which crews communicate and coordinate their work. In addition, teams and tasks may be designed, organized, and trained so that team interactions with each other are based upon appropriately shared knowledge, procedures and situation awareness. In short, we are interested in enhancing communication practices through (1) the training of specific communication skills, and (2) the design of equipment, tasks, procedures, and teams that optimize smooth, unambiguous communication processes. Two examples of communication research will be described; one in aviation and one in space operations. The first example is a high-fidelity full mission simulation study which investigates the affect of flightdeck automation on crew coordination and communication (contrasting crew performance in the DC-9 vs. MD88). Additional information is contained in the original extended abstract.

Communication as a Strategic Activity (Invited)

NASA Astrophysics Data System (ADS)

Fischhoff, B.

2010-12-01

Effective communication requires preparation. The first step is explicit analysis of the decisions faced by audience members, in order to identify the facts essential to their choices. The second step is assessing their current beliefs, in order to identify the gaps in their understanding, as well as their natural ways of thinking. The third step is drafting communications potentially capable of closing those gaps, taking advantage of the relevant behavioral science. The fourth step is empirically evaluating those communications, refining them as necessary. The final step is communicating through trusted channels, capable of getting the message out and receiving needed feedback. Executing these steps requires a team involving subject matter experts (for ensuring that the science is right), decision analysts (for identifying the decision-critical facts), behavioral scientists (for designing and evaluating messages), and communication specialists (for creating credible channels). Larger organizations should be able to assemble those teams and anticipate their communication needs. However, even small organizations, individuals, or large organizations that have been caught flat-footed can benefit from quickly assembling informal teams, before communicating in ways that might undermine their credibility. The work is not expensive, but does require viewing communication as a strategic activity, rather than an afterthought. The talk will illustrate the science base, with a few core research results; note the risks of miscommunication, with a few bad examples; and suggest the opportunities for communication leadership, focusing on the US Food and Drug Administration.

The impact of structuring multidisciplinary team conferences mediated by ICT in the treatment of patients with rheumatic diseases.

PubMed

Verhoef, J; Toussaint, P J; Vliet Vlieland, T P M; Zwetsloot-Schonk, J H M

2004-01-01

Communication processes are pervasive in the daily practice of health professionals. Reorganizing these daily practices by introducing ICT, inevitably effects one or more communication processes. Understanding exactly what these effects are, is a major problem in designing and implementing ICT-applications. In this paper we present an analysis of these effects, based on a theory of communication processes. The concept of 'decoupling' is pivotal in our analysis. Based on the identified effects, and some preconditions that have to be met in order for these effects to take place, we derive a number of guidelines for reorganizing communication processes by means of applying ICT. The application of these quidelines will be demonstrated and discussed in the context of the reorganization of a team conference at the Rehabilitation Clinic of the Rheumatology Department of the Leiden University Medical Center (RCRD/LUMC), a multidisciplinary team care setting.

Interprofessional communication and medical error: a reframing of research questions and approaches.

PubMed

Varpio, Lara; Hall, Pippa; Lingard, Lorelei; Schryer, Catherine F

2008-10-01

Progress toward understanding the links between interprofessional communication and issues of medical error has been slow. Recent research proposes that this delay may result from overlooking the complexities involved in interprofessional care. Medical education initiatives in this domain tend to simplify the complexities of team membership fluidity, rotation, and use of communication tools. A new theoretically informed research approach is required to take into account these complexities. To generate such an approach, we review two theories from the social sciences: Activity Theory and Knotworking. Using these perspectives, we propose that research into interprofessional communication and medical error can develop better understandings of (1) how and why medical errors are generated and (2) how and why gaps in team defenses occur. Such complexities will have to be investigated if students and practicing clinicians are to be adequately prepared to work safely in interprofessional teams.

Concurrent enterprise: a conceptual framework for enterprise supply-chain network activities

NASA Astrophysics Data System (ADS)

Addo-Tenkorang, Richard; Helo, Petri T.; Kantola, Jussi

2017-04-01

Supply-chain management (SCM) in manufacturing industries has evolved significantly over the years. Recently, a lot more relevant research has picked up on the development of integrated solutions. Thus, seeking a collaborative optimisation of geographical, just-in-time (JIT), quality (customer demand/satisfaction) and return-on-investment (profits), aspects of organisational management and planning through 'best practice' business-process management - concepts and application; employing system tools such as certain applications/aspects of enterprise resource planning (ERP) - SCM systems information technology (IT) enablers to enhance enterprise integrated product development/concurrent engineering principles. This article assumed three main organisation theory applications in positioning its assumptions. Thus, proposing a feasible industry-specific framework not currently included within the SCOR model's level four (4) implementation level, as well as other existing SCM integration reference models such as in the MIT process handbook's - Process Interchange Format (PIF), the TOVE project, etc. which could also be replicated in other SCs. However, the wider focus of this paper's contribution will be concentrated on a complimentary proposed framework to the SCC's SCOR reference model. Quantitative empirical closed-ended questionnaires in addition to the main data collected from a qualitative empirical real-life industrial-based pilot case study were used: To propose a conceptual concurrent enterprise framework for SCM network activities. This research adopts a design structure matrix simulation approach analysis to propose an optimal enterprise SCM-networked value-adding, customised master data-management platform/portal for efficient SCM network information exchange and an effective supply-chain (SC) network systems-design teams' structure. Furthermore, social network theory analysis will be employed in a triangulation approach with statistical correlation analysis to assess the scale/level of frequency, importance, level of collaborative-ness, mutual trust as well as roles and responsibility among the enterprise SCM network for systems product development (PD) design teams' technical communication network as well as extensive literature reviews.

Examining the Impact of Collaboration Technology Training Support on Virtual Team Collaboration Effectiveness

ERIC Educational Resources Information Center

Wright, Sharon L.

2013-01-01

Businesses and governmental agencies are increasingly reliant on virtual teams composed of team members in different location. However, such virtual teams face all the interpersonal challenges inherent in working in a group, plus additional challenges that are a consequence from communicating through electronic methods. Numerous technological…

Listening and Legos[TM

ERIC Educational Resources Information Center

Morris, Pamela

2012-01-01

This simple exercise, performed in teams, gives students practice in listening to instructions, particularly when there are restrictions for the communication. The teams compete in a limited amount of time to build a Lego[TM] structure based on the instructions of one team member. Which team listens the best and is most successful?

How Virtual Team Leaders Cope with Creativity Challenges

ERIC Educational Resources Information Center

Han, Soo Jeoung; Chae, Chungil; Macko, Patricia; Park, Woongbae; Beyerlein, Michael

2017-01-01

Purpose: As technology-mediated communication improves, many organizations increasingly use new types of collaborative online tools to promote team-based learning and performance. The purpose of this study is to explore how virtual team leaders cope with process challenges in developing a context for team creativity. Design/methodology/approach:…

Student Accountability in Team-Based Learning Classes

ERIC Educational Resources Information Center

Stein, Rachel E.; Colyer, Corey J.; Manning, Jason

2016-01-01

Team-based learning (TBL) is a form of small-group learning that assumes stable teams promote accountability. Teamwork promotes communication among members; application exercises promote active learning. Students must prepare for each class; failure to do so harms their team's performance. Therefore, TBL promotes accountability. As part of the…

Implementation of an in situ qualitative debriefing tool for resuscitations.

PubMed

Mullan, Paul C; Wuestner, Elizabeth; Kerr, Tarra D; Christopher, Daniel P; Patel, Binita

2013-07-01

Multiple guidelines recommend debriefing of resuscitations to improve clinical performance. We implemented a novel standardized debriefing program using a Debriefing In Situ Conversation after Emergent Resuscitation Now (DISCERN) tool. Following the development of the evidence-based DISCERN tool, we conducted an observational study of all resuscitations (intubation, CPR, and/or defibrillation) at a pediatric emergency department (ED) over one year. Resuscitation interventions, patient survival, and physician team leader characteristics were analyzed as predictors for debriefing. Each debriefing's participants, time duration, and content were recorded. Thematic content of debriefings was categorized by framework approach into Team Emergency Assessment Measure (TEAM) elements. There were 241 resuscitations and 63 (26%) debriefings. A higher proportion of debriefings occurred after CPR (p<0.001) or ED death (p<0.001). Debriefing participants always included an attending and nurse; the median number of staff roles present was six. Median intervals (from resuscitation end to start of debriefing) & debriefing durations were 33 (IQR 15, 67) and 10 min (IQR 5, 12), respectively. Common TEAM themes included co-operation/coordination (30%), communication (22%), and situational awareness (15%). Stated reasons for not debriefing included: unnecessary (78%), time constraints (19%), or other reasons (3%). Debriefings with the DISCERN tool usually involved higher acuity resuscitations, involved most of the indicated personnel, and lasted less than 10 min. Future studies are needed to evaluate the tool for adaptation to other settings and potential impacts on education, quality improvement programming, and staff emotional well-being. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

An analysis of the Research Team-Service User relationship from the Service User perspective: a consideration of 'The Three Rs' (Roles, Relations, and Responsibilities) for healthcare research organisations.

PubMed

Jordan, Melanie; Rowley, Emma; Morriss, Richard; Manning, Nick

2015-12-01

This article debates interview data from service users who engaged with the work of a Collaboration for Leadership in Applied Health Research and Care (CLAHRC). The evidence base, to date, concerning the nature of CLAHRC work at the frontline (i.e. What is it actually like to do CLAHRC work?) is meagre; thus, this article represents an original contribution to that literature. Further, this article analyses service users' participation in research - as members of the research team - and so contributes to the body of developing literature regarding involvement too. This article explores the nature of the Research Team-Service User relationship, plus associated roles, relations and responsibilities of collaborative health research. Qualitative social science research was undertaken in a health-care research organization utilizing interview method and a medical sociology and organizational sociology theoretical framework for analysis. Data utilized originate from a larger evaluation study that focuses on the CLAHRC as an iterative organization and explores members' experiences. There can be a disparity between initial expectations and actual experiences of involvement for service users. Therefore, as structured via 'The Three Rs' (Roles, Relations and Responsibilities), aspects of the relationship are evaluated (e.g. motivation, altruism, satisfaction, transparency, scope, feedback, communication, time). Regarding the inclusion of service users in health research teams, a careful consideration of 'The Three Rs' is required to ensure expectations match experiences. © 2014 John Wiley & Sons Ltd.

Using Cooperative Teams-Game-Tournament in 11 Religious School to Improve Mathematics Understanding and Communication

ERIC Educational Resources Information Center

Veloo, Arsaythamby; Md-Ali, Ruzlan; Chairany, Sitie

2016-01-01

Purpose: This paper was part of a larger study which looked into the effect of implementing Cooperative Teams-Games-Tournament (TGT) on understanding of and communication in mathematics. The study had identified the main and interaction effect of using Cooperative TGT for learning mathematics in religious secondary school classrooms. A…

A Point to Share: Streamlining Access Services Workflow through Online Collaboration, Communication, and Storage with Microsoft SharePoint

ERIC Educational Resources Information Center

Diffin, Jennifer; Chirombo, Fanuel; Nangle, Dennis; de Jong, Mark

2010-01-01

This article explains how the document management team (circulation and interlibrary loan) at the University of Maryland University College implemented Microsoft's SharePoint product to create a central hub for online collaboration, communication, and storage. Enhancing the team's efficiency, organization, and cooperation was the primary goal.…

The Effects of Communicative Genres on Intra-Group Conflict in Virtual Student Teams

ERIC Educational Resources Information Center

Hsu, Jung-Lung; Chou, Huey-Wen

2009-01-01

With increasing convenience and prevalence, the distant communication application has become a promising way for individuals who are eager to cooperate and interact virtually. This study explored the question of whether the collaborative interaction of the virtual teams has any effect on the conflict and network structure of virtual groups. A…

The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality.

PubMed

Fennell, Mary L; Das, Irene Prabhu; Clauser, Steven; Petrelli, Nicholas; Salner, Andrew

2010-01-01

Quality cancer treatment depends upon careful coordination between multiple treatments and treatment providers, the exchange of technical information, and regular communication between all providers and physician disciplines involved in treatment. This article will examine a particular type of organizational structure purported to regularize and streamline the communication between multiple specialists and support services involved in cancer treatment: the multidisciplinary treatment care (MDC) team. We present a targeted review of what is known about various types of MDC team structures and their impact on the quality of treatment care, and we outline a conceptual model of the connections between team context, structure, process, and performance and their subsequent effects on cancer treatment care processes and patient outcomes. Finally, we will discuss future research directions to understand how MDC teams improve patient outcomes and how characteristics of team structure, culture, leadership, and context (organizational setting and local environment) contribute to optimal multidisciplinary cancer care.

Technical discussions on Emissions and Atmospheric Modeling (TEAM)

NASA Astrophysics Data System (ADS)

Frost, G. J.; Henderson, B.; Lefer, B. L.

2017-12-01

A new informal activity, Technical discussions on Emissions and Atmospheric Modeling (TEAM), aims to improve the scientific understanding of emissions and atmospheric processes by leveraging resources through coordination, communication and collaboration between scientists in the Nation's environmental agencies. TEAM seeks to close information gaps that may be limiting emission inventory development and atmospheric modeling and to help identify related research areas that could benefit from additional coordinated efforts. TEAM is designed around webinars and in-person meetings on particular topics that are intended to facilitate active and sustained informal communications between technical staff at different agencies. The first series of TEAM webinars focuses on emissions of nitrogen oxides, a criteria pollutant impacting human and ecosystem health and a key precursor of ozone and particulate matter. Technical staff at Federal agencies with specific interests in emissions and atmospheric modeling are welcome to participate in TEAM.

Implementing augmentative and alternative communication in inclusive educational settings: a case study.

PubMed

Stoner, Julia B; Angell, Maureen E; Bailey, Rita L

2010-06-01

The purpose of this study was to describe a single case of augmentative and alternative communication (AAC) implementation. Case study methodology was used to describe the perspectives of educational team members regarding AAC implementation for Joey, a high school junior with athetoid cerebral palsy. Benefits included greater intelligibility for Joey and subsequent comfort of the staff. Facilitators of Joey's AAC system use included the team's student-focused disposition and willingness to implement use of the device, Joey's increased intelligibility, peers' acceptance of the technology, and the resulting increase in Joey's socialization. Limited team cohesiveness, problem solving, and communication were the true barriers in this case. Implications of these facilitators and barriers are discussed and recommendations for school-based AAC implementation are made.

Building the office team: what's the payoff?

PubMed

Anthony, Carol; Marcelo, Karen

2007-01-01

Bogged down in the everyday mire of a busy medical practice with multiple locations, a management team was faced with issues of cohesiveness, employee morale, and communication. Enter an outside facilitator who, with the executive director and president of the organization, developed a plan for a management retreat and subsequent monthly management meetings. The results were nothing short of astonishing, with a shared vision and goals communicated throughout the organization, communication being consciously expanded to all locations, and palpable physician support of employees.

Anxiety at the first radiotherapy session for non-metastatic breast cancer: key communication and communication-related predictors.

PubMed

Lewis, Florence; Merckaert, Isabelle; Liénard, Aurore; Libert, Yves; Etienne, Anne-Marie; Reynaert, Christine; Slachmuylder, Jean-Louis; Scalliet, Pierre; Van Houtte, Paul; Coucke, Philippe; Salamon, Emile; Razavi, Darius

2015-01-01

Patients may experience clinically relevant anxiety at their first radiotherapy (RT) sessions. To date, studies have not investigated during/around the RT simulation the key communication and communication-related predictors of this clinically relevant anxiety. Breast cancer patients (n=227) completed visual analog scale (VAS) assessments of anxiety before and after their first RT sessions. Clinically relevant anxiety was defined as having pre- and post-first RT session VAS scores ⩾4 cm. Communication during RT simulation was assessed with content analysis software (LaComm), and communication-related variables around the RT simulation were assessed with questionnaires. Clinically relevant anxiety at the first RT session was predicted by lower self-efficacy to communicate with the RT team (OR=0.65; p=0.020), the perception of lower support received from the RT team (OR=0.70; p=0.020), lower knowledge of RT-associated side effects (OR=0.95; p=0.057), and higher use of emotion-focused coping (OR=1.09; p=0.013). This study provides RT team members with information about potential communication strategies, which may be used to reduce patient anxiety at the first RT session. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The relationship between team climate and interprofessional collaboration: Preliminary results of a mixed methods study.

PubMed

Agreli, Heloise F; Peduzzi, Marina; Bailey, Christopher

2017-03-01

Relational and organisational factors are key elements of interprofessional collaboration (IPC) and team climate. Few studies have explored the relationship between IPC and team climate. This article presents a study that aimed to explore IPC in primary healthcare teams and understand how the assessment of team climate may provide insights into IPC. A mixed methods study design was adopted. In Stage 1 of the study, team climate was assessed using the Team Climate Inventory with 159 professionals in 18 interprofessional teams based in São Paulo, Brazil. In Stage 2, data were collected through in-depth interviews with a sample of team members who participated in the first stage of the study. Results from Stage 1 provided an overview of factors relevant to teamwork, which in turn informed our exploration of the relationship between team climate and IPC. Preliminary findings from Stage 2 indicated that teams with a more positive team climate (in particular, greater participative safety) also reported more effective communication and mutual support. In conclusion, team climate provided insights into IPC, especially regarding aspects of communication and interaction in teams. Further research will provide a better understanding of differences and areas of overlap between team climate and IPC. It will potentially contribute for an innovative theoretical approach to explore interprofessional work in primary care settings.

Distributed Framework for Dynamic Telescope and Instrument Control

NASA Astrophysics Data System (ADS)

Ames, Troy J.; Case, Lynne

2002-12-01

Traditionally, instrument command and control systems have been developed specifically for a single instrument. Such solutions are frequently expensive and are inflexible to support the next instrument development effort. NASA Goddard Space Flight Center is developing an extensible framework, known as Instrument Remote Control (IRC) that applies to any kind of instrument that can be controlled by a computer. IRC combines the platform independent processing capabilities of Java with the power of the Extensible Markup Language (XML). A key aspect of the architecture is software that is driven by an instrument description, written using the Instrument Markup Language (IML). IML is an XML dialect used to describe graphical user interfaces to control and monitor the instrument, command sets and command formats, data streams, communication mechanisms, and data processing algorithms. The IRC framework provides the ability to communicate to components anywhere on a network using the JXTA protocol for dynamic discovery of distributed components. JXTA (see http://www.jxta.org) is a generalized protocol that allows any devices connected by a network to communicate in a peer-to-peer manner. IRC uses JXTA to advertise a device?s IML and discover devices of interest on the network. Devices can join or leave the network and thus join or leave the instrument control environment of IRC. Currently, several astronomical instruments are working with the IRC development team to develop custom components for IRC to control their instruments. These instruments include: High resolution Airborne Wideband Camera (HAWC), a first light instrument for the Stratospheric Observatory for Infrared Astronomy (SOFIA); Submillimeter And Far Infrared Experiment (SAFIRE), a principal investigator instrument for SOFIA; and Fabry-Perot Interferometer Bolometer Research Experiment (FIBRE), a prototype of the SAFIRE instrument, used at the Caltech Submillimeter Observatory (CSO). Most recently, we have been working with the Submillimetre High Angular Resolution Camera IInd Generation (SHARCII) at the CSO to investigate using IRC capabilities with the SHARC instrument.

Distributed Framework for Dynamic Telescope and Instrument Control

NASA Technical Reports Server (NTRS)

Ames, Troy J.; Case, Lynne

2002-01-01

Traditionally, instrument command and control systems have been developed specifically for a single instrument. Such solutions are frequently expensive and are inflexible to support the next instrument development effort. NASA Goddard Space Flight Center is developing an extensible framework, known as Instrument Remote Control (IRC) that applies to any kind of instrument that can be controlled by a computer. IRC combines the platform independent processing capabilities of Java with the power of the Extensible Markup Language (XML). A key aspect of the architecture is software that is driven by an instrument description, written using the Instrument Markup Language (IML). IML is an XML dialect used to describe graphical user interfaces to control and monitor the instrument, command sets and command formats, data streams, communication mechanisms, and data processing algorithms. The IRC framework provides the ability to communicate to components anywhere on a network using the JXTA protocol for dynamic discovery of distributed components. JXTA (see httD://www.jxta.org,) is a generalized protocol that allows any devices connected by a network to communicate in a peer-to-peer manner. IRC uses JXTA to advertise a device's IML and discover devices of interest on the network. Devices can join or leave the network and thus join or leave the instrument control environment of IRC. Currently, several astronomical instruments are working with the IRC development team to develop custom components for IRC to control their instruments. These instruments include: High resolution Airborne Wideband Camera (HAWC), a first light instrument for the Stratospheric Observatory for Infrared Astronomy (SOFIA); Submillimeter And Far Infrared Experiment (SAFIRE), a Principal Investigator instrument for SOFIA; and Fabry-Perot Interferometer Bolometer Research Experiment (FIBRE), a prototype of the SAFIRE instrument, used at the Caltech Submillimeter Observatory (CSO). Most recently, we have been working with the Submillimetre High Angular Resolution Camera IInd Generation (SHARCII) at the CSO to investigate using IRC capabilities with the SHARC instrument.

Total Force Fitness in units part 1: military demand-resource model.

PubMed

Bates, Mark J; Fallesen, Jon J; Huey, Wesley S; Packard, Gary A; Ryan, Diane M; Burke, C Shawn; Smith, David G; Watola, Daniel J; Pinder, Evette D; Yosick, Todd M; Estrada, Armando X; Crepeau, Loring; Bowles, Stephen V

2013-11-01

The military unit is a critical center of gravity in the military's efforts to enhance resilience and the health of the force. The purpose of this article is to augment the military's Total Force Fitness (TFF) guidance with a framework of TFF in units. The framework is based on a Military Demand-Resource model that highlights the dynamic interactions across demands, resources, and outcomes. A joint team of subject-matter experts identified key variables representing unit fitness demands, resources, and outcomes. The resulting framework informs and supports leaders, support agencies, and enterprise efforts to strengthen TFF in units by (1) identifying TFF unit variables aligned with current evidence and operational practices, (2) standardizing communication about TFF in units across the Department of Defense enterprise in a variety of military organizational contexts, (3) improving current resources including evidence-based actions for leaders, (4) identifying and addressing of gaps, and (5) directing future research for enhancing TFF in units. These goals are intended to inform and enhance Service efforts to develop Service-specific TFF models, as well as provide the conceptual foundation for a follow-on article about TFF metrics for units. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Communications Specialist | Center for Cancer Research

Cancer.gov

Be part of our mission to support research against cancer. We have an exciting opportunity for a talented communicator to join our team and be part of the effort to find cures for cancer. We are looking for a creative, team-oriented communications professional, with strong writing skills to publicize our research advances, employment and training opportunities and clinical trials program. Work involves production of a monthly internal newsletter with circulation of 3,000, writing and editing a variety of stories, such as features on patients, and developing content for communications tactics. Must have a Bachelor’s degree in Communications, Biosciences and/or related field; Master’s degree or equivalent professional experience preferred. Full time position, business hours.

Timely Digital Patient-Clinician Communication in Specialist Clinical Services for Young People: A Mixed-Methods Study (The LYNC Study).

PubMed

Griffiths, Frances; Bryce, Carol; Cave, Jonathan; Dritsaki, Melina; Fraser, Joseph; Hamilton, Kathryn; Huxley, Caroline; Ignatowicz, Agnieszka; Kim, Sung Wook; Kimani, Peter K; Madan, Jason; Slowther, Anne-Marie; Sujan, Mark; Sturt, Jackie

2017-04-10

Young people (aged 16-24 years) with long-term health conditions can disengage from health services, resulting in poor health outcomes, but clinicians in the UK National Health Service (NHS) are using digital communication to try to improve engagement. Evidence of effectiveness of this digital communication is equivocal. There are gaps in evidence as to how it might work, its cost, and ethical and safety issues. Our objective was to understand how the use of digital communication between young people with long-term conditions and their NHS specialist clinicians changes engagement of the young people with their health care; and to identify costs and necessary safeguards. We conducted mixed-methods case studies of 20 NHS specialist clinical teams from across England and Wales and their practice providing care for 13 different long-term physical or mental health conditions. We observed 79 clinical team members and interviewed 165 young people aged 16-24 years with a long-term health condition recruited via case study clinical teams, 173 clinical team members, and 16 information governance specialists from study NHS Trusts. We conducted a thematic analysis of how digital communication works, and analyzed ethics, safety and governance, and annual direct costs. Young people and their clinical teams variously used mobile phone calls, text messages, email, and voice over Internet protocol. Length of clinician use of digital communication varied from 1 to 13 years in 17 case studies, and was being considered in 3. Digital communication enables timely access for young people to the right clinician at the time when it can make a difference to how they manage their health condition. This is valued as an addition to traditional clinic appointments and can engage those otherwise disengaged, particularly at times of change for young people. It can enhance patient autonomy, empowerment and activation. It challenges the nature and boundaries of therapeutic relationships but can improve trust. The clinical teams studied had not themselves formally evaluated the impact of their intervention. Staff time is the main cost driver, but offsetting savings are likely elsewhere in the health service. Risks include increased dependence on clinicians, inadvertent disclosure of confidential information, and communication failures, which are mostly mitigated by young people and clinicians using common-sense approaches. As NHS policy prompts more widespread use of digital communication to improve the health care experience, our findings suggest that benefit is most likely, and harms are mitigated, when digital communication is used with patients who already have a relationship of trust with the clinical team, and where there is identifiable need for patients to have flexible access, such as when transitioning between services, treatments, or lived context. Clinical teams need a proactive approach to ethics, governance, and patient safety. ©Frances Griffiths, Carol Bryce, Jonathan Cave, Melina Dritsaki, Joseph Fraser, Kathryn Hamilton, Caroline Huxley, Agnieszka Ignatowicz, Sung Wook Kim, Peter K Kimani, Jason Madan, Anne-Marie Slowther, Mark Sujan, Jackie Sturt. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.04.2017.

A Framework for Developing the Structure of Public Health Economic Models.

PubMed

Squires, Hazel; Chilcott, James; Akehurst, Ronald; Burr, Jennifer; Kelly, Michael P

2016-01-01

A conceptual modeling framework is a methodology that assists modelers through the process of developing a model structure. Public health interventions tend to operate in dynamically complex systems. Modeling public health interventions requires broader considerations than clinical ones. Inappropriately simple models may lead to poor validity and credibility, resulting in suboptimal allocation of resources. This article presents the first conceptual modeling framework for public health economic evaluation. The framework presented here was informed by literature reviews of the key challenges in public health economic modeling and existing conceptual modeling frameworks; qualitative research to understand the experiences of modelers when developing public health economic models; and piloting a draft version of the framework. The conceptual modeling framework comprises four key principles of good practice and a proposed methodology. The key principles are that 1) a systems approach to modeling should be taken; 2) a documented understanding of the problem is imperative before and alongside developing and justifying the model structure; 3) strong communication with stakeholders and members of the team throughout model development is essential; and 4) a systematic consideration of the determinants of health is central to identifying the key impacts of public health interventions. The methodology consists of four phases: phase A, aligning the framework with the decision-making process; phase B, identifying relevant stakeholders; phase C, understanding the problem; and phase D, developing and justifying the model structure. Key areas for further research involve evaluation of the framework in diverse case studies and the development of methods for modeling individual and social behavior. This approach could improve the quality of Public Health economic models, supporting efficient allocation of scarce resources. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

What makes maternity teams effective and safe? Lessons from a series of research on teamwork, leadership and team training.

PubMed

Siassakos, Dimitrios; Fox, Robert; Bristowe, Katherine; Angouri, Jo; Hambly, Helen; Robson, Lauren; Draycott, Timothy J

2013-11-01

We describe lessons for safety from a synthesis of seven studies of teamwork, leadership and team training across a healthcare region. Two studies identified successes and challenges in a unit with embedded team training: a staff survey demonstrated a positive culture but a perceived need for greater senior presence; training improved actual emergency care, but wide variation in team performance remained. Analysis of multicenter simulation records showed that variation in patient safety and team efficiency correlated with their teamwork but not individual knowledge, skills or attitudes. Safe teams tended to declare the emergency earlier, hand over in a more structured way, and use closed-loop communication. Focused and directed communication was also associated with better patient-actor perception of care. Focus groups corroborated these findings, proposed that the capability and experience of the leader is more important than seniority, and identified teamwork and leadership issues that require further research. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance.

PubMed

Johnsen, Bjørn Helge; Westli, Heidi Kristina; Espevik, Roar; Wisborg, Torben; Brattebø, Guttorm

2017-11-10

High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of "push" of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers. The results of this study emphasize the team leader's role in initiating and updating a team's shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.

Team working in intensive care: current evidence and future endeavors.

PubMed

Richardson, Joanne; West, Michael A; Cuthbertson, Brian H

2010-12-01

It has recently been argued that the future of intensive care medicine will rely on high quality management and teamwork. Therefore, this review takes an organizational psychology perspective to examine the most recent research on the relationship between teamwork, care processes, and patient outcomes in intensive care. Interdisciplinary communication within a team is crucial for the development of negotiated shared treatment goals and short-team patient outcomes. Interventions for maximizing team communication have received substantial interest in recent literature. Intensive care coordination is not a linear process, and intensive care teams often fail to discuss how to implement goals, trigger and align activities, or reflect on their performance. Despite a move toward interdisciplinary team working, clinical decision-making is still problematic and continues to be perceived as a top-down and authoritative process. The topic of team leadership in intensive care is underexplored and requires further research. Based on findings from the most recent research evidence in medicine and management, four principles are identified for improving the effectiveness of team working in intensive care: engender professional efficacy, create stable teams and leaders, develop trust and participative safety, and enable frequent team reflexivity.

Learning through "huddles" for health care leaders: why do some work teams learn as a result of huddles and others do not?

PubMed

Little, Johanna

2014-01-01

The health care industry embraces the concept that collective learning occurs through group social interactions and has been initiating huddles as an avenue for collaborative learning. During change of shift or prior to beginning daily tasks, a huddle is initiated and facilitated by the manager or frontline supervisor. Given that "shared knowledge is obtained through group-based learning," why are some teams learning and others are not? The phenomenon is perplexing, given that the same resources are provided to all teams. Based on the findings in the literature review on learning in groups, teams learn from huddles and others do not because of the following: communication style and dialogue among the group members, communication style and dialogue facilitated by the leader, team and member perceptions, and team membership. Teams that learn from huddles do so because of the elements within the dialogue between team members (reflexive questioning, redundancy of information, metaphors, analogies, dramatic dialogue, strategic meaning) and because the huddle team exhibits higher levels of collegiality, tenure, heterogeneity, team identification, and collective efficacy. Facilitators must encourage a conversation in order to encourage reframing of cognitive maps that encourage learning by huddle members.

Team Performance Assessment and Measurement: Theory, Methods, and Applications. Series in Applied Psychology.

ERIC Educational Resources Information Center

Brannick, Michael T., Ed.; Salas, Eduardo, Ed.; Prince, Carolyn, Ed.

This volume presents thoughts on measuring team performance written by experts currently working with teams in fields such as training, evaluation, and process consultation. The chapters are: (1) "An Overview of Team Performance Measurement" (Michael T. Brannick and Carolyn Prince); (2) "A Conceptual Framework for Teamwork Measurement" (Terry L.…

Dynamic Creative Interaction Networks and Team Creativity Evolution: A Longitudinal Study

ERIC Educational Resources Information Center

Jiang, Hui; Zhang, Qing-Pu; Zhou, Yang

2018-01-01

To assess the dynamical effects of creative interaction networks on team creativity evolution, this paper elaborates a theoretical framework that links the key elements of creative interaction networks, including node, edge and network structure, to creativity in teams. The process of team creativity evolution is divided into four phases,…

Environmental Research Translation: Enhancing Interactions with Communities at Contaminated Sites

NASA Astrophysics Data System (ADS)

Ramirez-Andreotta, M.; Brusseau, M. L. L.; Artiola, J. F.; Maier, R. M.; Gandolfi, A. J.

2015-12-01

The characterization and remediation of contaminated sites are complex endeavors fraught with numerous challenges. One particular challenge that is receiving increased attention is the development and encouragement of full participation by communities and community members affected by a given site in all facets of decision-making. Many disciplines have been grappling with the challenges associated with environmental and risk communication, public participation in environmental data generation and decision-making, and increasing community capacity. The concepts and methods developed by these disciplines are reviewed, with a focus on their relevance to the specific dynamics associated with contaminated sites. The contributions of these disciplines are then synthesized and integrated to help develop Environmental Research Translation (ERT), a proposed framework for environmental scientists to promote interaction and communication among involved parties at contaminated sites. This holistic approach is rooted in public participation approaches to science, which includes: a transdisciplinary team, effective collaboration, information transfer, public participation in environmental projects, and a cultural model of risk communication. Although there are challenges associated with the implementation of ERT, it is anticipated that application of this proposed translational science method could promote more robust community participation at contaminated sites.

Environmental Research Translation: Enhancing Interactions with Communities at Contaminated Sites

PubMed Central

Ramirez-Andreotta, Monica D.; Brusseau, Mark L.; Artiola, Janick F.; Maier, Raina M.; Gandolfi, A. Jay

2014-01-01

The characterization and remediation of contaminated sites are complex endeavors fraught with numerous challenges. One particular challenge that is receiving increased attention is the development and encouragement of full participation by communities and community members affected by a given site in all facets of decision-making. Many disciplines have been grappling with the challenges associated with environmental and risk communication, public participation in environmental data generation, and decision-making and increasing community capacity. The concepts and methods developed by these disciplines are reviewed, with a focus on their relevance to the specific dynamics associated with environmental contamination sites. The contributions of these disciplines are then synthesized and integrated to help develop Environmental Research Translation (ERT), a proposed framework for environmental scientists to promote interaction and communication among involved parties at contaminated sites. This holistic approach is rooted in public participation approaches to science, which includes: a transdisciplinary team, effective collaboration, information transfer, public participation in environmental projects, and a cultural model of risk communication. Although there are challenges associated with the implementation of ERT, it is anticipated that application of this proposed translational science method could promote more robust community participation at contaminated sites. PMID:25173762

Interdisciplinary simulation-based training to improve delivery room communication.

PubMed

Dadiz, Rita; Weinschreider, Joanne; Schriefer, Jan; Arnold, Christine; Greves, Cole D; Crosby, Erin C; Wang, Hongyue; Pressman, Eva K; Guillet, Ronnie

2013-10-01

Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams. Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008-2011 (Y1-Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance. At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05). Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.

Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.

PubMed

Cragun, Deborah; Zierhut, Heather

2018-02-01

Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, "Framework for Outcomes of Clinical commUnication Services" (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

Competency-Based Framework and Continuing Education for Preparing a Skilled School Health Workforce for Asthma Care: The Colorado Experience

ERIC Educational Resources Information Center

Cicutto, Lisa; Gleason, Melanie; Haas-Howard, Christy; Jenkins-Nygren, Lynn; Labonde, Susan; Patrick, Kathy

2017-01-01

School health teams commonly address the needs of students with asthma, which requires specific knowledge and skills. To develop a skilled school health team, a competency-based framework for managing asthma in schools was developed. A modified Delphi with 31 panelists was completed. Consensus (=80% agreement) was reached for all 148 items…

How Multi-Levels of Individual and Team Learning Interact in a Public Healthcare Organisation: A Conceptual Framework

ERIC Educational Resources Information Center

Doyle, Louise; Kelliher, Felicity; Harrington, Denis

2016-01-01

The aim of this paper is to review the relevant literature on organisational learning and offer a preliminary conceptual framework as a basis to explore how the multi-levels of individual learning and team learning interact in a public healthcare organisation. The organisational learning literature highlights a need for further understanding of…

Rapid Prototyping of an Aircraft Model in an Object-Oriented Simulation

NASA Technical Reports Server (NTRS)

Kenney, P. Sean

2003-01-01

A team was created to participate in the Mars Scout Opportunity. Trade studies determined that an aircraft provided the best opportunity to complete the science objectives of the team. A high fidelity six degree of freedom flight simulation was required to provide credible evidence that the aircraft design fulfilled mission objectives and to support the aircraft design process by providing performance evaluations. The team created the simulation using the Langley Standard Real-Time Simulation in C++ (LaSRS++) application framework. A rapid prototyping approach was necessary because the team had only three months to both develop the aircraft simulation model and evaluate aircraft performance as the design and mission parameters matured. The design of LaSRS++ enabled rapid-prototyping in several ways. First, the framework allowed component models to be designed, implemented, unit-tested, and integrated quickly. Next, the framework provides a highly reusable infrastructure that allowed developers to maximize code reuse while concentrating on aircraft and mission specific features. Finally, the framework reduces risk by providing reusable components that allow developers to build a quality product with a compressed testing cycle that relies heavily on unit testing of new components.

Examination of Communication Delays on Team Performance: Utilizing the International Space Station (ISS) as a Test Bed for Analog Research

NASA Technical Reports Server (NTRS)

Keeton, K. E.; Slack, K, J.; Schmidt, L. L.; Ploutz-Snyder, R.; Baskin, P.; Leveton, L. B.

2011-01-01

Operational conjectures about space exploration missions of the future indicate that space crews will need to be more autonomous from mission control and operate independently. This is in part due to the expectation that communication quality between the ground and exploration crews will be more limited and delayed. Because of potential adverse effects on communication quality, both researchers and operational training and engineering experts have suggested that communication delays and the impact these delays have on the quality of communications to the crew will create performance decrements if crews are not given adequate training and tools to support more autonomous operations. This presentation will provide an overview of a research study led by the Behavioral Health and Performance Element (BHP) of the NASA Human Research Program that examines the impact of implementing a communication delay on ISS on individual and team factors and outcomes, including performance and related perceptions of autonomy. The methodological design, data collection efforts, and initial results of this study to date will be discussed . The results will focus on completed missions, DRATS and NEEMO15. Lessons learned from implementing this study within analog environments will also be discussed. One lesson learned is that the complexities of garnishing a successful data collection campaign from these high fidelity analogs requires perseverance and a strong relationship with operational experts. Results of this study will provide a preliminary understanding of the impact of communication delays on individual and team performance as well as an insight into how teams perform and interact in a space-like environment . This will help prepare for implementation of communication delay tests on the ISS, targeted for Increment 35/36.

The reablement team's voice: a qualitative study of how an integrated multidisciplinary team experiences participation in reablement.

PubMed

Hjelle, Kari Margrete; Skutle, Olbjørg; Førland, Oddvar; Alvsvåg, Herdis

2016-01-01

Reablement is an early and time-limited home-based rehabilitation intervention that emphasizes intensive, goal-oriented, and multidisciplinary assistance for people experiencing functional decline. Few empirical studies to date have examined the experiences of the integrated multidisciplinary teams involved in reablement. Accordingly, the aim of this study was to explore and describe how an integrated multidisciplinary team in Norway experienced participation in reablement. An integrated multidisciplinary team consisting of health care professionals with a bachelor's degree (including a physiotherapist, a social educator, occupational therapists, and nurses) and home-based care personnel without a bachelor's degree (auxiliary nurses and nursing assistants) participated in focus group discussions. Qualitative content analysis was used to analyze the resulting data. Three main themes emerged from the participants' experiences with participating in reablement, including "the older adult's goals are crucial", "a different way of thinking and acting - a shift in work culture", and "a better framework for cooperation and application of professional expertise and judgment". The integrated multidisciplinary team and the older adults collaborated and worked in the same direction to achieve the person's valued goals. The team supported the older adults in performing activities themselves rather than completing tasks for them. To facilitate cooperation and application of professional expertise and judgment, common meeting times and meeting places for communication and supervision were necessary. Structural factors that promote integrated multidisciplinary professional decisions include providing common meeting times and meeting places as well as sufficient time to apply professional knowledge when supervising and supporting older persons in everyday activities. These findings have implications for practice and suggest future directions for improving health care services. The shift in work culture from static to dynamic service is time consuming and requires politicians, community leaders, and health care systems to allocate the necessary time to support this approach to thinking and working.

Analysis of Controller Communication in En Route Air Traffic Control.

ERIC Educational Resources Information Center

Seamster, Thomas L.; And Others

To contribute to an understanding of the elements of good air traffic controller communication with the objective of providing recommendations to improve controller communication training, two studies analyzed team communication, ground-air communication, and ground-line communication. The simulated and live traffic analyses examined established…

An interprofessional communication training using simulation to enhance safe care for a deteriorating patient.

PubMed

Liaw, Sok Ying; Zhou, Wen Tao; Lau, Tang Ching; Siau, Chiang; Chan, Sally Wai-Chi

2014-02-01

Communication and teamwork between doctors and nurses are critical for optimal patient care. Simulation and interprofessional team learning are emerging as significant learning strategies to promote teamwork and communication between different health professionals. The aim of the study is to describe the development, implementation and evaluation of a simulation-based interprofessional educational (Sim-IPE) program, using a presage-process-product (3P) model, for improving medical and nursing students' communication skills in caring of a patient with physiological deterioration. The program was conducted using full-scale simulation and communication strategies adapted from Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). 127 medical and nursing students participated in a 3-hour small group interprofessional learning that incorporated simulation scenarios of deteriorating patients. Pre and post-tests were conducted to assess the students' self-confidence in interprofessional communication and perception in interprofessional learning. After the training, the students completed a satisfaction questionnaire. Both medicine and nursing groups demonstrated a significant improvement on post-test score from pre-test score for self-confidence (p<.0001) and perception (p<.0001) with no significant differences detected between the two groups. The participants were highly satisfied with their simulation learning. The Sim-IPE has better prepared the medical and nursing students in communicating with one another in providing safe care for deteriorating patient. In addition, it has improved their perception towards interprofessional learning. This pre-registration interprofessional education could prepare them for more comprehensive interprofessional team learning at post-registration level. Copyright © 2014 Elsevier Ltd. All rights reserved.

Team communication during patient handover from the operating room: more than facts and figures.

PubMed

Manser, Tanja; Foster, Simon; Flin, Rhona; Patey, Rona

2013-02-01

This study was aimed at examining team communication during postoperative handover and its relationship to clinicians' self-ratings of handover quality. Adverse events can often be traced back to inadequate communication during patient handover. Research and improvement efforts have mostly focused on the information transfer function of patient handover. However, the specific mechanisms between handover communication processes among teams of transferring and receiving clinicians and handover quality are poorly understood. We conducted a prospective, cross-sectional observation study using a taxonomy for handover behaviors developed on the basis of established approaches for analyzing teamwork in health care. Immediately after the observation, transferring and receiving clinicians rated the quality of the handover using a structured tool for handover quality assessment. Handover communication during 117 handovers in three postoperative settings and its relationship to clinicians' self-ratings of handover quality were analyzed with the use of correlation analyses and analyses of variance. We identified significantly different patterns of handover communication between clinical settings and across handover roles. Assessments provided during handover were related to higher ratings of handover quality overall and to all four dimensions of handover quality identified in this study. If assessment was lacking, we observed compensatory information seeking by the receiving team. Handover quality is more than the correct, complete transmission of patient information. Assessments, including predictions or anticipated problems, are critical to the quality of postoperative handover. The identification of communication behaviors related to high-quality handovers is necessary to effectively support the design and evaluation of handover improvement efforts.

Computerized Tests of Team Performance and Crew Coordination Suitable for Military/Aviation Settings.

PubMed

Lawson, Ben D; Britt, Thomas W; Kelley, Amanda M; Athy, Jeremy R; Legan, Shauna M

2017-08-01

The coordination of team effort on shared tasks is an area of inquiry. A number of tests of team performance in challenging environments have been developed without comparison or standardization. This article provides a systematic review of the most accessible and usable low-to-medium fidelity computerized tests of team performance and determines which are most applicable to military- and aviation-relevant research, such as studies of group command, control, communication, and crew coordination. A search was conducted to identify computerized measures of team performance. In addition to extensive literature searches (DTIC, Psychinfo, PubMed), the authors reached out to team performance researchers at conferences and through electronic communication. Identified were 57 potential tests according to 6 specific selection criteria (e.g., the requirement for automated collection of team performance and coordination processes, the use of military-relevant scenarios). The following seven tests (listed alphabetically) were considered most suitable for military needs: Agent Enabled Decision Group Environment (AEDGE), C3Conflict, the C3 (Command, Control, & Communications) Interactive Task for Identifying Emerging Situations (NeoCITIES), Distributed Dynamic Decision Making (DDD), Duo Wondrous Original Method Basic Awareness/Airmanship Test (DuoWOMBAT), the Leader Development Simulator (LDS), and the Planning Task for Teams (PLATT). Strengths and weaknesses of these tests are described and recommendations offered to help researchers identify the test most suitable for their particular needs. Adoption of a few standard computerized test batteries to study team performance would facilitate the evaluation of interventions intended to enhance group performance in multiple challenging military and aerospace operational environments.Lawson BD, Britt TW, Kelley AM, Athy JR, Legan SM. Computerized tests of team performance and crew coordination suitable for military/aviation settings. Aerosp Med Hum Perform. 2017; 88(8):722-729.

Team knowledge research: emerging trends and critical needs.

PubMed

Wildman, Jessica L; Thayer, Amanda L; Pavlas, Davin; Salas, Eduardo; Stewart, John E; Howse, William R

2012-02-01

This article provides a systematic review of the team knowledge literature and guidance for further research. Recent research has called attention to the need for the improved study and understanding of team knowledge. Team knowledge refers to the higher level knowledge structures that emerge from the interactions of individual team members. We conducted a systematic review of the team knowledge literature, focusing on empirical work that involves the measurement of team knowledge constructs. For each study, we extracted author degree area, study design type, study setting, participant type, task type, construct type, elicitation method, aggregation method, measurement timeline, and criterion domain. Our analyses demonstrate that many of the methodological characteristics of team knowledge research can be linked back to the academic training of the primary author and that there are considerable gaps in our knowledge with regard to the relationships between team knowledge constructs, the mediating mechanisms between team knowledge and performance, and relationships with criteria outside of team performance, among others. We also identify categories of team knowledge not yet examined based on an organizing framework derived from a synthesis of the literature. There are clear opportunities for expansion in the study of team knowledge; the science of team knowledge would benefit from a more holistic theoretical approach. Human factors researchers are increasingly involved in the study of teams. This review and the resulting organizing framework provide researchers with a summary of team knowledge research over the past 10 years and directions for improving further research.

An empirically based conceptual framework for fostering meaningful patient engagement in research.

PubMed

Hamilton, Clayon B; Hoens, Alison M; Backman, Catherine L; McKinnon, Annette M; McQuitty, Shanon; English, Kelly; Li, Linda C

2018-02-01

Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data. To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective. We conducted a qualitative secondary analysis of in-depth interviews with 18 patient research partners from a research centre-affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team. Participants' experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team. The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient-researcher partnerships are led by researchers with little experience of engaging patients in research. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Education and Training of Emergency Medical Teams: Recommendations for a Global Operational Learning Framework.

PubMed

Amat Camacho, Nieves; Hughes, Amy; Burkle, Frederick M; Ingrassia, Pier Luigi; Ragazzoni, Luca; Redmond, Anthony; Norton, Ian; von Schreeb, Johan

2016-10-21

An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization's Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs. An essential component to reach this goal is appropriate education and training. Multiple disaster education and training programs are available. However, most are centred on individuals' professional development rather than on the EMTs operational performance. Moreover, no common overarching or standardised training frameworks exist. In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally. The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field. A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training. Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies.  Keywords: disasters; education; emergencies; global health; learning.

Education and Training of Emergency Medical Teams: Recommendations for a Global Operational Learning Framework

PubMed Central

Amat Camacho, Nieves; Hughes, Amy; Burkle, Frederick M.; Ingrassia, Pier Luigi; Ragazzoni, Luca; Redmond, Anthony; Norton, Ian; von Schreeb, Johan

2016-01-01

An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization’s Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs. An essential component to reach this goal is appropriate education and training. Multiple disaster education and training programs are available. However, most are centred on individuals’ professional development rather than on the EMTs operational performance. Moreover, no common overarching or standardised training frameworks exist. In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally. The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field. A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training. Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies.  Keywords: disasters; education; emergencies; global health; learning PMID:27917306

Earth Science Mobile App Development for Non-Programmers

NASA Astrophysics Data System (ADS)

Oostra, D.; Crecelius, S.; Lewis, P.; Chambers, L. H.

2012-08-01

A number of cloud based visual development tools have emerged that provide methods for developing mobile applications quickly and without previous programming experience. The MY NASA DATA (MND) team would like to begin a discussion on how we can best leverage current mobile app technologies and available Earth science datasets. The MY NASA DATA team is developing an approach based on two main ideas. The first is to teach our constituents how to create mobile applications that interact with NASA datasets; the second is to provide web services or Application Programming Interfaces (APIs) that create sources of data that educators, students and scientists can use in their own mobile app development. This framework allows data providers to foster mobile application development and interaction while not becoming a software clearing house. MY NASA DATA's research has included meetings with local data providers, educators, libraries and individuals. A high level of interest has been identified from initial discussions and interviews. This overt interest combined with the marked popularity of mobile applications in our societies has created a new channel for outreach and communications with and between the science and educational communities.

Future perspectives on space psychology: Recommendations on psychosocial and neurobehavioural aspects of human spaceflight

NASA Astrophysics Data System (ADS)

De La Torre, Gabriel G.; van Baarsen, Berna; Ferlazzo, Fabio; Kanas, Nick; Weiss, Karine; Schneider, Stefan; Whiteley, Iya

2012-12-01

Recently the psychological effects of space flight have gained in attention. In uncovering the psychological challenges that individuals and teams can face, we need research options that integrate psychosocial aspects with behavioral, performance, technical and environmental issues. Future perspectives in Space Psychology and Human Spaceflight are reviewed in this paper. The topics covered include psychosocial and neurobehavioural aspects, neurocognitive testing tools, decision making, autonomy and delayed communications, well being, mental health, situational awareness, and methodology. Authors were members of a European Space Agency (ESA) Research Topical Team on Psychosocial and Behavioral Aspects of Human Spaceflight. They discuss the different topics under a common perspective of a theoretical and practical framework, showing interactions, relationships and possible solutions for the different aspects and variables in play. Recommendations for every topic are offered and summarized for future research in the field. The different proposed research ideas can be accomplished using analogs and simulation experiments, short- and long-duration bed rest, and in-flight microgravity studies. These topics are especially important for future Moon and Mars mission design and training.

Rules and regulations as potential moderator on the relationship between organizational internal and external factors with effective construction risk management in Nigerian construction companies: A proposed framework

NASA Astrophysics Data System (ADS)

Adeleke, A. Q.; Bahaudin, A. Y.; Kamaruddeen, A. M.

2016-08-01

Certain organizational internal and external factors have been found to influence effective construction risk management within the construction company which has contributed to massive risk occurrence on the projects. Yet, the influence of the organizational factors such as effective communication, team competency with skills, active leadership, political factor, organizational culture, technology factor and economic factor on effective construction risk management among the construction companies operating in Abuja and Lagos state Nigeria have not received considerable attention. More so, a moderating variable is proposed. This paper proposes rules and regulations as the potential moderator on the relationship between organisational internal factors, external factors and effective construction risk management.

Coordinating Initiation and Response in Computer-Mediated Communication

DTIC Science & Technology

2006-12-01

69 3.4.2.2 Busyness Manipulation ...............................................................69 3.4.2.3 Team Manipulation...70 Figure 3.12. Response likelihood across receiver level of busyness (# of jumpers on-screen) for team versus non-team messages...71 Figure 3.13. Response delay in seconds across receiver busyness level (# of jumpers on-screen) for team versus non

The Value of 4-H Judging Teams--Missouri Dairy Judging Alumni Survey

ERIC Educational Resources Information Center

Deaver, Karla; Probert, Ted

2016-01-01

Former Missouri 4-H Dairy Judging Team members responded to a survey about life skills development and the value of the judging team experience. Results of the survey indicate that judging team experience was highly influential in the development of communication, public speaking, and presentation skills. Respondents also indicated that judging…

Stasis Theory as a Strategy for Workplace Teaming and Decision Making

ERIC Educational Resources Information Center

Brizee, H. Allen

2008-01-01

Current scholarship tells us that skills in teaming are essential for students and practitioners of professional communication. Writers must be able to cooperate with subject-matter experts and team members to make effective decisions and complete projects. Scholarship also suggests that rapid changes in technology and changes in teaming processes…

Task Virtuality and Its Effect on Student Project Team Effectiveness

ERIC Educational Resources Information Center

Pineda, Rodley C.

2015-01-01

This study explores the extent to which students in colocated teams use synchronous and asynchronous computer-mediated communication channels (task virtuality) and how this use affects their perceptions of the team's performance, their satisfaction with the team, and the learning they derive from the process. Survey results show that different…

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…

The Promise of Virtual Teams: Identifying Key Factors in Effectiveness and Failure

ERIC Educational Resources Information Center

Horwitz, Frank M.; Bravington, Desmond; Silvis, Ulrik

2006-01-01

Purpose: The aim of the investigation is to identify enabling and disenabling factors in the development and operation of virtual teams; to evaluate the importance of factors such as team development, cross-cultural variables, leadership, communication and social cohesion as contributors to virtual team effectiveness. Design/methodology/approach:…

Implementation and Evaluation of a Team Simulation Training Program.

PubMed

Rice, Yvonne; DeLetter, Mary; Fryman, Lisa; Parrish, Evelyn; Velotta, Cathie; Talley, Cynthia

2016-01-01

Care of the trauma patient requires a well-coordinated intensive effort during the golden hour to optimize survival. We hypothesized that this program would improve knowledge, satisfaction, self-confidence, and simulated team performance. A pre-, post-test design with N = 7 BSN nurses, 21 years of age, less than 2 years of intensive care unit and nursing experience. Trauma intensive care unit, single-center academic Level 1 trauma center. Improvement was shown in perception of team structure (paired t test 13.71-12.57; p = .0001) and communication (paired t test 14.85-12.14; p = .009). Improvement was shown in observed situation monitoring (paired t test 17.42-25.28; p = .000), mutual support (paired t test 12.57-18.57; p = .000), and communication (paired t test 15.42-25.00; p = .001). A decrease was shown in attitudes of mutual support (paired t test 25.85-19.71; p = .04) and communication (paired t test 26.14-23.00; p = .001). Mean satisfaction scores were 21.5 of a possible 25 points. Mean self-confidence scores were 38.83 out of a possible 40 points. Simulation-based team training improved teamwork attitudes, perceptions, and performance. Team communication demonstrated significant improvement in 2 of the 3 instruments. Most participants agreed or strongly agreed that they were satisfied with simulation and had gained self-confidence.

The Effects of 10 Communication Modes on the Behavior of Teams During Co-Operative Problem-Solving

ERIC Educational Resources Information Center

Ochsman, Richard B.; Chapanis, Alphonse

1974-01-01

Sixty teams of two college students each solved credible "real world" problems co-operatively. Conversations were carried on in one of 10 modes of communication: (1) typewriting only, (2) handwriting only, (3) handwriting and typewriting, (4) typewriting and video, (5) handwriting and video, (6) voice only, (7) voice and typewriting, (8) voice and…

Enhancing Student Learning in Knowledge-Based Courses: Integrating Team-Based Learning in Mass Communication Theory Classes

ERIC Educational Resources Information Center

Han, Gang; Newell, Jay

2014-01-01

This study explores the adoption of the team-based learning (TBL) method in knowledge-based and theory-oriented journalism and mass communication (J&MC) courses. It first reviews the origin and concept of TBL, the relevant theories, and then introduces the TBL method and implementation, including procedures and assessments, employed in an…

Health Occupations Curriculum. Skills and Theory for Health Assistant. Volume I, Units 1-4.

ERIC Educational Resources Information Center

Arizona State Dept. of Education, Phoenix.

This volume consists of the first four units of a basic core curriculum that is intended for all health workers. The units deal with the following topics: (1) the health care facility, the long-term care facility, the health team, and the nursing team; (2) verbal and nonverbal communication, written communication, human behavior, ethical behavior,…

"Achieving Ensemble": Communication in Orthopaedic Surgical Teams and the Development of Situation Awareness--An Observational Study Using Live Videotaped Examples

ERIC Educational Resources Information Center

Bleakley, Alan; Allard, Jon; Hobbs, Adrian

2013-01-01

Focused dialogue, as good communication between practitioners, offers a condition of possibility for development of high levels of situation awareness in surgical teams. This has been termed "achieving ensemble". Situation awareness grasps what is happening in time and space with regard to one's own unfolding work in relation to that of…

Managing complex research datasets using electronic tools: A meta-analysis exemplar

PubMed Central

Brown, Sharon A.; Martin, Ellen E.; Garcia, Theresa J.; Winter, Mary A.; García, Alexandra A.; Brown, Adama; Cuevas, Heather E.; Sumlin, Lisa L.

2013-01-01

Meta-analyses of broad scope and complexity require investigators to organize many study documents and manage communication among several research staff. Commercially available electronic tools, e.g., EndNote, Adobe Acrobat Pro, Blackboard, Excel, and IBM SPSS Statistics (SPSS), are useful for organizing and tracking the meta-analytic process, as well as enhancing communication among research team members. The purpose of this paper is to describe the electronic processes we designed, using commercially available software, for an extensive quantitative model-testing meta-analysis we are conducting. Specific electronic tools improved the efficiency of (a) locating and screening studies, (b) screening and organizing studies and other project documents, (c) extracting data from primary studies, (d) checking data accuracy and analyses, and (e) communication among team members. The major limitation in designing and implementing a fully electronic system for meta-analysis was the requisite upfront time to: decide on which electronic tools to use, determine how these tools would be employed, develop clear guidelines for their use, and train members of the research team. The electronic process described here has been useful in streamlining the process of conducting this complex meta-analysis and enhancing communication and sharing documents among research team members. PMID:23681256