Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A
2015-07-01
Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty-three patients (6%) required emergent surgical airways. Sixty-two patients (17%) were stabilized and transported to the operating room for definitive airway management. There were no airway management-related deaths, sentinel events, or malpractice claims in adult patients managed by DART. Five in situ simulations conducted in the first program year improved DART's teamwork, communication, and response times and increased the functionality of the difficult airway carts. Over the 5-year period, we conducted 18 airway courses, through which >200 providers were trained. DART is a comprehensive program for improving difficult airway management. Future studies will examine the comparative effectiveness of the DART program and evaluate how DART has impacted patient outcomes, operational efficiency, and costs of care.
Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.
2015-01-01
Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty-three patients (6%) required emergent surgical airways. Sixty-two patients (17%) were stabilized and transported to the operating room for definitive airway management. There were no airway management-related deaths, sentinel events, or malpractice claims in adult patients managed by DART. Five in situ simulations conducted in the first program year improved DART's teamwork, communication, and response times and increased the functionality of the difficult airway carts. Over the 5-year period, we conducted 18 airway courses, through which more than 200 providers were trained. Conclusions DART is a comprehensive program for improving difficult airway management. Future studies will examine the comparative effectiveness of the DART program and evaluate how DART has impacted patient outcomes, operational efficiency, and costs of care. PMID:26086513
Improving Virtual Teams through Knowledge Management: A Case Study
ERIC Educational Resources Information Center
Laughridge, James F.
2012-01-01
Within the dynamic globalized operating environment, organizations are increasingly relying on virtual teams to solve their most difficult problems, leverage their expertise and expand their presence. The use of virtual teams by organizations continues to increase greatly as the technologies supporting them evolve. Despite improvements in…
Conflict management: difficult conversations with difficult people.
Overton, Amy R; Lowry, Ann C
2013-12-01
Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed.
1986-12-01
Power, Less Noise - 11 Quality Teams Assure Success - 16 Progeram Motagier (ISSN 0199-7114) is published Air Conditioner for Vests -16 bimonthly by...decision- Our Team Plays Better makers are The Naval Surface Weapons Center probably as heavy has been a key link in the difficult now as at any time...Administration examine what we in the weapons business know our we are doing, why we are doing it, and team plays better because you’re on it. whether
McCaul, Lorna K
2012-03-01
The incidence of head and neck cancer is rising. The attendant oral complications of cancer management make oral health maintenance a lifelong challenge for these patients. Holistic management in the context of a core multidisciplinary team is essential in optimizing outcomes. Predicting the risk of adverse oral outcomes is difficult. Effective communication between healthcare professionals in the core and extended teams and with the patient is essential. Primary care dental teams will be involved in the long-term management of oral care for head and cancer patients. A broad understanding of the management of head and neck cancer, consequences of treatment and the need for good communication is key to good quality patient care.
Conflict Management: Difficult Conversations with Difficult People
Overton, Amy R.; Lowry, Ann C.
2013-01-01
Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed. PMID:24436688
Caruso, Rosangela; Biancosino, Bruno; Borghi, Cristiana; Marmai, Luciana; Kerr, Ian B; Grassi, Luigi
2013-12-01
The clinical management of 'difficult' patients is a major challenge which exposes mental health teams to an increased risk of frustration and stress and may lead to professional burnout. The aim of the present study was to investigate whether a cognitive-analytic therapy (CAT) based training undertaken by a mental health team working with 'difficult' patients reduced professional burnout symptoms, improved patients' service engagement and increased the levels of team-cohesion. Twelve mental health staff members from different professional and educational backgrounds took part in five 2-hour sessions providing a basic CAT training intervention, an integrative and relational model of psychotherapy for the treatment of borderline personality disorders. Participants were administered the Maslach Burnout Inventory (MBI), the Service Engagement Scale (SES) and the Group Environment Questionnaire (GEQ) before (T0) and after (T1) CAT training, and at 1-month follow-up (T2). A significant decrease were found, at T2, on the MBI Emotional Exhaustion scores, the SES Availability subscale, the GEQ Attraction to Group-Social and Group Integration-Social, while the MBI-Personal Accomplishment scores increased from baseline.The results of this study suggest that a CAT-based training can facilitate team cohesion and patient engagement with a service and reduce burnout levels among mental health team members dealing with 'difficult' patients.
Pandit, J J; Popat, M T; Cook, T M; Wilkes, A R; Groom, P; Cooke, H; Kapila, A; O'Sullivan, E
2011-08-01
Faced with the concern that an increasing number of airway management devices were being introduced into clinical practice with little or no prior evidence of their clinical efficacy or safety, the Difficult Airway Society formed a working party (Airway Device Evaluation Project Team) to establish a process by which the airway management community within the profession could itself lead a process of formal device/equipment evaluation. Although there are several national and international regulations governing which products can come on to the market and be legitimately sold, there has hitherto been no formal professional guidance relating to how products should be selected (i.e. purchased). The Airway Device Evaluation Project Team's first task was to formulate such advice, emphasising evidence-based principles. Team discussions led to a definition of the minimum level of evidence needed to make a pragmatic decision about the purchase or selection of an airway device. The Team concluded that this definition should form the basis of a professional standard, guiding those with responsibility for selecting airway devices. We describe how widespread adoption of this professional standard can act as a driver to create an infrastructure in which the required evidence can be obtained. Essential elements are that: (i) the Difficult Airway Society facilitates a coherent national network of research-active units; and (ii) individual anaesthetists in hospital trusts play a more active role in local purchasing decisions, applying the relevant evidence and communicating their purchasing decisions to the Difficult Airway Society. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Garcia, Evangeline; Horton, Denise A
2003-02-01
The purpose of this article was to document the efforts of two military installations in facilitating Critical Incident Stress Management teams for Federal Emergency Management Agency Rescue and Recovery Units following the attacks on the World Trade Center on September 11, 2001. McGuire Air Force Base accepted the mission to support the rotating task forces with emotional support, and Fort Dix offered temporary lodging while the teams were in-bound and out-bound to the "Ground Zero" site. A team, comprised of staff from both installations due to the configuration of professional and support staffs, does the Critical Incident Stress Management work. Both installations are within commuting distance of New York City and could provide adequate safety, security, and logistics to the teams. The classic crisis management models were not called into play, as that service was not asked for; however, it was clear to the McGuire Air Force Base/Fort Dix Critical Incident Stress Management team members that the rescue and recovery teams needed their physical presence. Many rescue organizations have their own "debriefing teams," yet it is believed that "outside teams" may be helpful as interim measures to demonstrate the universality of the process of coping with traumatic stress and grief management. It is hoped that this article honors the workers who came together to help in a very difficult time for our country. This article documents the interim measures that were taken for a group of people moving through crisis.
Managers' views on and experiences with moral case deliberation in nursing teams.
Weidema, Froukje C; Molewijk, A C Bert; Kamsteeg, Frans; Widdershoven, Guy A M
2015-11-01
Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences regarding facilitating MCD's implementation have not yet been studied. As part of an empirical qualitative study on implementing MCD in mental health care, a responsive evaluation design was used. Using former research findings (iterative procedures), a managers' focus group was organised. Managers appreciated MCD, fostering nurses' empowerment and critical reflection - according to managers, professional core competences. Managers found MCD a challenging intervention, resulting in dilemmas due to MCD's confidential and egalitarian nature. Managers value MCD's process-related outcomes, yet these are difficult to control/regulate. MCD urges managers to reflect on their role and (hierarchical) position both within MCD and in the nursing team. MCD is in line with transformative and participatory management, fostering dialogical interaction between management and nursing team. © 2015 John Wiley & Sons Ltd.
Managing System of Systems Requirements with a Requirements Screening Group
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ronald R. Barden
2012-07-01
Figuring out an effective and efficient way to manage not only your Requirement’s Baseline, but also the development of all your individual requirements during a Program’s/Project’s Conceptual and Development Life Cycle Stages can be both daunting and difficult. This is especially so when you are dealing with a complex and large System of Systems (SoS) Program with potentially thousands and thousands of Top Level Requirements as well as an equal number of lower level System, Subsystem and Configuration Item requirements that need to be managed. This task is made even more overwhelming when you have to add in integration withmore » multiple requirements’ development teams (e.g., Integrated Product Development Teams (IPTs)) and/or numerous System/Subsystem Design Teams. One solution for tackling this difficult activity on a recent large System of Systems Program was to develop and make use of a Requirements Screening Group (RSG). This group is essentially a Team made up of co-chairs from the various Stakeholders with an interest in the Program of record that are enabled and accountable for Requirements Development on the Program/Project. The RSG co-chairs, often with the help of individual support team, work together as a Program Board to monitor, make decisions on, and provide guidance on all Requirements Development activities during the Conceptual and Development Life Cycle Stages of a Program/Project. In addition, the RSG can establish and maintain the Requirements Baseline, monitor and enforce requirements traceability across the entire Program, and work with other elements of the Program/Project to ensure integration and coordination.« less
Sakashita, Akihiro; Kishino, Megumi; Nakazawa, Yoko; Yotani, Nobuyuki; Yamaguchi, Takashi; Kizawa, Yoshiyuki
2016-07-01
To clarify how highly active hospital palliative care teams can provide efficient and effective care regardless of the lack of full-time palliative care physicians. Semistructured focus group interviews were conducted, and content analysis was performed. A total of 7 physicians and 6 nurses participated. We extracted 209 codes from the transcripts and organized them into 3 themes and 21 categories, which were classified as follows: (1) tips for managing palliative care teams efficiently and effectively (7 categories); (2) ways of acquiring specialist palliative care expertise (9 categories); and (3) ways of treating symptoms that are difficult to alleviate (5 categories). The findings of this study can be used as a nautical chart of hospital-based palliative care team (HPCT) without full-time PC physician. Full-time nurses who have high management and coordination abilities play a central role in resource-limited HPCTs. © The Author(s) 2015.
A Multidisciplinary Approach to a Pediatric Difficult Airway Simulation Course.
Lind, Meredith Merz; Corridore, Marco; Sheehan, Cameron; Moore-Clingenpeel, Melissa; Maa, Tensing
2018-02-01
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork. Participants completed pre- and postworkshop questionnaires. Results Thirty-nine trainees participated over the 3-year study period. Compared with their precourse responses, participants' postcourse responses indicated either agreement or strong agreement that the multidisciplinary format (1) helped in the development of team communication skills and (2) was preferred over single-discipline training. Improvement in confidence in managing critical airway situations and in advanced airway management skills was significant ( P < .05). Eighty-one percent of participants had improved confidence in following the hospital's critical airway protocol, and 64% were better able to locate advanced airway management equipment. Discussion Multiple subspecialists manage pediatric respiratory failure, where successful care requires complex handoffs and teamwork. Multidisciplinary education to teach advanced airway management, teamwork, and communication skills is practical and preferred by learners and is possible to achieve despite differences in experience. Future study is required to better understand the impact of this course on patient care outcomes. Implications for Practice Implementation of a pediatric difficult airway course through simulation-based team training is feasible and preferred by learners among multiple disciplines. A multidisciplinary approach exposes previously unrecognized knowledge gaps and allows for better communication and collaboration among the fields.
Rao, Durga Prasada; Rao, Venkateswara A
2010-01-01
The purpose of this article is to review the fundamental aspects of obesity, pregnancy and a combination of both. The scientific aim is to understand the physiological changes, pathological clinical presentations and application of technical skills and pharmacological knowledge on this unique clinical condition. The goal of this presentation is to define the difficult airway, highlight the main reasons for difficult or failed intubation and propose a practical approach to management Throughout the review, an important component is the necessity for team work between the anaesthesiologist and the obstetrician. Certain protocols are recommended to meet the anaesthetic challenges and finally concluding with “what is new?” in obstetric anaesthesia. PMID:21224967
Building the occupational health team: keys to successful interdisciplinary collaboration.
Wachs, Joy E
2005-04-01
Teamwork among occupational health and safety professionals, management, and employees is vital to solving today's complex problems cost-effectively. No single discipline can meet all the needs of workers and the workplace. However, teamwork can be time-consuming and difficult if attention is not given to the role of the team leader, the necessary skills of team members, and the importance of a supportive environment. Bringing team members together regularly to foster positive relationships and infuse them with the philosophy of strength in diversity is essential for teams to be sustained and work to be accomplished. By working in tandem, occupational health and safety professionals can become the model team in business and industry delivering on their promise of a safe and healthy workplace for America's work force.
Fire, Earth and Wind: Managing Risk in Today's Schools Part 2--The Environment
ERIC Educational Resources Information Center
Weeks, Richard
2010-01-01
Because school business officials are pushed to make difficult decisions quickly when it comes to risk management, they should be aware of the issues associated with environmental safety. School business officials are integral members of the teams that handle crises--big and small--in the school district. A crisis may be as straightforward as the…
Gold-Collar Workers. ERIC Digest.
ERIC Educational Resources Information Center
Wonacott, Michael E.
The gold-collar worker has problem-solving abilities, creativity, talent, and intelligence; performs non-repetitive and complex work difficult to evaluate; and prefers self management. Gold-collar information technology workers learn continually from experience; recognize the synergy of teams; can demonstrate leadership; and are strategic thinkers…
Making strategy: learning by doing.
Christensen, C M
1997-01-01
Companies find it difficult to change strategy for many reasons, but one stands out: strategic thinking is not a core managerial competence at most companies. Executives hone their capabilities by tackling problems over and over again. Changing strategy, however, is not usually a task that they face repeatedly. Once companies have found a strategy that works, they want to use it, not change it. Consequently, most managers do not develop a competence in strategic thinking. This Manager's Tool Kit presents a three-stage method executives can use to conceive and implement a creative and coherent strategy themselves. The first stage is to identify and map the driving forces that the company needs to address. The process of mapping provides strategy-making teams with visual representations of team members' assumptions, those pictures, in turn, enable managers to achieve consensus in determining the driving forces. Once a senior management team has formulated a new strategy, it must align the strategy with the company's resource-allocation process to make implementation possible. Senior management teams can translate their strategy into action by using aggregate project planning. And management teams that link strategy and innovation through that planning process will develop a competence in implementing strategic change. The author guides the reader through the three stages of strategy making by examining the case of a manufacturing company that was losing ground to competitors. After mapping the driving forces, the company's senior managers were able to devise a new strategy that allowed the business to maintain a competitive advantage in its industry.
Medical ethics in pediatric critical care.
Orioles, Alberto; Morrison, Wynne E
2013-04-01
Ethically charged situations are common in pediatric critical care. Most situations can be managed with minimal controversy within the medical team or between the team and patients/families. Familiarity with institutional resources, such as hospital ethics committees, and national guidelines, such as publications from the American Academy of Pediatrics, American Medical Association, or Society of Critical Care Medicine, are an essential part of the toolkit of any intensivist. Open discussion with colleagues and within the multidisciplinary team can also ensure that when difficult situations arise, they are addressed in a proactive, evidence-based, and collegial manner. Copyright © 2013 Elsevier Inc. All rights reserved.
Student Discipline Data Tracker v.1
ERIC Educational Resources Information Center
Steel, Lawrence E.
2005-01-01
One of the most difficult tasks facing today's busy school administrative teams is tracking and managing student discipline. Administrators must balance the rights of students with cultivating classroom environments conducive to learning. Breakdowns in communication, procedure, and due process can lead to unpleasant situations, and ultimately, a…
Managing in the interprofessional environment: a theory of action perspective.
Rogers, Tim
2004-08-01
Managers of multidisciplinary teams face difficult dilemmas in managing competing interests, diverse perspectives and interpersonal conflicts. This paper illustrates the potential of the theory of action methodology of Argyris and Schön (1974, 1996) to illuminate these problems and contribute to their resolution. An empirical example of a depth-investigation with one multidisciplinary community health care team leader in Australia demonstrates that the theory of action offers a more accurate account of the causal dimensions of her dilemmas and provides more scope for effective intervention than her lay explanation will allow. It also provides a more satisfactory analysis of her difficulties with two common problems identified in the literature: defining the appropriate level of autonomy for team members and developing constructive dialogue across perceived discipline-based differences of opinion. Consequently the theory of action appears to offer enormous promise to managers of multidisciplinary teams wanting to understand and resolve their problems and develop a rigorous reflective practice. Further research on the viability of the theory to facilitate a self-correcting system that can promote learning even under conditions of stress and conflict is suggested and implications for learning and teaching for the multidisciplinary environment are briefly discussed.
Report of the Space Shuttle Management Independent Review Team
NASA Technical Reports Server (NTRS)
1995-01-01
At the request of the NASA Administrator a team was formed to review the Space Shuttle Program and propose a new management system that could significantly reduce operating costs. Composed of a group of people with broad and extensive experience in spaceflight and related areas, the team received briefings from the NASA organizations and most of the supporting contractors involved in the Shuttle Program. In addition, a number of chief executives from the supporting contractors provided advice and suggestions. The team found that the present management system has functioned reasonably well despite its diffuse structure. The team also determined that the shuttle has become a mature and reliable system, and--in terms of a manned rocket-propelled space launch system--is about as safe as today's technology will provide. In addition, NASA has reduced shuttle operating costs by about 25 percent over the past 3 years. The program, however, remains in a quasi-development mode and yearly costs remain higher than required. Given the current NASA-contractor structure and incentives, it is difficult to establish cost reduction as a primary goal and implement changes to achieve efficiencies. As a result, the team sought to create a management structure and associated environment that enables and motivates the Program to further reduce operational costs. Accordingly, the review team concluded that the NASA Space Shuttle Program should (1) establish a clear set of program goals, placing a greater emphasis on cost-efficient operations and user-friendly payload integration; (2) redefine the management structure, separating development and operations and disengaging NASA from the daily operation of the space shuttle; and (3) provide the necessary environment and conditions within the program to pursue these goals.
Report of the Space Shuttle Management Independent Review Team
NASA Astrophysics Data System (ADS)
1995-02-01
At the request of the NASA Administrator a team was formed to review the Space Shuttle Program and propose a new management system that could significantly reduce operating costs. Composed of a group of people with broad and extensive experience in spaceflight and related areas, the team received briefings from the NASA organizations and most of the supporting contractors involved in the Shuttle Program. In addition, a number of chief executives from the supporting contractors provided advice and suggestions. The team found that the present management system has functioned reasonably well despite its diffuse structure. The team also determined that the shuttle has become a mature and reliable system, and--in terms of a manned rocket-propelled space launch system--is about as safe as today's technology will provide. In addition, NASA has reduced shuttle operating costs by about 25 percent over the past 3 years. The program, however, remains in a quasi-development mode and yearly costs remain higher than required. Given the current NASA-contractor structure and incentives, it is difficult to establish cost reduction as a primary goal and implement changes to achieve efficiencies. As a result, the team sought to create a management structure and associated environment that enables and motivates the Program to further reduce operational costs. Accordingly, the review team concluded that the NASA Space Shuttle Program should (1) establish a clear set of program goals, placing a greater emphasis on cost-efficient operations and user-friendly payload integration; (2) redefine the management structure, separating development and operations and disengaging NASA from the daily operation of the space shuttle; and (3) provide the necessary environment and conditions within the program to pursue these goals.
Implementing Large Projects in Software Engineering Courses
ERIC Educational Resources Information Center
Coppit, David
2006-01-01
In software engineering education, large projects are widely recognized as a useful way of exposing students to the real-world difficulties of team software development. But large projects are difficult to put into practice. First, educators rarely have additional time to manage software projects. Second, classrooms have inherent limitations that…
Dealing with aggressive behavior within the health care team: a leadership challenge.
Hynes, Patricia; Kissoon, Niranjan; Hamielec, Cindy M; Greene, Anne Marie; Simone, Carmine
2006-06-01
During an interdisciplinary Canadian leadership forum [ (click on the Conferences icon)], participants were challenged to develop an approach to a difficult leadership/management situation. In a scenario involving aggressive behavior among health care providers, participants identified that, before responding, an appropriate leader should collect additional information to identify the core problem(s) causing such behavior. Possibilities include stress; lack of clear roles, responsibilities, and standard operating procedures; and, finally, lack of training on important leadership/management skills. As a result of these core problems, several potential solutions are possible, all with potential obstacles to implementation. Additional education around communication and team interaction was felt to be a priority. In summary, clinical leaders probably have a great deal to gain from augmenting their leadership/management skills.
A scoping review of crisis teams managing dementia in older people.
Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin
2017-01-01
Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.
A scoping review of crisis teams managing dementia in older people
Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin
2017-01-01
Background Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. Methods For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. Results The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Conclusion Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness. PMID:29042760
Zimmerman, Christine; Kennedy, Christopher; Schremmer, Robert; Smith, Katharine V.
2010-01-01
Objective To design and implement a demonstration project to teach interprofessional teams how to recognize and engage in difficult conversations with patients. Design Interdisciplinary teams consisting of pharmacy students and residents, student nurses, and medical residents responded to preliminary questions regarding difficult conversations, listened to a brief discussion on difficult conversations; formed ad hoc teams and interacted with a standardized patient (mother) and a human simulator (child), discussing the infant's health issues, intimate partner violence, and suicidal thinking; and underwent debriefing. Assessment Participants evaluated the learning methods positively and a majority demonstrated knowledge gains. The project team also learned lessons that will help better design future programs, including an emphasis on simulations over lecture and the importance of debriefing on student learning. Drawbacks included the major time commitment for design and implementation, sustainability, and the lack of resources to replicate the program for all students. Conclusion Simulation is an effective technique to teach interprofessional teams how to engage in difficult conversations with patients. PMID:21088725
Pol, Manjunath Maruti; Prasad, K Shiv Krishna; Deo, Vishant; Uniyal, Madhur
2016-09-02
Penetrating cardiac injury (PCI) is gradually increasing in developing countries owing to large-scale manufacturing of illegal country-made weapons. These injuries are associated with significant morbidity and mortality. Logistically it is difficult to have all organ-based specialists arrive together and attend every critically injured patient round-the-clock in developing countries. It is therefore important for doctors (physicians, surgeons and anaesthetists) to be trained for adequate management of critically injured patients following trauma. We report the approach towards 2 cases of haemodynamically unstable PCI managed by a team of trauma doctors. Time lag (duration between injury and arrival at hospital) and quick horizontal resuscitation are important considerations in the treatment. By not referring these patients to different hospitals the team actually reduced the time lag, and a quick life-saving surgery by trauma surgeons (trained in torso surgery) offered these almost dying patients a chance of survival. 2016 BMJ Publishing Group Ltd.
Simulation Based Training Improves Airway Management for Helicopter EMS Teams
NASA Technical Reports Server (NTRS)
Dhindsa, Harinder S.; Reid, Renee; Murray, David; Lovelady, James; Powell, Katie; Sayles, Jeff; Stevenson, Christopher; Baker, Kathy; Solada, Brian; Carroll, Scott;
2011-01-01
The use of paralytic medications in the performance of RSI intubation is a high risk intervention used by many HEMS crews. There is no margin for error in RSI intubation as the results can be fatal. Operating room access for airway management training has become more difficult, and is not representative of the environment in which HEMS crews typically function. LifeEvac of Virginia designed and implemented an SST airway management program to provide a realistic, consistent training platform. The dynamic program incorporates standardized scenarios, and real life challenging cases that this and other programs have encountered. SST is done in a variety of settings including the helicopter, back of ambulances, staged car crashes and simulation centers. The result has been the indoctrination of a well defined, consistent approach to every airway management intervention. The SST program facillitates enhancement of technical skills. as well as team dynamics and communication.
Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M; Gullickson, Amy M; Orizondo-Korotko, Krystyna; Gross, Amy C; Fuqua, Wayne; Lammers, Richard
2010-01-01
Since the publication of "To Err Is Human" in 1999, health care professionals have looked to high-reliability industries such as aviation for guidance on improving system safety. One of the most widely adopted aviation-derived approaches is simulation-based team training, also known as crew resource management training. In the health care domain, crew resource management training often takes place in custom-built simulation laboratories that are designed to replicate operating rooms or labor and delivery rooms. Unlike these traditional crew resource management training programs, "in situ simulation" occurs on actual patient care units, involves actual health care team members, and uses actual organization processes to train and assess team performance. During the past 24 months, our research team has conducted nearly 40 in situ simulations. In this article, we present the results from 1 such simulation: a patient who experienced a difficult labor that resulted in an emergency caesarian section and hysterectomy. During the simulation, a number of latent environmental threats to safety were identified. This article presents the latent threats and the steps that the hospital has taken to remedy them.
Wilk, Szymon; Kezadri-Hamiaz, Mounira; Rosu, Daniela; Kuziemsky, Craig; Michalowski, Wojtek; Amyot, Daniel; Carrier, Marc
2016-02-01
In healthcare organizations, clinical workflows are executed by interdisciplinary healthcare teams (IHTs) that operate in ways that are difficult to manage. Responding to a need to support such teams, we designed and developed the MET4 multi-agent system that allows IHTs to manage patients according to presentation-specific clinical workflows. In this paper, we describe a significant extension of the MET4 system that allows for supporting rich team dynamics (understood as team formation, management and task-practitioner allocation), including selection and maintenance of the most responsible physician and more complex rules of selecting practitioners for the workflow tasks. In order to develop this extension, we introduced three semantic components: (1) a revised ontology describing concepts and relations pertinent to IHTs, workflows, and managed patients, (2) a set of behavioral rules describing the team dynamics, and (3) an instance base that stores facts corresponding to instances of concepts from the ontology and to relations between these instances. The semantic components are represented in first-order logic and they can be automatically processed using theorem proving and model finding techniques. We employ these techniques to find models that correspond to specific decisions controlling the dynamics of IHT. In the paper, we present the design of extended MET4 with a special focus on the new semantic components. We then describe its proof-of-concept implementation using the WADE multi-agent platform and the Z3 solver (theorem prover/model finder). We illustrate the main ideas discussed in the paper with a clinical scenario of an IHT managing a patient with chronic kidney disease.
Managing Your Team's Weakest Link.
Hills, Laura
2015-01-01
Do you have a poor-performing employee on your medical practice team? If so, you're not alone. Unfortunately, this is a problem that many medical practice managers face. This article describes the best strategies for managing your team's weakest link. It explores common yet very difficult circumstances that cause low employee performance and that test the patience, heart, and skills of a practice manager. It guides readers through a process of self-discovery to determine whether their negative biases or grudges may be causing employees to perform poorly. It suggests several possible other reasons for weak employee performance, including problems with the job, practice, leadership, communication, and fit between the employee and the job. This article also suggests the best strategy for communicating concerns about performance to the weakest-link employee. It offers guidance to practice managers about protecting their time and energy when handling a poor performer. It provides a simple formula for calculating the cost of a low-performing employee, 10 possible personal reasons for the employee's poor work performance, specific questions to ask to uncover the reasons for poor performance, and an eight-rule strategy for confronting poor performance effectively. Finally, this article offers practice managers a practical strategy for handling resistance from their weakest link, illustrated with a sample dialogue.
Conflicts in the operating theatre.
Booij, Leo H D J
2007-04-01
Quality and safety of healthcare depend on team performance. Conflicts decrease team performance. A number of studied factors involved in the development and solution of conflicts are discussed. An operating team consists of individuals, with specific roles requiring specific expertise and skills, performing interdependent tasks with patient treatment as a common goal. Teams are prone to conflicts: a dispute, disagreement or difference of opinion related to patient management, requiring some decision or action. Many factors determine the character of the conflicts, and these vary between different countries, hospitals and teams. Factors include culture, professional social status, personality of members, etc. Conflicts can induce innovation, but can also result in job dissatisfaction. They even can affect the functioning of the hospital. On average, four conflicts can be observed per operation, which are mostly solved immediately. Communication in an open atmosphere is a major issue in dealing with conflicts. If conflicts are unresolved they grow into relationship conflicts, which are difficult to handle. Understanding the factors that contribute to the conflict is important for mediators. Most conflicts arise about theatre management, case acceptation, unexpected changes in the team or incapability of one of its members. There are many possible inductors of conflicts. Conflicts should be immediately resolved by open communication and respectful discussion.
Paolini, Jean-Baptiste; Donati, François; Drolet, Pierre
2013-02-01
An adequate airway management plan is essential for patient safety. Recently, new tools have been developed as alternatives to direct laryngoscopy and intubation. Among these, video-laryngoscopy has enjoyed a rapid increase in popularity and is now considered by many as the first-line technique in airway management. This paradigm shift may have an impact on patient safety. Studies show that video-laryngoscopes are associated with better glottic visualization, a higher success rate for difficult airways, and a faster learning curve, resulting in a higher success rate for intubations by novice physicians. Thus, unanticipated difficult intubations may be less frequent if video-laryngoscopy is used as the first-line approach. In addition, on-screen viewing by the operator creates a new dynamic interaction during airway management. The entire operating room team can assess progress in real time, which enhances communication and improves teaching. However, if video-laryngoscopes become standard tools for tracheal intubation, these more costly devices will need to be widely available in all locations where airway management is conducted. Furthermore, algorithms for difficult intubation will require modification, and the question of selecting alternate devices will arise. If the incidence of difficult intubation decreases, the lack of motivation to teach and learn the use of alternative devices might adversely impact patient safety. The greater effectiveness of video-laryngoscopes associated with multi-person visualization could enhance overall patient safety during airway management. However, the routine use of video-laryngoscopy also introduces some issues that need to be addressed to avoid potentially dangerous pitfalls.
Bearman, Chris; Grunwald, Jared A; Brooks, Benjamin P; Owen, Christine
2015-03-01
Emergency situations are by their nature difficult to manage and success in such situations is often highly dependent on effective team coordination. Breakdowns in team coordination can lead to significant disruption to an operational response. Breakdowns in coordination were explored in three large-scale bushfires in Australia: the Kilmore East fire, the Wangary fire, and the Canberra Firestorm. Data from these fires were analysed using a top-down and bottom-up qualitative analysis technique. Forty-four breakdowns in coordinated decision making were identified, which yielded 83 disconnects grouped into three main categories: operational, informational and evaluative. Disconnects were specific instances where differences in understanding existed between team members. The reasons why disconnects occurred were largely consistent across the three sets of data. In some cases multiple disconnects occurred in a temporal manner, which suggested some evidence of disconnects creating states that were conducive to the occurrence of further disconnects. In terms of resolution, evaluative disconnects were nearly always resolved however operational and informational disconnects were rarely resolved effectively. The exploratory data analysis and discussion presented here represents the first systematic research to provide information about the reasons why breakdowns occur in emergency management and presents an account of how team processes can act to disrupt coordination and the operational response. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
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.
Does participative leadership reduce the onset of mobbing risk among nurse working teams?
Bortoluzzi, Guido; Caporale, Loretta; Palese, Alvisa
2014-07-01
To evaluate the advancement of knowledge on the impact of an empowering leadership style on the risk of mobbing behaviour among nurse working teams. The secondary aim was to evaluate, along with leadership style, the contribution of other organisational- and individual-related mobbing predictors. The style of leadership in reducing the onset of mobbing risk in nurse working teams still remains a matter of discussion. Nurse working teams are particularly affected by mobbing and studies exploring individual and organisational inhibiting/modulating factors are needed. An empirical study involving 175 nurses of various public hospital corporations in northern Italy. Data were collected via structured and anonymous questionnaires and analysed through a logistic regression. Organisational, individual and participative leadership variables explained 33.5% (P < 0.01) of variance in the onset of mobbing. Two predictive factors emerged: a participative leadership enacted by nursing managers and the nursing shortage as perceived by clinical nurses. Results confirmed that the contribution made by a participative leadership style in attenuating the onset of mobbing risk in working teams was significant. A participative leadership style adopted by the nurse manager allows for the reduction of tensions in nurse working teams. However, mobbing remains a multifaceted phenomenon that is difficult to capture in its entirety and the leadership style cannot be considered as a panacea for resolving this problem in nurse working teams. © 2013 John Wiley & Sons Ltd.
Hiring an associate dean of academic affairs.
Pressler, Jana L; Kenner, Carole A
2009-01-01
Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Effecting change in striving to achieve capacity.
Pressler, Jana L; Kenner, Carole
2007-01-01
Many new nursing leaders assuming deanships and assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Embracing new directions in curricula and teaching.
Pressler, Jana L; Kenner, Carole
2009-01-01
Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Addressing the underperformance of faculty and staff.
Kenner, Carole; Pressler, Jana L
2006-01-01
Many new nursing leaders assuming work as deans, assistant deans, or interim deans have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, both deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
When does outsourcing become a right source for academic excellence?
Kenner, Carole; Pressler, Jana L
2006-01-01
Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Capitalizing on joint ventures to economize in nursing.
Pressler, Jana L; Kenner, Carole A
2010-01-01
Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Starting small and early for research funding.
Pressler, Jana L; Kenner, Carole A
2009-01-01
Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
The ripple effect: advancing faculty research?
Kenner, Carole; Pressler, Jana L
2008-01-01
Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Performance evaluations and literacy.
Pressler, Jana L; Kenner, Carole A
2009-01-01
Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Return on investment: an essential economics measure in higher education.
Pressler, Jana L; Kenner, Carole A
2014-01-01
Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.
Implementing large projects in software engineering courses
NASA Astrophysics Data System (ADS)
Coppit, David
2006-03-01
In software engineering education, large projects are widely recognized as a useful way of exposing students to the real-world difficulties of team software development. But large projects are difficult to put into practice. First, educators rarely have additional time to manage software projects. Second, classrooms have inherent limitations that threaten the realism of large projects. Third, quantitative evaluation of individuals who work in groups is notoriously difficult. As a result, many software engineering courses compromise the project experience by reducing the team sizes, project scope, and risk. In this paper, we present an approach to teaching a one-semester software engineering course in which 20 to 30 students work together to construct a moderately sized (15KLOC) software system. The approach combines carefully coordinated lectures and homeworks, a hierarchical project management structure, modern communication technologies, and a web-based project tracking and individual assessment system. Our approach provides a more realistic project experience for the students, without incurring significant additional overhead for the instructor. We present our experiences using the approach the last 2 years for the software engineering course at The College of William and Mary. Although the approach has some weaknesses, we believe that they are strongly outweighed by the pedagogical benefits.
Solid organ transplantation: referral, management, and outcomes in HIV-infected patients.
Roland, Michelle E; Carlson, Laurie L; Frassetto, Lynda A; Stock, Peter G
2006-12-01
Advances in HIV management make it difficult to deny solid organ transplantation to HIV-infected patients based on futility arguments. Preliminary studies suggest that both patient and graft survival are similar in HIV-negative and HIV-positive transplant recipients. While there has been no significant HIV disease progression, substantial interactions between immunosuppressants and antiretroviral drugs necessitate careful monitoring. The evaluation and management of HIV-infected transplant candidates and recipients require excellent communication among a multidisciplinary team, the primary HIV care provider, and the patient. Timely referral for transplant evaluation will prevent unnecessary mortality during the pre-transplant evaluation process.
Managing the negatives of experience in physician teams.
Hoff, Timothy
2010-01-01
Experience is a key shaper of thought and action in the health care workplace and a fundamental component of management and professional policies dealing with improving quality of care. Physicians rely on experience to structure social interaction, to determine authority relations, and to resist organizational encroachments on their work and autonomy. However, an overreliance on experience within physician teams may paradoxically undermine learning, participation, and entrepreneurship, affecting organizational performance. Approximately 100 hours of direct observation of normal workdays for physician teams (n = 17 physicians) in two different work settings in a single academic medical center located in the Northeastern part of the United States. Qualitative data were collected from physician teams in the medical intensive care unit and trauma/general surgery settings. Data were transcribed and computer analyzed through an interactive process of open coding, theoretical sampling, and pattern recognition that proceeded longitudinally. Three particular experience-based schemas were identified that physician teams used to structure social relations and perform work. These schemas involved using experience as a commodity, trump card, and liberator. Each of these schemas consisted of strongly held norms, beliefs, and values that produced team dynamics with the potential for undermining learning, participation, and entrepreneurship in the group. Organizations may move to mitigate the negative impact of an overreliance on experience among physicians by promoting bureaucratic forms of control that enable physicians to engage learning, participation, and entrepreneurship in their work while not usurping existing and difficult-to-change cultural drivers of team behavior.
NASA Technical Reports Server (NTRS)
Eppler, Dean B.
2013-01-01
The scientific success of any future human lunar exploration mission will be strongly dependent on design of both the systems and operations practices that underpin crew operations on the lunar surface. Inept surface mission preparation and design will either ensure poor science return, or will make achieving quality science operation unacceptably difficult for the crew and the mission operations and science teams. In particular, ensuring a robust system for managing real-time science information flow during surface operations, and ensuring the crews receive extensive field training in geological sciences, are as critical to mission success as reliable spacecraft and a competent operations team.
Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina
2012-01-01
Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.
How to have an honest conversation about your business strategy.
Beer, Michael; Eisenstat, Russell A
2004-02-01
Too many organizations descend into underperformance because they can't confront the painful gap between their strategy and the reality of their capabilities, their behaviors, and their markets. That's because senior managers don't know how to engage in truthful conversations about the problems that threaten the business--and because lower-level managers are afraid to speak up. These factors lie behind many failures to implement strategy. Indeed, the dynamics in almost any organization are such that it's extremely difficult for senior people to hear the unfiltered truth from managers lower down. Beer and Eisenstat present the methodology they've developed for getting the truth about an organization's problems (and the truth is always embedded within the organization) onto the table in a way that allows senior management to do something useful with it. By assembling a task force of the most effective managers to collect data about strategic and organizational problems, the senior team sends a clear message that it is serious about uncovering the truth. Task force members present their findings to the senior team in the form of a discussion. This conversation needs to move back and forth between advocacy and inquiry; it has to be about the issues that matter most; it has to be collective and public; it has to allow employees to be honest without risking their jobs; and it has to be structured. This direct feedback from a handful of their best people moves senior teams to make changes they otherwise might not have. Senior teams that have engaged in this process have made dramatic changes in how their businesses are organized and managed--and in their bottom-line results. Success that begins with honest conversations begets future conversations that further improve performance.
Psychosocial interventions in patients with dual diagnosis
Subodh, B.N; Sharma, Nidhi; Shah, Raghav
2018-01-01
Management of patients with dual diagnosis (Mental illness and substance use disorders) is a challenge. A lack of improvement in either disorder can lead to a relapse in both. The current consensus opinion favours an integrated approach to management of both the disorders wherein the same team of professionals manages both the disorders in the same setting. The role of pharmacotherapy for such dual diagnosis patients is well established but the non-pharmacological approaches for their management are still evolving. After stabilization of the acute phase of illnesses, non-pharmacological management takes centre stage. Evidence points to the beneficial effect of psychosocial approaches in maintaining abstinence, adherence to medication, maintenance of a healthy life style, better integration in to community, occupational rehabilitation and an overall improvement in functioning. Psychosocial approaches although beneficial, are difficult to implement. They require teamwork, involving professionals other than psychiatrists and psychologists alone. These approaches need to be comprehensive, individualized and require training to various levels that is difficult to achieve in most Indian settings. In this article we provide a brief review of these approaches. PMID:29540920
Integrality: life principle and right to health.
Viegas, Selma Maria Fonseca; Penna, Cláudia Maria de Mattos
2015-01-01
To understand the health integrality in the daily work of Family Health Strategy (FHS) and its concept according to the managers in Jequitinhonha Valley, Minas Gerais, Brazil. This is a multiple case study of holistic and qualitative approach based on the Quotidian Comprehensive Sociology. The subjects were workers of the Family Health Strategy teams, the support team and managers in a total of 48. The results show the integrality as a principle of life and right to health and to contemplate it in the quotidian of doings in health, others principles of the Unified Health System may be addressed consecutively. The universal right to health care needs is declared in contemplation of integrity of being, the idealization of a subject-centered care, one that is our aim in health care, which signals a step towards a change of attitude in seeking comprehensive care. It is considered that the principle of integrality is a difficult accomplishment in its dimensions.
Systems engineering implementation in the preliminary design phase of the Giant Magellan Telescope
NASA Astrophysics Data System (ADS)
Maiten, J.; Johns, M.; Trancho, G.; Sawyer, D.; Mady, P.
2012-09-01
Like many telescope projects today, the 24.5-meter Giant Magellan Telescope (GMT) is truly a complex system. The primary and secondary mirrors of the GMT are segmented and actuated to support two operating modes: natural seeing and adaptive optics. GMT is a general-purpose telescope supporting multiple science instruments operated in those modes. GMT is a large, diverse collaboration and development includes geographically distributed teams. The need to implement good systems engineering processes for managing the development of systems like GMT becomes imperative. The management of the requirements flow down from the science requirements to the component level requirements is an inherently difficult task in itself. The interfaces must also be negotiated so that the interactions between subsystems and assemblies are well defined and controlled. This paper will provide an overview of the systems engineering processes and tools implemented for the GMT project during the preliminary design phase. This will include requirements management, documentation and configuration control, interface development and technical risk management. Because of the complexity of the GMT system and the distributed team, using web-accessible tools for collaboration is vital. To accomplish this GMTO has selected three tools: Cognition Cockpit, Xerox Docushare, and Solidworks Enterprise Product Data Management (EPDM). Key to this is the use of Cockpit for managing and documenting the product tree, architecture, error budget, requirements, interfaces, and risks. Additionally, drawing management is accomplished using an EPDM vault. Docushare, a documentation and configuration management tool is used to manage workflow of documents and drawings for the GMT project. These tools electronically facilitate collaboration in real time, enabling the GMT team to track, trace and report on key project metrics and design parameters.
Challenges in defining 'palliative care' for the purposes of clinical trials.
Bausewein, Claudia; Higginson, Irene J
2012-12-01
Palliative care has become part of mainstream medicine with increasing evidence about the effectiveness of specialist palliative care (SPC) on patient and family outcomes. Comparison of studies testing SPC interventions is challenging as types of interventions and reporting of components of the intervention vary. In consequence, study results are difficult to interpret. There is a continuous lack of clarity in palliative care definitions. For clinical trials, multidisciplinary care, supportive care documentation, symptom assessment and symptom management are suggested as key domains. In recent studies testing palliative care as an intervention SPC physicians and palliative care nurses were core members of multiprofessional teams, but integration of other team members varied. Management of symptoms and psychosocial issues were central to SPC with various other areas described. Services were delivered by hospital and community support teams, in palliative care units, outpatient clinics and hospital. Cost information was only provided by a few studies. Due to the lack of an agreed definition of palliative care and heterogeneity in reporting of components of an SPC intervention comparison of studies remains challenging. Key aspects of palliative care interventions are incurable disease, multidisciplinary approach, focus on symptom management including standardized assessment, psychosocial and family support, and (advance) care planning. Detailed information about all aspects of the intervention should be provided.
Gender identity in disorders of sex development: review article.
Yang, Jennifer H; Baskin, Laurence S; DiSandro, Michael
2010-01-01
Many concerns have been raised regarding the treatment and long-term outcome of infants born with complex genital anomalies. Debate among clinicians, psychologists, ethicists, and patient advocate groups regarding the optimal management of these individuals is ongoing. Although determining the most appropriate gender is a difficult task, this review will help clarify some of the issues at hand. A literature review which addresses the challenges of advising families about gender identity in infants and children with disorders of sex development. The evidence for endocrine effects on neurobiological development with regard to sexual behavior is compelling, although the existing outcome studies are largely anecdotal and somewhat contradictory. Gender assignment in infants born with a disorder of sex development remains only one of the many difficult decisions faced by both the treatment team and the family. Improved long-term follow-up of these patients will provide much needed feedback on previous and contemporary management. 2010 Elsevier Inc. All rights reserved.
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
Management of district hospitals--exploring success.
Couper, Ian D; Hugo, Jannie F M
2005-01-01
The aim of the study was to explore and document what assists a rural district hospital to function well. The lessons learned may be applicable to similar hospitals all over the world. A cross-sectional exploratory study was carried out using in-depth interviews with 21 managers of well-functioning district hospitals in two districts in South Africa. Thirteen themes were identified, integrated into three clusters, namely 'Teams working together for a purpose', 'Foundational framework and values' and 'Health Service and the community'. Teamwork and teams was a dominant theme. Teams working together are held together by the cement of good relationships and are enhanced by purposeful meetings. Unity is grown through solving difficult problems together and commitment to serving the community guides commitment towards each other, and towards patients and staff. Open communication and sharing lots of information between people and teams is the way in which these things happen. The structure and systems that have developed over years form the basis for teamwork. The different management structures and processes are developed with a view to supporting service and teamwork. A long history of committed people who hand over the baton when they leave creates a stable context. The health service and community theme cluster describes how integration in the community and community services is important for these managers. There is also a focus on involving community representatives in the hospital development and governance. Capacity building for staff is seen in the same spirit of serving people and thus serving staff, all aimed at reaching out to people in need in the community. The three clusters and thirteen themes and the relationships between them are described in detail through diagrams and narrative in the article. Much can be learned from the experience of these managers. The key issue is the development of a team in the hospital, a team with a unified vision of giving patients priority, respecting each other as well as patients, and working in and with the community to achieve optimal health care in the district hospital.
Wang, Yunjiao J; Seggelke, Stacey; Hawkins, R Matthew; Gibbs, Joanna; Lindsay, Mark; Hazlett, Ingrid; Low Wang, Cecilia C; Rasouli, Neda; Young, Kendra A; Draznin, Boris
2016-12-01
To improve glycemic control of hospitalized patients with diabetes and hyperglycemia, many medical centers have established dedicated glucose management teams (GMTs). However, the impact of these specialized teams on clinical outcomes has not been evaluated. We conducted a retrospective study of 440 patients with type 2 diabetes admitted to the medical service for cardiac or infection-related diagnosis. The primary endpoint was a composite outcome of several well-recognized markers of morbidity, consisting of: death during hospitalization, transfer to intensive care unit, initiation of enteral or parenteral nutrition, line infection, new in-hospital infection or infection lasting more than 20 days of hospitalization, deep venous thrombosis or pulmonary embolism, rise in plasma creatinine, and hospital re-admissions. Medical housestaff managed the glycemia in 79% of patients (usual care group), while the GMT managed the glycemia in 21% of patients (GMT group). The primary outcome was similar between cohorts (0.95 events per patient versus 0.99 events per patient in the GMT and usual care cohorts, respectively). For subanalysis, the subjects in both groups were stratified into those with average glycemia of <180 mg/dL versus those with glycemia >180 mg/dL. We found a significant beneficial impact of glycemic management by the GMT on the composite outcome in patients with average glycemia >180 mg/dL during their hospital stay. The number of patients who met primary outcome was significantly higher in the usual care group (40 of 83 patients, 48%) than in the GMT-treated cohort (8 of 33 patients, 25.7%) (P<.02). Our data suggest that GMTs may have an important role in managing difficult-to-control hyperglycemia in the inpatient setting. BG = blood glucose GMT = glucose management team HbA1c = hemoglobin A1c ICU = intensive care unit POC = point of care T2D = type 2 diabetes.
Ares I Integrated Vehicle System Safety Team
NASA Technical Reports Server (NTRS)
Wetherholt, Jon; McNairy, Lisa; Shackelford, Carla
2009-01-01
Complex systems require integrated analysis teams which sometimes are divided into subsystem teams. Proper division of the analysis in to subsystem teams is important. Safety analysis is one of the most difficult aspects of integration.
Critical Airway Team: A Retrospective Study of an Airway Response System in a Pediatric Hospital.
Sterrett, Emily C; Myer, Charles M; Oehler, Jennifer; Das, Bobby; Kerrey, Benjamin T
2017-12-01
Objective Study the performance of a pediatric critical airway response team. Study Design Case series with chart review. Setting Freestanding academic children's hospital. Subjects and Methods A structured review of the electronic medical record was conducted for all activations of the critical airway team. Characteristics of the activations and patients are reported using descriptive statistics. Activation of the critical airway team occurred 196 times in 46 months (March 2012 to December 2015); complete data were available for 162 activations (83%). For 49 activations (30%), patients had diagnoses associated with difficult intubation; 45 (28%) had a history of difficult laryngoscopy. Results Activation occurred at least 4 times per month on average (vs 3 per month for hospital-wide codes). The most common reasons for team activation were anticipated difficult intubation (45%) or failed intubation attempt (20%). For 79% of activations, the team performed an airway procedure, most commonly direct laryngoscopy and tracheal intubation. Bronchoscopy was performed in 47% of activations. Surgical airway rescue was attempted 4 times. Cardiopulmonary resuscitation occurred in 41 activations (25%). Twenty-nine patients died during or following team activation (18%), including 10 deaths associated with the critical airway event. Conclusion Critical airway team activation occurred at least once per week on average. Direct laryngoscopy, tracheal intubation, and bronchoscopic procedures were performed frequently; surgical airway rescue was rare. Most patients had existing risk factors for difficult intubation. Given our rate of serious morbidity and mortality, primary prevention of critical airway events will be a focus of future efforts.
Being Right Isn't Always Enough: NFL Culture and Team Physicians' Conflict of Interest.
McKinney, Ross
2016-11-01
The job of being a sports team physician is difficult, regardless of the level, from high school to the National Football League. When a sports league receives the intensity of attention leveled at the NFL, though, a difficult occupation becomes even more challenging. Even for the NFL players themselves, players' best interests regarding health issues are often unclear. Football players are, as a lot, highly competitive individuals. They want to win, and they want to help the team win. It's a warrior culture, and respect is earned by playing hurt. Should the team physician respect a player's autonomy when this means allowing him to make choices that might lead to further personal harm, especially if the player's choices align with the preference of the coach and management? Or should the doctor set limits and balance the player's choices with a paternalistic set of constraints, perhaps in opposition to both the player's and the team's desires? Simplification of this web of conflicts of interest is the goal of the model proposed by Glenn Cohen, Holly Lynch, and Christopher Deubert. In my view, their proposal is very clever. As an idea, it meets the expectations its authors set, namely, to minimize the problem of conflict of interest in the delivery of health care services to NFL football players. The ethics of the proposal align well with certain moral goals, like treating the player's interests more fairly and treating the player's health as an end instead of as the means to an end. But will such a proposal ever make headway in the pressurized environment of the NFL? © 2016 The Hastings Center.
Practical multimodal care for cancer cachexia.
Maddocks, Matthew; Hopkinson, Jane; Conibear, John; Reeves, Annie; Shaw, Clare; Fearon, Ken C H
2016-12-01
Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate nutritional support, exercise, and anti-inflammatory agents, on a background of personalized oncology care and family-centred education. Collectively, the cases reveal that multimodal care is part of everyone's remit, often focuses on supported self-management, and demands buy-in from the patient and their family. Once operationalized, multimodal care approaches can be tested pragmatically, including alongside emerging pharmacological cachexia treatments. We demonstrate that multimodal care for cancer cachexia can be achieved using simple treatments and without a dedicated team of specialists. The sharing of advice between health professionals can help build collective confidence and expertise, moving towards a position in which every team member feels they can contribute towards multimodal care.
Thompson, Cesarina M
2011-01-01
Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, Jana L. Pressler, PhD, RN, and Carole A. Kenner, PhD, RNC-NIC, FAAN, the editors of this department, address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. In this article, the editors asked guest author, Dr Cesarina Thompson, to discuss the transition process from faculty to administrative role.
Tuck, Geoffrey N; Whitten, Athol R
2013-01-01
Annual draft systems are the principal method used by teams in major sporting leagues to recruit amateur players. These draft systems frequently take one of three forms: a lottery style draft, a weighted draft, or a reverse-order draft. Reverse-order drafts can create incentives for teams to deliberately under-perform, or tank, due to the perceived gain from obtaining quality players at higher draft picks. This paper uses a dynamic simulation model that captures the key components of a win-maximising sporting league, including the amateur player draft, draft choice error, player productivity, and between-team competition, to explore how competitive balance and incentives to under-perform vary according to league characteristics. We find reverse-order drafts can lead to some teams cycling between success and failure and to other teams being stuck in mid-ranking positions for extended periods of time. We also find that an incentive for teams to tank exists, but that this incentive decreases (i) as uncertainty in the ability to determine quality players in the draft increases, (ii) as the number of teams in the league reduces, (iii) as team size decreases, and (iv) as the number of teams adopting a tanking strategy increases. Simulation models can be used to explore complex stochastic dynamic systems such as sports leagues, where managers face difficult decisions regarding the structure of their league and the desire to maintain competitive balance.
Tuck, Geoffrey N.; Whitten, Athol R.
2013-01-01
Annual draft systems are the principal method used by teams in major sporting leagues to recruit amateur players. These draft systems frequently take one of three forms: a lottery style draft, a weighted draft, or a reverse-order draft. Reverse-order drafts can create incentives for teams to deliberately under-perform, or tank, due to the perceived gain from obtaining quality players at higher draft picks. This paper uses a dynamic simulation model that captures the key components of a win-maximising sporting league, including the amateur player draft, draft choice error, player productivity, and between-team competition, to explore how competitive balance and incentives to under-perform vary according to league characteristics. We find reverse-order drafts can lead to some teams cycling between success and failure and to other teams being stuck in mid-ranking positions for extended periods of time. We also find that an incentive for teams to tank exists, but that this incentive decreases (i) as uncertainty in the ability to determine quality players in the draft increases, (ii) as the number of teams in the league reduces, (iii) as team size decreases, and (iv) as the number of teams adopting a tanking strategy increases. Simulation models can be used to explore complex stochastic dynamic systems such as sports leagues, where managers face difficult decisions regarding the structure of their league and the desire to maintain competitive balance. PMID:24312243
Multidisciplinary team management in thoracic oncology: more than just a concept?
Powell, Helen A; Baldwin, David R
2014-06-01
Multidisciplinary team (MDT) management in thoracic oncology has been introduced over the past two decades with the aim of improving outcomes for patients. While MDT management has become the standard of care in some countries, not all healthcare systems have adopted this practice. In this article we review the history and implementation of MDT care in thoracic oncology and explore the evidence for, and challenges associated with, this system of working. There are many advantages of an MDT both to the patient, the clinicians and the wider population, but it is difficult to demonstrate a beneficial effect on outcomes such as treatment rates or survival given the substantial number of coexistent changes in the management of thoracic malignancies over the same time period. There are also some disadvantages associated with MDT working, particularly the costs of setting up the service and the time commitment from each of the healthcare professionals involved. Barriers to effective MDT working include poor attendance by some specialists, inadequate preparation and poor quality information about the patient. Variation in quality of MDTs has been reported so it is important that practice is monitored and areas for improvement identified. ©ERS 2014.
Rodriguez, Amanda I; Zupancic, Steven; Song, Michael M; Cordero, Joehassin; Nguyen, Tam Q; Seifert, Charles
2017-03-01
Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach. To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system. Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other. A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation. Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns. Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained unspecific following the balance function assessment, and (4) the most frequently occurring vestibular diagnoses were unilateral vestibular hypofunction and benign paroxysmal positional vertigo. Following the use of an interprofessional management approach, it was determined that (1) disease-specific diagnoses increased, (2) patients with dizziness were referred for balance function testing mainly by otolaryngologists, (3) dizziness was considered to be multifaceted for a greater number of patients, (4) a larger percentage of patients were referred to a specialist other than the otolaryngologist as a result of their diagnosis, and (5) patients reported reduction or resolution of their symptoms. An interprofessional management approach for the dizzy patient can lead to more specific diagnoses and provide alternative referral pathways to other health-care professionals (e.g., audiologists, physical therapists, and pharmacists) in an effort to reduce over-referral to one specialist. Future studies should address the utility of an interprofessional team approach in the overall management of patients with dizziness. American Academy of Audiology
Foundations of teamwork and collaboration.
Driskell, James E; Salas, Eduardo; Driskell, Tripp
2018-01-01
The term teamwork has graced countless motivational posters and office walls. However, although teamwork is often easy to observe, it is somewhat more difficult to describe and yet more difficult to produce. At a broad level, teamwork is the process through which team members collaborate to achieve task goals. Teamwork refers to the activities through which team inputs translate into team outputs such as team effectiveness and satisfaction. In this article, we describe foundational research underlying current research on teamwork. We examine the evolution of team process models and outline primary teamwork dimensions. We discuss selection, training, and design approaches to enhancing teamwork, and note current applications of teamwork research in real-world settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Family reactions and their management in a parents group with beta-thalassaemia.
Tsiantis, J; Xypolita-Tsantili, D; Papadakou-Lagoyianni, S
1982-01-01
The parents of children with beta-thalassaemia displayed various patterns of emotion (guilt, death anxiety, denial of feelings) and their behaviour towards the child was inappropriate (overprotective, conspiracy of silence); this could affect his psychosocial development and lead to tension within the family. Some parents were overdemanding and even hostile to hospital staff, thus making the management of cases difficult. The therapeutic team has tried to concentrate on these problems in order to clarify them and give support to the families. This has facilitated communication within the family as well as between the family and hospital staff, and had diminished the problems. PMID:7149759
Family reactions and their management in a parents group with beta-thalassaemia.
Tsiantis, J; Xypolita-Tsantili, D; Papadakou-Lagoyianni, S
1982-11-01
The parents of children with beta-thalassaemia displayed various patterns of emotion (guilt, death anxiety, denial of feelings) and their behaviour towards the child was inappropriate (overprotective, conspiracy of silence); this could affect his psychosocial development and lead to tension within the family. Some parents were overdemanding and even hostile to hospital staff, thus making the management of cases difficult. The therapeutic team has tried to concentrate on these problems in order to clarify them and give support to the families. This has facilitated communication within the family as well as between the family and hospital staff, and had diminished the problems.
Hughes, Anne K; Woodward, Amanda T; Fritz, Michele C; Reeves, Mathew J
2018-02-01
Strokes impact over 800,000 people every year. Stroke care typically begins with inpatient care and then continues across an array of healthcare settings. These transitions are difficult for patients and caregivers, with psychosocial needs going unmet. Our team developed a case management intervention for acute stroke patients and their caregivers aimed at improving stroke transitions. The intervention focusses on four aspects of a successful care transition: support, preparedness, identifying and addressing unmet needs, and stroke education. This paper describes the development and implementation of this program, and is an example of the synergy created between neuroscience and clinical practice.
Are wildlife detector dogs or people better at finding Desert Tortoises (Gopherus agassizii)?
Nussear, K.E.; Esque, T.C.; Heaton, J.S.; Cablk, Mary E.; Drake, K.K.; Valentin, C.; Yee, J.L.; Medica, P.A.
2008-01-01
Our ability to study threatened and endangered species depends on locating them readily in the field. Recent studies highlight the effectiveness of trained detector dogs to locate wildlife during field surveys, including Desert Tortoises in a semi-natural setting. Desert Tortoises (Gopherus agassizii) are cryptic and difficult to detect during surveys, especially the smaller size classes. We conducted comparative surveys to determine whether human or detector dog teams were more effective at locating Desert Tortoises in the wild. We compared detectability of Desert Tortoises and the costs to deploy human and dog search teams. Detectability of tortoises was not statistically different for either team, and was estimated to be approximately 70% (SE = 5%). Dogs found a greater proportion of tortoises located in vegetation than did humans. The dog teams finished surveys 2.5 hours faster than the humans on average each day. The human team cost was approximately $3,000 less per square kilometer sampled. Dog teams provided a quick and effective method for surveying for adult Desert Tortoises; however, we were unable to determine-their effectiveness at locating smaller size classes. Detection of smaller size classes during surveys would improve management of the species and should be addressed by future research using Desert Tortoise detector dogs.
The AGING Initiative experience: a call for sustained support for team science networks.
Garg, Tullika; Anzuoni, Kathryn; Landyn, Valentina; Hajduk, Alexandra; Waring, Stephen; Hanson, Leah R; Whitson, Heather E
2018-05-18
Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the increasing impact on the United States society, MCC research has been identified as a high priority research area by multiple federal agencies. In response to this need, two national research entities, the Healthcare Systems Research Network (HCSRN) and the Claude D. Pepper Older Americans Independence Centers (OAIC), formed the Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative to build nationwide capacity for MCC team science. This article describes the structure, lessons learned and initial outcomes of the AGING Initiative. We call for funding mechanisms to sustain infrastructures that have demonstrated success in fostering team science and innovation in translating findings to policy change necessary to solve complex problems in healthcare.
Huh, Jin Won; Lim, Chae-Man; Koh, Younsuck; Lee, Jury; Jung, Youn-Kyung; Seo, Hyun-Suk; Hong, Sang-Bum
2014-04-01
To evaluate the efficacy of a medical emergency team activated using 24-hour monitoring by electronic medical record-based screening criteria followed by immediate intervention by a skilled team. Retrospective cohort study. Academic tertiary care hospital with approximately 2,700 beds. A total of 3,030 events activated by a medical emergency team from March 1, 2008, to February 28, 2010. None. We collected data for all medical emergency team activations: patient characteristics, trigger type for medical emergency team (electronic medical record-based screening vs calling criteria), interventions during each event, outcomes of the medical emergency team intervention, and 28-day mortality after medical emergency team activation. We analyzed data for 2009, when the medical emergency team functioned 24 hours a day, 7 days a week (period 2), compared with that for 2008, when the medical emergency team functioned 12 hours a day, 7 days a week (period 1). The commonest cause of medical emergency team activation was respiratory distress (43.6%), and the medical emergency team performed early goal-directed therapy (21.3%), respiratory care (19.9%), and difficult airway management (12.3%). For patients on general wards, 51.3% (period 1) and 38.4% (period 2) of medical emergency team activations were triggered by the electronic medical record-based screening system (electronic medical record-triggered group). In 23.4%, activation occurred because of an abnormality in laboratory screening criteria. The commonest activation criterion from electronic medical record-based screening was respiratory rate (39.4%). Over half the patients were treated in the general ward, and one third of the patients were transferred to the ICU. The electronic medical record-triggered group had lower ICU admission with an odds ratio of 0.35 (95% CI, 0.22-0.55). In surgical patients, the electronic medical record-triggered group showed the lower 28-day mortality (10.5%) compared with the call-triggered group (26.7%) or the double-triggered group (33.3%) (odds ratio 0.365 with 95% CI, 0.154-0.867, p = 0.022). We successful managed the medical emergency team with electronic medical record-based screening criteria and a skilled intervention team. The electronic medical record-triggered group had lower ICU admission than the call-triggered group or the double-triggered group. In surgical patients, the electronic medical record-triggered group showed better outcome than other groups.
Kruger, Erwin A.; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah
2013-01-01
Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179
Acute severe asthma presenting in late pregnancy.
Holland, S M; Thomson, K D
2006-01-01
Asthma is the commonest pre-existing medical condition to complicate pregnancy. Acute severe asthma in pregnancy is rare, but poses difficult problems. In particular, the decision about when and where to deliver the fetus is complex, since maternal response to asthma treatment is unpredictable. We report the successful management of a parturient presenting with acute severe asthma at 37 weeks' gestation. The controversies involved and the importance of adopting a multi-disciplinary team approach to optimise maternal and neonatal outcomes are discussed.
Smith, Marie; Cannon-Breland, Michelle L; Spiggle, Susan
2014-01-01
Health care reform initiatives are examining new care delivery models and payment reform alternatives such as medical homes, health homes, community-based care transitions teams, medical neighborhoods and accountable care organizations (ACOs). Of particular interest is the extent to which pharmacists are integrated in team-based health care reform initiatives and the related perspectives of consumers, physicians, and payers. To assess the current knowledge of consumers and physicians about pharmacist training/expertise and capacity to provide primary care medication management services in a shared resource network; determine factors that will facilitate/limit consumer interest in having pharmacists as a member of a community-based "health care team;" determine factors that will facilitate/limit physician utilization of pharmacists for medication management services; and determine factors that will facilitate/limit payer reimbursement models for medication management services using a shared resource pharmacist network model. This project used qualitative research methods to assess the perceptions of consumers, primary care physicians, and payers on pharmacist-provided medication management services using a shared resource network of pharmacists. Focus groups were conducted with primary care physicians and consumers, while semi-structured discussions were conducted with a public and private payer. Most consumers viewed pharmacists in traditional dispensing roles and were unaware of the direct patient care responsibilities of pharmacists as part of community-based health teams. Physicians noted several chronic disease states where clinically-trained pharmacists could collaborate as health care team members yet had uncertainties about integrating pharmacists into their practice workflow and payment sources for pharmacist services. Payers were interested in having credentialed pharmacists provide medication management services if the services improved quality of patient care and/or prevented adverse drug events, and the services were cost neutral (at a minimum). It was difficult for most consumers and physicians to envision pharmacists practicing in non-dispensing roles. The pharmacy profession must disseminate the existing body of evidence on pharmacists as care providers of medication management services and the related impact on clinical outcomes, patient safety, and cost savings to external audiences. Without such, new pharmacist practice models may have limited acceptance by consumers, primary care physicians, and payers. Copyright © 2014 Elsevier Inc. All rights reserved.
Texter, Karen; Davis, Jo Ann M; Phelps, Christina; Cheatham, Sharon; Cheatham, John; Galantowicz, Mark; Feltes, Timothy F
2017-07-01
With increasing survival of children with HLHS and other single ventricle lesions, the complexity of medical care for these patients is substantial. Establishing and adhering to best practice models may improve outcome, but requires careful coordination and monitoring. In 2013 our Heart Center began a process to build a comprehensive Single Ventricle Team designed to target these difficult issues. Comprehensive Single Ventricle Team in 2014 was begun, to standardize care for children with single ventricle heart defects from diagnosis to adulthood within our institution. The team is a multidisciplinary group of providers committed to improving outcomes and quality of life for children with single ventricle heart defects, all functioning within the medical home of our heart center. Standards of care were developed and implemented in five target areas to standardize medical management and patient and family support. Under the team 100 patients have been cared for. Since 2014 a decrease in interstage mortality for HLHS were seen. Using a team approach and the tools of Quality Improvement they have been successful in reaching high protocol compliance for each of these areas. This article describes the process of building a successful Single Ventricle team, our initial results, and lessons learned. Additional study is ongoing to demonstrate the effects of these interventions on patient outcomes. © 2017 Wiley Periodicals, Inc.
ERIC Educational Resources Information Center
Layton, Richard A.; Loughry, Misty L.; Ohland, Matthew W.; Ricco, George D.
2010-01-01
A significant body of research identifies a large number of team composition characteristics that affect the success of individuals and teams in cooperative learning and project-based team environments. Controlling these factors when assigning students to teams should result in improved learning experiences. However, it is very difficult for…
Pain Part 8: Burning Mouth Syndrome.
Beneng, Kiran; Renton, Tara
2016-04-01
Burning mouth syndrome (BMS) is a rare but impactful condition affecting mainly post-menopausal women resulting in constant pain and significant difficulty with eating, drinking and daily function. The aetiology of BMS remains an enigma. Recent evidence suggests it likely to be neuropathic in origin, the cause of which remains unknown. There is no cure for this condition and the unfortunate patients remain managed on a variety of neuropathic pain medication, salivary substitutes and other non-medical interventions that help the patient 'get through the day'. Some simple strategies can assist both clinician and patient to manage this debilitating condition. CPD/Clinical Relevance: The dental team will recognize patients presenting with burning mouth syndrome. They are difficult patients to manage and are often referred to secondary care and, ultimately, depend on their general medical practitioners for pain management.
TEAMS. Team Exercise for Action Management Skills: A Semester-Long Team-Management Simulation.
ERIC Educational Resources Information Center
Wagenheim, Gary
A team-oriented approach is replacing the traditional management style in today's organizations. Because team management skills differ, they require different teaching methods. This paper describes an administrator education course designed to develop team management skills from an applied and behavioral viewpoint. Students participate in…
Crisis Management Simulation: Establishing a Dual Neurosurgery and Anesthesia Training Experience.
Ciporen, Jeremy; Gillham, Haley; Noles, Michele; Dillman, Dawn; Baskerville, Mark; Haley, Caleb; Spight, Donn; Turner, Ryan C; Lucke-Wold, Brandon P
2018-01-01
Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique. Learners were evaluated on communication skills, crisis management algorithms, and implementation of appropriate skill sets at the right time. A preanatomic and postanatomic examination and postsimulation survey was administered to neurosurgery learners. Anesthesia learners provided posttraining evaluation through a tailored realism and teaching survey. Neurosurgery learners' anatomic examination score improved from presimulation (33.89%) to postsimulation (86.11%). No significant difference between learner specialties was observed for situation awareness, decision making, communications and teamwork, or leadership evaluations. Learners reported the simulation realistic, beneficial, and highly instructive. Realistic, first of kind, clinical simulation scenarios were presented to a neurosurgery/anesthesia resident team who worked together to manage an intraoperative crisis. Learners were effectively trained on crisis management, the importance of communication, and how to develop algorithms for future implementation in difficult scenarios. Learners were highly satisfied with the simulation training experience and requested that it be integrated more consistently into their residency training programs.
Perceived distributed effort in team ball sports.
Beniscelli, Violeta; Tenenbaum, Gershon; Schinke, Robert Joel; Torregrosa, Miquel
2014-01-01
In this study, we explored the multifaceted concept of perceived mental and physical effort in team sport contexts where athletes must invest individual and shared efforts to reach a common goal. Semi-structured interviews were conducted with a convenience sample of 15 Catalan professional coaches (3 women and 12 men, 3 each from the following sports: volleyball, basketball, handball, soccer, and water polo) to gain their views of three perceived effort-related dimensions: physical, psychological, and tactical. From a theoretical thematic analysis, it was found that the perception of effort is closely related to how effort is distributed within the team. Moreover, coaches viewed physical effort in relation to the frequency and intensity of the players' involvement in the game. They identified psychological effort in situations where players pay attention to proper cues, and manage emotions under difficult circumstances. Tactical effort addressed the decision-making process of players and how they fulfilled their roles while taking into account the actions of their teammates and opponents. Based on these findings, a model of perceived distributed effort was developed, which delineates the elements that compose each of the aforementioned dimensions. Implications of perceived distributed effort in team coordination and shared mental models are discussed.
Conflict in medical teams: opportunity or danger?
Greer, Lindred L; Saygi, Ozum; Aaldering, Hillie; de Dreu, Carsten K W
2012-10-01
Intragroup conflicts often occur when people are called upon to collaborate in the accomplishment of a task. For example, when surgeons and nurses work together during an operation, conflicts may emerge because of differences in functional understanding. Whether these conflicts are beneficial or detrimental to team outcomes has been the source of much debate. From one perspective, a conflict that stems from differences in members' functional understanding may enhance team members' understanding and performance of the task at hand. By contrast, such a conflict may cause hostility, emotionality and distraction from actual task accomplishment. This study reviews findings on the relationships between intragroup conflict and team outcomes, discusses potential conflict resolution strategies for intragroup conflicts and explores how these link to the field of medical education. Three primary types of conflict have been distinguished, involving, respectively, task-, process- and relationship-associated conflict. Both process conflict, or conflict about the logistics of task accomplishment, and relationship conflict, or conflict about interpersonal incompatibilities, have been shown to detract from effective team functioning. Task conflict, or conflict about the content of the task itself, is also generally negative for team functioning, but under certain conditions its negative effects may be minimised. For example, when teams can clearly separate task issues from relationship issues, task conflicts are less destructive for team outcomes. However, achieving such a separation in practice, and thereby realising the benefits of task conflict, is quite difficult to achieve. Intragroup conflicts pose a challenge to effective team functioning. In the education of medical professionals, effective training in conflict management skills and their application to specific team conflict dynamics, such as with reference to how to resolve task as opposed to relationship conflict, is critical. © Blackwell Publishing Ltd 2012.
Technology-driven dietary assessment: a software developer’s perspective
Buday, Richard; Tapia, Ramsey; Maze, Gary R.
2015-01-01
Dietary researchers need new software to improve nutrition data collection and analysis, but creating information technology is difficult. Software development projects may be unsuccessful due to inadequate understanding of needs, management problems, technology barriers or legal hurdles. Cost overruns and schedule delays are common. Barriers facing scientific researchers developing software include workflow, cost, schedule, and team issues. Different methods of software development and the role that intellectual property rights play are discussed. A dietary researcher must carefully consider multiple issues to maximize the likelihood of success when creating new software. PMID:22591224
Optimising medication for Parkinson's disease patients with dysphagia.
Patel, Krupa
2015-07-01
In addition to movement disorders, Parkinson's disease (PD) is associated with several nonmotor symptoms, including dysphagia (swallowing difficulties). Dysphagia can make the consumption of solid medicines difficult, which potentially contributes to the poor adherence that is common among people with PD. However, patients may be reluctant to admit that they experience dysphagia. Community nurses should actively enquire into swallowing difficulties among all patients, not only those with PD, and should work with pharmacists and other members of the multidisciplinary team to help optimise medication management to help improve adherence.
Science Planning and Orbit Classification for Solar Probe Plus
NASA Astrophysics Data System (ADS)
Kusterer, M. B.; Fox, N. J.; Rodgers, D. J.; Turner, F. S.
2016-12-01
There are a number of challenges for the Science Planning Team (SPT) of the Solar Probe Plus (SPP) Mission. Since SPP is using a decoupled payload operations approach, tight coordination between the mission operations and payload teams will be required. The payload teams must manage the volume of data that they write to the spacecraft solid-state recorders (SSR) for their individual instruments for downlink to the ground. Making this process more difficult, the geometry of the celestial bodies and the spacecraft during some of the SPP mission orbits cause limited uplink and downlink opportunities. The payload teams will also be required to coordinate power on opportunities, command uplink opportunities, and data transfers from instrument memory to the spacecraft SSR with the operation team. The SPT also intend to coordinate observations with other spacecraft and ground based systems. To solve these challenges, detailed orbit activity planning is required in advance for each orbit. An orbit planning process is being created to facilitate the coordination of spacecraft and payload activities for each orbit. An interactive Science Planning Tool is being designed to integrate the payload data volume and priority allocations, spacecraft ephemeris, attitude, downlink and uplink schedules, spacecraft and payload activities, and other spacecraft ephemeris. It will be used during science planning to select the instrument data priorities and data volumes that satisfy the orbit data volume constraints and power on, command uplink and data transfer time periods. To aid in the initial stages of science planning we have created an orbit classification scheme based on downlink availability and significant science events. Different types of challenges arise in the management of science data driven by orbital geometry and operational constraints, and this scheme attempts to identify the patterns that emerge.
Frerk, C.; Mitchell, V. S.; McNarry, A. F.; Mendonca, C.; Bhagrath, R.; Patel, A.; O'Sullivan, E. P.; Woodall, N. M.; Ahmad, I.
2015-01-01
These guidelines provide a strategy to manage unanticipated difficulty with tracheal intubation. They are founded on published evidence. Where evidence is lacking, they have been directed by feedback from members of the Difficult Airway Society and based on expert opinion. These guidelines have been informed by advances in the understanding of crisis management; they emphasize the recognition and declaration of difficulty during airway management. A simplified, single algorithm now covers unanticipated difficulties in both routine intubation and rapid sequence induction. Planning for failed intubation should form part of the pre-induction briefing, particularly for urgent surgery. Emphasis is placed on assessment, preparation, positioning, preoxygenation, maintenance of oxygenation, and minimizing trauma from airway interventions. It is recommended that the number of airway interventions are limited, and blind techniques using a bougie or through supraglottic airway devices have been superseded by video- or fibre-optically guided intubation. If tracheal intubation fails, supraglottic airway devices are recommended to provide a route for oxygenation while reviewing how to proceed. Second-generation devices have advantages and are recommended. When both tracheal intubation and supraglottic airway device insertion have failed, waking the patient is the default option. If at this stage, face-mask oxygenation is impossible in the presence of muscle relaxation, cricothyroidotomy should follow immediately. Scalpel cricothyroidotomy is recommended as the preferred rescue technique and should be practised by all anaesthetists. The plans outlined are designed to be simple and easy to follow. They should be regularly rehearsed and made familiar to the whole theatre team. PMID:26556848
de Stampa, Matthieu; Vedel, Isabelle; Trouvé, Hélène; Ankri, Joël; Saint Jean, Olivier; Somme, Dominique
2014-04-07
The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.
A Path to Actionable Climate Science: Perspectives from the Field
NASA Astrophysics Data System (ADS)
DeCrappeo, Nicole M.; Bisbal, Gustavo A.; Meadow, Alison M.
2018-02-01
The U.S. Department of the Interior Climate Science Centers (CSCs) work with natural and cultural resource managers and scientists to gather information and build tools needed to help fish, wildlife, and ecosystems adapt to the impacts of climate change. The CSCs prioritize the delivery of actionable science products (e.g., synthesized scientific information, maps, decision support tools, etc.) that are focused on key management priorities and co-produced by teams of scientists and managers. In the specific case of the Northwest CSC, we have been successful at promoting and supporting the co-production of actionable climate science at the individual project level, but it has been more difficult to replicate this success at the regional program level. Here we identify the most significant challenges in satisfying this mandate and propose the creation of a Science Advisory Panel to provide improved interface between resource managers and scientists engaged with the Northwest CSC.
Anaesthesia and intensive care management of face transplantation.
Sedaghati-nia, A; Gilton, A; Liger, C; Binhas, M; Cook, F; Ait-Mammar, B; Scherrer, E; Hivelin, M; Lantieri, L; Marty, J; Plaud, B
2013-10-01
The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.
Leeper, W Robert; Haut, Elliott R; Pandian, Vinciya; Nakka, Sajan; Dodd-O, Jeffrey; Bhatti, Nasir; Hunt, Elizabeth A; Saheed, Mustapha; Dalesio, Nicholas; Schiavi, Adam; Miller, Christina; Kirsch, Thomas D; Berkow, Lauren
2018-04-05
A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management. The MDAC occurs within the Johns Hopkins Medicine Simulation Center approximately four times per year and uses a combination of didactic lectures, hands-on sessions, and high-fidelity simulation training. Participation in MDAC is the main intervention being investigated in this study. Data were collected prospectively using course evaluation survey with quantitative and qualitative components, and prepost course knowledge assessment multiple choice questions (MCQ). Outcomes include course evaluation scores and themes derived from qualitative assessments, and prepost course knowledge assessment MCQ scores. Tertiary care academic hospital center PARTICIPANTS: Students, residents, fellows, and practicing physicians from the departments of Surgery, Otolaryngology Head and Neck Surgery, Anesthesiology/Critical Care Medicine, and Emergency Medicine; advanced practice providers (nurse practitioners and physician assistants), nurse anesthetists, nurses, and respiratory therapists. Totally, 23 MDACs have been conducted, including 499 participants. Course evaluations were uniformly positive with mean score of 86.9 of 95 points. Qualitative responses suggest major value from high-fidelity simulation, the hands-on skill stations, and teamwork practice. MCQ scores demonstrated significant improvement: median (interquartile range) pre: 69% (60%-81%) vs post: 81% (72%-89%), p < 0.001. Implementation of a MDAC successfully disseminated principles and protocols to all airway providers. Demonstrable improvement in prepost course knowledge assessment and overwhelmingly positive course evaluations (quantitative and qualitative) suggest a critical and ongoing role for the MDAC course. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Making sense of health information technology implementation: A qualitative study protocol.
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
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
Whalen, Madeleine; Maliszewski, Barbara; Sheinfeld, Rebecca; Gardner, Heather; Baptiste, Diana
2018-04-25
Difficult venous access is a common problem in health care-especially in the emergency setting-that relies on quick diagnostics to differentiate patient acuities and administer critical medications. The creation of a dedicated team to address difficult venous access (DVA) is a possible solution to the problems of delayed venous access, yet no studies have been published on implementing such a team in the emergency department. This was a quasi-experimental study in an urban emergency department. Researchers performed chart audits of staff-identified patients with DVA to gather baseline data. A DVA team was subsequently implemented 16 hours a day, 7 days a week. Data were recorded on patients referred to the team and included time, number of IV attempts, and patient characteristics. Baseline data were collected on 53 patients, and postintervention data included 135 patients. The implementation of a DVA team decreased the mean lab order-to-lab completion time by 115 minutes (P < 0.0001). Decreases in the number of attempts were not statistically significant. Patients requiring increased numbers of IV attempts also had many common characteristics including history of multiple attempts, poor skin quality, and IV drug use. The use of a dedicated team for DVA reduces the lag time from physician orders to actionable diagnostics or administration of medication. A dedicated DVA technician is a concrete solution to threats of patient safety, as well as ED crowding, and has the potential to affect both patient- and department-level care. Copyright © 2018 Elsevier Inc. All rights reserved.
Lighthall, Geoffrey K; Bahmani, Dona; Gaba, David
2016-02-01
Classroom lectures are the mainstay of imparting knowledge in a structured manner and have the additional goals of stimulating critical thinking, lifelong learning, and improvements in patient care. The impact of lectures on patient care is difficult to examine in critical care because of the heterogeneity in patient conditions and personnel as well as confounders such as time pressure, interruptions, fatigue, and nonstandardized observation methods. The critical care environment was recreated in a simulation laboratory using a high-fidelity mannequin simulator, where a mannequin simulator with a standardized script for septic shock was presented to trainees. The reproducibility of this patient and associated conditions allowed the evaluation of "clinical performance" in the management of septic shock. In a previous study, we developed and validated tools for the quantitative analysis of house staff managing septic shock simulations. In the present analysis, we examined whether measures of clinical performance were improved in those cases where a lecture on the management of shock preceded a simulated exercise on the management of septic shock. The administration of the septic shock simulations allowed for performance measurements to be calculated for both medical interns and for subsequent management by a larger resident-led team. The analysis revealed that receiving a lecture on shock before managing a simulated patient with septic shock did not produce scores higher than for those who did not receive the previous lecture. This result was similar for both interns managing the patient and for subsequent management by a resident-led team. We failed to find an immediate impact on clinical performance in simulations of septic shock after a lecture on the management of this syndrome. Lectures are likely not a reliable sole method for improving clinical performance in the management of complex disease processes.
Team safety and innovation by learning from errors in long-term care settings.
Buljac-Samardžić, Martina; van Woerkom, Marianne; Paauwe, Jaap
2012-01-01
Team safety and team innovation are underexplored in the context of long-term care. Understanding the issues requires attention to how teams cope with error. Team managers could have an important role in developing a team's error orientation and managing team membership instabilities. The aim of this study was to examine the impact of team member stability, team coaching, and a team's error orientation on team safety and innovation. A cross-sectional survey method was employed within 2 long-term care organizations. Team members and team managers received a survey that measured safety and innovation. Team members assessed member stability, team coaching, and team error orientation (i.e., problem-solving and blaming approach). The final sample included 933 respondents from 152 teams. Stable teams and teams with managers who take on the role of coach are more likely to adopt a problem-solving approach and less likely to adopt a blaming approach toward errors. Both error orientations are related to team member ratings of safety and innovation, but only the blaming approach is (negatively) related to manager ratings of innovation. Differences between members' and managers' ratings of safety are greater in teams with relatively high scores for the blaming approach and relatively low scores for the problem-solving approach. Team coaching was found to be positively related to innovation, especially in unstable teams. Long-term care organizations that wish to enhance team safety and innovation should encourage a problem-solving approach and discourage a blaming approach. Team managers can play a crucial role in this by coaching team members to see errors as sources of learning and improvement and ensuring that individuals will not be blamed for errors.
Wilson, M E; Pandey, S K; Thakur, J
2003-01-01
Paediatric cataract blindness presents an enormous problem to developing countries in terms of human morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge: treatment is often difficult, tedious, and requires a dedicated team effort. To assure the best long term outcome for cataract blind children, appropriate paediatric surgical techniques need to be defined and adopted by ophthalmic surgeons of developing countries. The high cost of operative equipment and the uneven world distribution of ophthalmologists, paediatricians, and anaesthetists create unique challenges. This review focuses on issues related to paediatric cataract management that are appropriate and suitable for ophthalmic surgeons in the developing world. Practical guidelines and recommendations have also been provided for ophthalmic surgeons and health planners dealing with childhood cataract management in the developing world. PMID:12488254
Cross-cultural and psychological issues in irritable bowel syndrome.
Sahoo, Swapnajeet; Padhy, Susanta Kumar
2017-10-01
Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders encountered by gastroenterologists worldwide. Of all the etiological factors that had been postulated to explain the pathophysiology of IBS, cultural and psychological factors are unique and difficult to understand. Culture plays an important role in coloring the presentation of IBS, and many a times, it has a significant role in several treatment aspects too. Psychological aspects like personality profiles, family relationships, societal myths, and abuse in any form are equally important in the management perspectives of IBS. In this brief review, we had tried to specifically focus on these aspects in IBS and have explained the evidences in favor of these factors. Knowledge about various cross-cultural aspects and psychological factors in patients with IBS is essential for taking an appropriate history and for undertaking a holistic approach for the management of the same. A collaborative team effort by psychiatrists and gastroenterologists could help in reducing the burden of this difficult to treat functional bowel disorder. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
Interprofessional education and working in mental health: in search of the evidence base.
Priest, Helena M; Roberts, Paula; Dent, Helen; Blincoe, Christine; Lawton, Diana; Armstrong, Christine
2008-05-01
To explore interprofessional attitudes arising from shared learning in mental health. Inter-professional education in healthcare is a priority area for improving team-working and communication. Many studies have attempted to evaluate its benefits and challenges, although few emanate from the mental health arena. However, producing evidence to link educational input with clinical outcomes is notoriously difficult. This project attempted to produce evidence for changes in interprofessional attitudes and stereotypes. Mental health nursing students and clinical psychology trainees participated in inter-professional education. An evaluation tool was designed to evaluate the experience and outcomes, and to consider implications for interprofessional working. There was an increase in clarity regarding roles, approaches and resources, and how to collaborate in practice. There was no significant change in professional identity. Many challenges were identified, including differences in academic level, previous experience, expectations, assessment, motivation and effort. Despite the challenges, it remains important to offer collaboration with future mental health colleagues as a foundation for effective team-working. Recommendations are made for creating inter-professional education opportunities for diverse student groups. Mental health professionals need to work effectively in multidisciplinary teams. Drawing on available guidance, managers should encourage and support team members to undertake shared learning where possible, both within clinical settings and through more formal educational provision. In this way, managers can facilitate collaborative relationships which will pay dividends for the provision of effective mental health care. This project adds to the limited knowledge currently available on interprofessional learning and attitudes within a mental health context.
Standardizing the care of detox patients to achieve quality outcomes.
Becker, Kathy; Semrow, Sue
2006-03-01
Providing appropriate treatment for detoxification patients is both challenging and difficult because alcohol abuse and dependence are largely underestimated in the acute hospital setting. Alcohol withdrawal syndrome is treated not only by addictionologists on chemical dependency units, but also by primary care physicians in acute inpatient settings. The need for consistent inpatient treatment through the use of identified protocols can help provide safe and effective care. The need for consistent, inpatient medical-surgical detoxification treatment in our organization became apparent with the staff's identification of patient care concerns. Using an organizational approach, a multidisciplinary team was created to standardize the care of detoxification patients, beginning with patient admission and ending with discharge and referral for outpatient management. Standardization would ensure consistent assessment and intervention, and improve communication among the clinical team members. A protocol was developed for both the emergency department and the inpatient units. The goals of the team were to decrease the adverse events related to detoxification, such as seizures and aggression, and provide a consistent method of treatment for staff to follow.
Bashshur, Michael R; Hernández, Ana; González-Romá, Vicente
2011-05-01
The authors argue that over time the difference between team members' perception of the organizational support received by the team (or team climate for organizational support) and their manager's perception of the organizational support received by the team has an effect on important outcomes and emergent states, such as team performance and team positive and negative affect above and beyond the main effects of climate perceptions themselves. With a longitudinal sample of 179 teams at Time 1 and 154 teams at Time 2, the authors tested their predictions using a combined polynomial regression and response surface analyses approach. The results supported the authors' predictions. When team managers and team members' perceptions of organizational support were high and in agreement, outcomes were maximized. When team managers and team members disagreed, team negative affect increased and team performance and team positive affect decreased. The negative effects of disagreement were most amplified when managers perceived that the team received higher levels of support than did the team itself.
7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 7 Agriculture 15 2012-01-01 2012-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 15 2010-01-01 2010-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 7 Agriculture 15 2011-01-01 2011-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 7 Agriculture 15 2013-01-01 2013-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
7 CFR 4290.360 - Initial review of Applicant's management team's qualifications.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 7 Agriculture 15 2014-01-01 2014-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
Wilkinson, D S; Dilts, T J
1999-01-01
We believe the team approach to laboratory management achieves the best outcomes. Laboratory management requires the integration of medical, technical, and administrative expertise to achieve optimal service, quality, and cost performance. Usually, a management team of two or more individuals must be assembled to achieve all of these critical leadership functions. The individual members of the management team must possess the requisite expertise in clinical medicine, laboratory science, technology management, and administration. They also must work together in a unified and collaborative manner, regardless of where individual team members appear on the organizational chart. The management team members share in executing the entire human resource management life cycle, creating the proper environment to maximize human performance. Above all, the management team provides visionary and credible leadership.
Long-term weight loss maintenance for obesity: a multidisciplinary approach
Montesi, Luca; El Ghoch, Marwan; Brodosi, Lucia; Calugi, Simona; Marchesini, Giulio; Dalle Grave, Riccardo
2016-01-01
The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight), a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help), and a few to personality traits (eg, low novelty seeking) and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner”) as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. PMID:27013897
NASA Astrophysics Data System (ADS)
Merritt, Donald R.; Cardesin Moinelo, Alejandro; Marin Yaseli de la Parra, Julia; Breitfellner, Michel; Blake, Rick; Castillo Fraile, Manuel; Grotheer, Emmanuel; Martin, Patrick; Titov, Dmitri
2018-05-01
This paper summarizes the changes required to the science planning of the Mars Express spacecraft to deal with the second-half of 2017, a very restrictive period that combined low power, low data rate and deep eclipses, imposing very limiting constraints for science operations. With this difficult operational constraint imposed, the ESAC Mars Express science planning team worked very hard with the ESOC flight control team and all science experiment teams to maintain a minimal level of science operations during this difficult operational period. This maintained the integrity and continuity of the long term science observations, which is a hallmark and highlight of such long-lived missions.
Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C
2015-11-01
The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training. © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.
Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C
2015-01-01
The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the ‘can't intubate, can't oxygenate’ situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training. PMID:26449292
Black swans, cognition, and the power of learning from failure.
Catalano, Allison S; Redford, Kent; Margoluis, Richard; Knight, Andrew T
2018-06-01
Failure carries undeniable stigma and is difficult to confront for individuals, teams, and organizations. Disciplines such as commercial and military aviation, medicine, and business have long histories of grappling with it, beginning with the recognition that failure is inevitable in every human endeavor. Although conservation may arguably be more complex, conservation professionals can draw on the research and experience of these other disciplines to institutionalize activities and attitudes that foster learning from failure, whether they are minor setbacks or major disasters. Understanding the role of individual cognitive biases, team psychological safety, and organizational willingness to support critical self-examination all contribute to creating a cultural shift in conservation to one that is open to the learning opportunity that failure provides. This new approach to managing failure is a necessary next step in the evolution of conservation effectiveness. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.
Systems Engineering and Integration for Technology Programs
NASA Technical Reports Server (NTRS)
Kennedy, Kruss J.
2006-01-01
The Architecture, Habitability & Integration group (AH&I) is a system engineering and integration test team within the NASA Crew and Thermal Systems Division (CTSD) at Johnson Space Center. AH&I identifies and resolves system-level integration issues within the research and technology development community. The timely resolution of these integration issues is fundamental to the development of human system requirements and exploration capability. The integration of the many individual components necessary to construct an artificial environment is difficult. The necessary interactions between individual components and systems must be approached in a piece-wise fashion to achieve repeatable results. A formal systems engineering (SE) approach to define, develop, and integrate quality systems within the life support community has been developed. This approach will allow a Research & Technology Program to systematically approach the development, management, and quality of technology deliverables to the various exploration missions. A tiered system engineering structure has been proposed to implement best systems engineering practices across all development levels from basic research to working assemblies. These practices will be implemented through a management plan across all applicable programs, projects, elements and teams. While many of the engineering practices are common to other industries, the implementation is specific to technology development. An accounting of the systems engineering management philosophy will be discussed and the associated programmatic processes will be presented.
Reactor Decommissioning - Balancing Remote and Manual Activities - 12159
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cole, Matt
2012-07-01
Nuclear reactors come in a wide variety of styles, size, and ages. However, during decommissioned one issue they all share is the balancing of remotely and manually activities. For the majority of tasks there is a desire to use manual methods because remote working can be slower, more expensive, and less reliable. However, because of the unique hazards of nuclear reactors some level of remote activity will be necessary to provide adequate safety to workers and properly managed and designed it does not need to be difficult nor expensive. The balance of remote versus manual work can also affect themore » amount and types of waste that is generated. S.A.Technology (SAT) has worked on a number of reactor decommissioning projects over the last two decades and has a range of experience with projects using remote methods to those relying primarily on manual activities. This has created a set of lessons learned and best practices on how to balance the need for remote handling and manual operations. Finding a balance between remote and manual operations on reactor decommissioning can be difficult but by following certain broad guidelines it is possible to have a very successfully decommissioning. It is important to have an integrated team that includes remote handling experts and that this team plans the work using characterization efforts that are efficient and realistic. The equipment need to be simple, robust and flexible and supported by an on-site team committed to adapting to day-to-day challenges. Also, the waste strategy needs to incorporate the challenges of remote activities in its planning. (authors)« less
SOFIA Program SE and I Lessons Learned
NASA Technical Reports Server (NTRS)
Ray, Ronald J.; Fobel, Laura J.; Brignola, Michael P.
2011-01-01
Once a "Troubled Project" threatened with cancellation, the Stratospheric Observatory for Infrared Astronomy (SOFIA) Program has overcome many difficult challenges and recently achieved its first light images. To achieve success, SOFIA had to overcome significant deficiencies in fundamental Systems Engineering identified during a major Program restructuring. This presentation will summarize the lessons learn in Systems Engineering on the SOFIA Program. After the Program was reformulated, an initial assessment of Systems Engineering established the scope of the problem and helped to set a list of priorities that needed to be work. A revised Systems Engineering Management Plan (SEMP) was written to address the new Program structure and requirements established in the approved NPR7123.1A. An important result of the "Technical Planning" effort was the decision by the Program and Technical Leadership team to re-phasing the lifecycle into increments. The reformed SOFIA Program Office had to quickly develop and establish several new System Engineering core processes including; Requirements Management, Risk Management, Configuration Management and Data Management. Implementing these processes had to consider the physical and cultural diversity of the SOFIA Program team which includes two Projects spanning two NASA Centers, a major German partnership, and sub-contractors located across the United States and Europe. The SOFIA Program experience represents a creative approach to doing "System Engineering in the middle" while a Program is well established. Many challenges were identified and overcome. The SOFIA example demonstrates it is never too late to benefit from fixing deficiencies in the System Engineering processes.
Order management empowering entrepreneurial partnerships in the context of new technologies
NASA Astrophysics Data System (ADS)
Tămăşilă, M.; Proştean, G.; Diaconescu, A.
2018-01-01
The expansiveness of latest generation technologies triggers manufacturers from different industry sectors more complex situations in order management with various loyal customers and occasional customers. More specifically, orders variations in logistics chain make it difficult to achieve entrepreneurial partnerships in the context of new technologies integrated into automotive and wind industry processes, which hinders getting major investments. Within this framework, the research team investigates the bottlenecks in the supply chain and indicates some rules and methods to solve the desynchronizations and fluctuations caused by the constraints of cutting-edge technologies. The paper aims to solve order management problems based on both an algorithm and an implementation in SAP. Also, in the paper, a conceptual model is created for the user whose basic task is the management of the entrepreneurial orders. Solutions identified based on the algorithm offers an order management plan by optimally adjusting inventories to deal with any kind of orders, thus achieving a profitable entrepreneurial approach between the two partners.
76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-04
...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...
Community Disaster and Sustainability Teams for Civil Protection
NASA Astrophysics Data System (ADS)
Kelman, I.; Cordonnier, B.
2009-04-01
Many examples of community-based teams for civil protection and disaster risk reduction exist. Turkey has a Community Disaster Volunteer Training Program while the USA has Community Emergency Response Teams which have been extended into secondary schools as Teen School Emergency Response Training. The principles and practices of these teams further apply directly to other development and sustainability endeavours, all of which are intricately linked to disaster risk reduction and civil protection. An example is keeping local water courses and storm drains clear from rubbish. That improves community health and cleanliness while assisting rainfall drainage to reduce flood risk. The "community teams" concept, as implemented for civil protection and disaster risk reduction, therefore connects with day-to-day living, such as ensuring that all community members have adequate access to water, food, waste management, shelter, health care, education, and energy. Community teams should be based on the best science and pedagogy available to ensure that concepts, training, skills, and implementation are effective and are maintained over the long-term. That entails going beyond the interest that is commonly generated by highlighting high-profile events, such as hurricanes and earthquakes, or high-profile concerns, such as climate change or terrorism. When community teams are focused on high-profile challenges, maintaining interest can be difficult without specific manifestations of the perceived "number one threat". Incorporating day-to-day concerns into civil protection can overcome that. For example, the community teams' talents and energy could be used for picking up rubbish, for educating about health and waste disposal, and for conducting vulnerability assessments in order to inspire action for continual vulnerability reduction. In addition to the examples given above, Japan's Jishu-bosai-soshiki community activities and Asia's "Townwatch" initiative adopt wider and deeper perspectives and actions, connecting disaster and civil protection to development and sustainability.
Current Management of Neonatal Liver Tumors.
Langham, Max R; Furman, Wayne L; Fernandez-Pineda, Israel
2015-01-01
This review is focused on the special issues and challenges confronting physicians and surgeons caring for an unborn child, or a newborn with a liver tumor. Liver tumors at this age are very rare and they make it difficult for pediatric surgeons to gain experience necessary to obtain good results. On the other hand, adult hepatobiliary surgeons faced with a fetus or infant with a liver mass are ill equipped to care for the patient even if they have done a high volume of adult liver surgery and are expert in the field. Often a team approach is the best solution.
Intelligent Virtual Assistant's Impact on Technical Proficiency within Virtual Teams
ERIC Educational Resources Information Center
Graham, Christian; Jones, Nory B.
2016-01-01
Information-systems development continues to be a difficult process, particularly for virtual teams that do not have the luxury of meeting face-to-face. The research literature on this topic reinforces this point: the greater part of database systems development projects ends in failure. The use of virtual teams to complete projects further…
The Anonymity Factor in Making Multicultural Teams Work: Virtual and Real Teams
ERIC Educational Resources Information Center
Berg, Roberta Wiig
2012-01-01
A major purpose of courses in intercultural communication is often to improve students' ability to perform well in situations with the potential to be both highly enlightening and highly difficult--in multicultural teams. This article reports the results of exercises in which members of a dysfunctional multicultural class were assigned to teams…
[How management teams use information and control systems to manage hospitals].
Naranjo-Gil, David
2016-01-01
To analyze the relationship between the characteristics of top management teams and the different use of management information and control systems (MICS) to implement policies that encourage cooperation and activity coordination in public hospitals. Data were collected through a questionnaire sent to each member of the top management teams of 231 Spanish public hospitals (chief executive director, medical director, nursing director and director for financial and social issues). A total of 457 valid questionnaires were returned, composing 86 full top management teams (37.23%). Top management team diversity was positively related to the interactive use of MICS. Management teams composed of younger members and members with longer service used MICS interactively. Top management teams with a predominantly clinical education and experience used MICS interactively, while top teams with a predominantly administrative education and experience used MICS diagnostically. The results also showed that cooperation and coordination in hospitals were positively related to the interactive use of MICS and were negatively related to the diagnostic use of MICS. The interactive use of MICS is an important mediator in the relationship between top team diversity and policies focused on hospital decentralization. Top management teams with diverse characteristics (e.g. age, length of service, education and experience) use management information interactively to enhance activity coordination and resource allocation in hospitals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
Self-Managed Work Teams in Nursing Homes: Implementing and Empowering Nurse Aide Teams
ERIC Educational Resources Information Center
Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney
2004-01-01
Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…
"That's not how we do it": managing the inherited medical practice team.
Hills, Laura
2013-01-01
Most medical practice managers who take a new job will inherit an existing team. Those first few days on the job are critical because they can determine whether or not the new manager will succeed. This article provides a game plan for new medical practice managers so they get off on the right foot with their inherited teams. It suggests strategies for learning about the team's culture and for demonstrating visibly that there is a new manager in the job. It offers guidelines about introducing the new manager to the inherited team, discussing past experiences, and establishing new expectations. This article further provides practical tips for serving as a role model, gaining allies, and dealing with troublemakers quickly and effectively. It suggests strategies for speaking about the previous practice manager and for creating excitement with the inherited team. Finally, this article offers a set of 15 questions a new manager can ask members of the inherited team to get to know them, an additional 25-point team assessment instrument, and a step-by-step strategy for raising the bar for mediocre, lackluster, or dysfunctional inherited teams.
2010-01-01
The Fort Collins Science Center's Policy Analysis and Science Assistance (PASA) Branch is a team of approximately 22 scientists, technicians, and graduate student researchers. PASA provides unique capabilities in the U.S. Geological Survey by leading projects that integrate social, behavioral, economic, and biological analyses in the context of human-natural resource interactions. Resource planners, managers, and policymakers in the U.S. Departments of the Interior (DOI) and Agriculture (USDA), State and local agencies, as well as international agencies use information from PASA studies to make informed natural resource management and policy decisions. PASA scientists' primary functions are to conduct both theoretical and applied social science research, provide technical assistance, and offer training to advance performance in policy relevant research areas. Management and research issues associated with human-resource interactions typically occur in a unique context, involve difficult to access populations, require knowledge of both natural/biological science in addition to social science, and require the skill to integrate multiple science disciplines. In response to these difficult contexts, PASA researchers apply traditional and state-of-the-art social science methods drawing from the fields of sociology, demography, economics, political science, communications, social-psychology, and applied industrial organization psychology. Social science methods work in concert with our rangeland/agricultural management, wildlife, ecology, and biology capabilities. The goal of PASA's research is to enhance natural resource management, agency functions, policies, and decision-making. Our research is organized into four broad areas of study.
Khodaverdi, Sepideh; Nazari, Leila; Mehdizadeh-Kashi, Abolfazl; Vahdat, Mansoureh; Rokhgireh, Samaneh; Farbod, Ali; Tajbakhsh, Banafsheh
2018-01-01
Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder with predisposition to basal cell carcinomas (BCCs) and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests. PMID:29334213
Johnson, K
2000-01-01
While community based crisis response teams offer needed resources to schools impacted by crisis, they are often not asked to help. Reports from crisis team leaders at the school shooting incidents at James W. Parker Middle School, Edinboro, Pennsylvania and Columbine High School, Littleton, Colorado are contrasted regarding utilization of community resources. Factors limiting the usefulness of community based teams include unfamiliarity with school organization, culture, and procedures. Key differences in school vs. community team precepts, decision-making, and strategic paradigms render team coordination difficult. Successful cross training presents opportunities for school-community partnership and utilization of community teams for school duty.
Bour, Robert K.; Pozniak, Myron; Ranallo, Frank N.
2015-01-01
The purpose of this paper is to describe our experience with the AAPM Medical Physics Practice Guideline 1.a: “CT Protocol Management and Review Practice Guideline”. Specifically, we will share how our institution's quality management system addresses the suggestions within the AAPM practice report. We feel this paper is needed as it was beyond the scope of the AAPM practice guideline to provide specific details on fulfilling individual guidelines. Our hope is that other institutions will be able to emulate some of our practices and that this article would encourage other types of centers (e.g., community hospitals) to share their methodology for approaching CT protocol optimization and quality control. Our institution had a functioning CT protocol optimization process, albeit informal, since we began using CT. Recently, we made our protocol development and validation process compliant with a number of the ISO 9001:2008 clauses and this required us to formalize the roles of the members of our CT protocol optimization team. We rely heavily on PACS‐based IT solutions for acquiring radiologist feedback on the performance of our CT protocols and the performance of our CT scanners in terms of dose (scanner output) and the function of the automatic tube current modulation. Specific details on our quality management system covering both quality control and ongoing optimization have been provided. The roles of each CT protocol team member have been defined, and the critical role that IT solutions provides for the management of files and the monitoring of CT protocols has been reviewed. In addition, the invaluable role management provides by being a champion for the project has been explained; lack of a project champion will mitigate the efforts of a CT protocol optimization team. Meeting the guidelines set forth in the AAPM practice guideline was not inherently difficult, but did, in our case, require the cooperation of radiologists, technologists, physicists, IT, administrative staff, and hospital management. Some of the IT solutions presented in this paper are novel and currently unique to our institution. PACS number: 87.57.Q PMID:26103176
Model of Team Organization and Behavior and Team Description Method
1984-10-01
cumbersome or difficult to use or which did not result in the quality of data desired were revised, or discarded and replaced by alternative procedures. The...observation and study of a variety of real-world teams performing real-world missions. Since time and resources for model development were limited, only...of equipment and supplies , team strength, terrain, weather, and illumination (if’ the mission it performed at night). Any or all of these factors may
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-25
.../B/A/Anthem Blue Cross & Blue Shield Enterprise Provider Data Management Team Including On-Site... & Blue Shield, Enterprise Provider Data Management Team, Including On-Site Leased Workers From Kelly... Of Kentucky, Enterprise Provider Data Management Team, Louisville, Kentucky TA-W-74,895B Wellpoint...
NASA Astrophysics Data System (ADS)
Shokory, Suzyanty Mohd; Suradi, Nur Riza Mohd
2018-04-01
The current study examines the impact of transformational and transactional leadership of project manager on the extra-role performance of project team members. In addition, this study also identifies factor dominant to extra-role performance of project team members when the transformational and transactional leadership of project managers are analyzed simultaneously. The study involved 175 of project team members from 35 project teams (each project team consists of different contracting companies registered in the Selangor (N = 175 from 35 contractors company). A multilevel analysis with hierarchical linear modeling (HLM) approach was used in this study. The analysis showed that transformational and transactional leadership of the project manager is a positive significant with extra-role performance project team members when analyzed separately. However when the two constructs (transformational leadership and transactional leadership of project manager) were analyzed simultaneously, transformational leadership was found to have more impact on extra-role performance project team members compared to transactional leadership. These findings explained that although transformational and transactional leadership of project managers can improve extra-role performance project team members, but this study has proved that transformational leadership of project managers affect extra-role performance project team members more as compared to transactional leadership.
Fowler, Terri O; Wise, Holly H; Mauldin, Mary P; Ragucci, Kelly R; Scheurer, Danielle B; Su, Zemin; Mauldin, Patrick D; Bailey, Jennifer R; Borckardt, Jeffrey J
2018-04-11
Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their reliability as teamwork-observers was a valuable learning experience and also yielded an opportunity to gather unique, and otherwise difficult to attain, data from a hospital unit for use by quality managers and administrators.
Management Guidelines for Database Developers' Teams in Software Development Projects
NASA Astrophysics Data System (ADS)
Rusu, Lazar; Lin, Yifeng; Hodosi, Georg
Worldwide job market for database developers (DBDs) is continually increasing in last several years. In some companies, DBDs are organized as a special team (DBDs team) to support other projects and roles. As a new role, the DBDs team is facing a major problem that there are not any management guidelines for them. The team manager does not know which kinds of tasks should be assigned to this team and what practices should be used during DBDs work. Therefore in this paper we have developed a set of management guidelines, which includes 8 fundamental tasks and 17 practices from software development process, by using two methodologies Capability Maturity Model (CMM) and agile software development in particular Scrum in order to improve the DBDs team work. Moreover the management guidelines developed here has been complemented with practices from authors' experience in this area and has been evaluated in the case of a software company. The management guidelines for DBD teams presented in this paper could be very usefully for other companies too that are using a DBDs team and could contribute towards an increase of the efficiency of these teams in their work on software development projects.
Problem Solving Teams in a Total Quality Management Environment.
ERIC Educational Resources Information Center
Towler, Constance F.
1993-01-01
Outlines the problem-solving team training process used at Harvard University (Massachusetts), including the size and formation of teams, roles, and time commitment. Components of the process are explained, including introduction to Total Quality Management (TQM), customer satisfaction, meeting management, Parker Team Player Survey, interactive…
Mentoring Human Performance - 12480
DOE Office of Scientific and Technical Information (OSTI.GOV)
Geis, John A.; Haugen, Christian N.
2012-07-01
Although the positive effects of implementing a human performance approach to operations can be hard to quantify, many organizations and industry areas are finding tangible benefits to such a program. Recently, a unique mentoring program was established and implemented focusing on improving the performance of managers, supervisors, and work crews, using the principles of Human Performance Improvement (HPI). The goal of this mentoring was to affect behaviors and habits that reliably implement the principles of HPI to ensure continuous improvement in implementation of an Integrated Safety Management System (ISMS) within a Conduct of Operations framework. Mentors engaged with personnel inmore » a one-on-one, or one-on-many dialogue, which focused on what behaviors were observed, what factors underlie the behaviors, and what changes in behavior could prevent errors or events, and improve performance. A senior management sponsor was essential to gain broad management support. A clear charter and management plan describing the goals, objectives, methodology, and expected outcomes was established. Mentors were carefully selected with senior management endorsement. Mentors were assigned to projects and work teams based on the following three criteria: 1) knowledge of the work scope; 2) experience in similar project areas; and 3) perceived level of trust they would have with project management, supervision, and work teams. This program was restructured significantly when the American Reinvestment and Recovery Act (ARRA) and the associated funding came to an end. The program was restructured based on an understanding of the observations, attributed successes and identified shortfalls, and the consolidation of those lessons. Mentoring the application of proven methods for improving human performance was shown effective at increasing success in day-to-day activities and increasing confidence and level of skill of supervisors. While mentoring program effectiveness is difficult to measure, and return on investment is difficult to quantify, especially in complex and large organizations where the ability to directly correlate causal factors can be challenging, the evidence presented by Sydney Dekker, James Reason, and others who study the field of human factors does assert managing and reducing error is possible. Employment of key behaviors-HPI techniques and skills-can be shown to have a significant impact on error rates. Our mentoring program demonstrated reduced error rates and corresponding improvements in safety and production. Improved behaviors are the result, of providing a culture with consistent, clear expectations from leadership, and processes and methods applied consistently to error prevention. Mentoring, as envisioned and executed in this program, was effective in helping shift organizational culture and effectively improving safety and production. (authors)« less
Trantham, Doug; Sherry, Anne
2012-01-01
Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.
Hassling, Linda; Nordfeldt, Sam; Eriksson, Henrik; Timpka, Toomas
2005-01-01
Chronic diseases do not only manifest themselves as sets of pathophysiological factors. They bring about an equally important psychosocial impact. Unfortunately, it is difficult to account for this impact in the development of supportive technologies. This study describes and explores a method for elicitation of requirements on technologies supporting self-management including emotional aspects. The method takes advantage of a self-documentary media kit for collection of data from the everyday context of chronic disease. The resulting contextual data can contribute new insights to multi-disciplinary teams in the design of supporting technologies.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Miller, M.A.
1996-08-01
Teamwork is the key to the future of effective technology management. Today`s technologies and markets have become too complex for individuals to work alone. Global competition, limited resources, cost consciousness, and time pressures have forced organizations and project managers to encourage teamwork. Many of these teams will be cross-functional teams that can draw on a multitude of talents and knowledge. To develop high-performing cross-functional teams, managers must understand motivations, functional loyalties, and the different backgrounds of the individual team members. To develop a better understanding of these issues, managers can learn from experience and from literature on teams and teamingmore » concepts. When studying the literature to learn about cross-functional teaming, managers will find many good theoretical concepts, but when put into practice, these concepts have varying effects. This issue of varying effectiveness is what drives the research for this paper. The teaming concepts were studied to confirm or modify current understanding. The literature was compared with a {open_quotes}ground truth{close_quotes}, a survey of the reality of teaming practices, to examine the teaming concepts that the literature finds to be critical to the success of teams. These results are compared to existing teams to determine if such techniques apply in real-world cases.« less
National Ignition Facility Construction Safety Management Review
DOE Office of Scientific and Technical Information (OSTI.GOV)
Warner, B.E.
2000-02-01
An accident occurred at the NIF construction site on January 13, 2000, in which a worker sustained a serious injury when a 42-inch-diameter duct fell during installation. Following the accident, NIF Project Management chartered two review teams: (1) an Incident Analysis Team to independently assess the direct and root causes of the accident, and (2) a Management Review Team to review the roles and responsibilities of the line, support, and construction management organizations involved. This report provides a discussion of the information gathered by the Management Review Team and provides a list of observations and recommendations based on an analysismore » of the information. The Management Review Team includes senior managers who represent several Directorates within LLNL and DOE OAK: Dick Billia representing Engineering; Dave Leary representing Business Services and Public Affairs; Jim Jackson representing Hazards Control; Chuck Taylor representing DOE OAK; Arnie Clobes representing the ICF/NIF Program; and Jon Yatabe and Bruce Warner (Chairperson) representing the NIF Project. The attached letter from the NIF Project Manager, Ed Moses, to the Management Review Team contains the team's Charter. The team was asked to evaluate the effectiveness of the line management and its supporting safety functions in managing safety during NIF construction. The evaluation was to include the current conventional facility construction, which is 85% complete, and upcoming activities such as Beampath Infrastructure System installation, which will begin in the next six months and which represents a significant amount of work over the next two to three years. The remainder of this document describes the Management Review Team's review process (Section 2), its observations gathered during the review (Section 3), and its recommendations to the NIF Project Manager based on those observations (Section 4).« less
Schwartz, Mark D; Jensen, Ashley; Wang, Binhuan; Bennett, Katelyn; Dembitzer, Anne; Strauss, Shiela; Schoenthaler, Antoinette; Gillespie, Colleen; Sherman, Scott
2015-07-01
Panel Management can expand prevention and chronic illness management beyond the office visit, but there is limited evidence for its effectiveness or guidance on how best to incorporate it into practice. We aimed to test the effectiveness of incorporating panel management into clinical practice by incorporating Panel Management Assistants (PMAs) into primary care teams with and without panel management education. We conducted an 8-month cluster-randomized controlled trial of panel management for improving hypertension and smoking cessation outcomes among veterans. Twenty primary care teams from the Veterans Affairs New York Harbor were randomized to control, panel management support, or panel management support plus education groups. Teams included 69 clinical staff serving 8,153 hypertensive and/or smoking veterans. Teams assigned to the intervention groups worked with non-clinical Panel Management Assistants (PMAs) who monitored care gaps and conducted proactive patient outreach, including referrals, mail reminders and motivational interviewing by telephone. Measurements included mean systolic and diastolic blood pressure, proportion of patients with controlled blood pressure, self-reported quit attempts, nicotine replacement therapy (NRT) prescriptions, and referrals to disease management services. Change in mean blood pressure, blood pressure control, and smoking quit rates were similar across study groups. Patients on intervention teams were more likely to receive NRT (OR = 1.4; 95% CI 1.2-1.6) and enroll in the disease management services MOVE! (OR = 1.2; 95% CI 1.1-1.6) and Telehealth (OR = 1.7, 95% CI 1.4-2.1) than patients on control teams. Panel Management support for primary care teams improved process, but not outcome variables among veterans with hypertension and smoking. Incorporating PMAs into teams was feasible and highly valued by the clinical staff, but clinical impact may require a longer intervention.
Teaching Tip: Managing Software Engineering Student Teams Using Pellerin's 4-D System
ERIC Educational Resources Information Center
Doman, Marguerite; Besmer, Andrew; Olsen, Anne
2015-01-01
In this article, we discuss the use of Pellerin's Four Dimension Leadership System (4-D) as a way to manage teams in a classroom setting. Over a 5-year period, we used a modified version of the 4-D model to manage teams within a senior level Software Engineering capstone course. We found that this approach for team management in a classroom…
Getting More out of Team Projects: Incentivizing Leadership to Enhance Performance
ERIC Educational Resources Information Center
Ferrante, Claudia J.; Green, Steve G.; Forster, William R.
2006-01-01
This study addresses changes in student perceptions when team leaders are incentivized. Although the benefits of groupwork have been thoroughly studied and documented, minimizing dysfunctional teamwork may prove difficult because of leadership incentives, social loafing, and organizational justice implications. Using an innovative pedagogical…
Khodaverdi, Sepideh; Nazari, Leila; Mehdizadeh-Kashi, Abolfazl; Vahdat, Mansoureh; Rokhgireh, Samaneh; Farbod, Ali; Tajbakhsh, Banafsheh
2018-04-01
Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder with predisposition to basal cell carcinomas (BCCs) and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests. Copyright© by Royan Institute. All rights reserved.
Special considerations in the medical management of professional basketball players.
Steingard, S A
1993-04-01
The NBA basketball players are among the finest athletes in the world. That along with the increased popularity of the NBA has put a premium on the health of the players. The course of the season puts tremendous stress and strain on players. As medical illnesses occur, the physician may feel increased pressure to put the ill player back into the line-up. One cannot let the pressure for the player to return to activity interfere with good medical practice. At times, it is difficult to allow for the natural course of an illness, however, as discussed in this article, sometimes this is exactly what needs to be done. The temptation to overtreat is also seen in some team physicians. This too must be avoided. Along with proper treatment, there is the need for education of the athletes both in social interactions and in diet and life-style. Then we, as team physicians, can sit back and enjoy the performance on the court.
Better team management--better team care?
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.
Putting the "Team" in the Fine Arts Team: An Application of Business Management Team Concepts
ERIC Educational Resources Information Center
Fisher, Ryan
2007-01-01
In this article, the author discusses current challenges to the idea of teamwork in fine arts teams, redefines the terms team and collaboration using a business management perspective, discusses the success of effective teams in the business world and the characteristics of those teams, and proposes the implementation of the business model of…
Al-Alawi, Kamila; Johansson, Helene; Al Mandhari, Ahmed; Norberg, Margareta
2018-05-08
AimThe aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches. The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines. A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FindingsThe study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.
Trust in Culturally Diverse Teams
2008-09-01
Humansystems® Incorporated 111 Farquhar St., Guelph, ON N1H 3N4 Project Manager : Barbara D. Adams, Ph.D. (519) 836 5911 PWGSC Contract...on trust in teams and on the management of trust violations within these teams. Reserve force military personnel (n = 106) were recruited to...cultural diversity on trust in teams and on the management of trust violations within these teams. CF reserve force personnel (n = 106) were
A Theoretical Model and New Test of Managerial Legitimacy in Work Teams
ERIC Educational Resources Information Center
Yoon, Jeongkoo; Thye, Shane
2011-01-01
This study examines endorsement and authorization as two social mechanisms that can induce perceptions of legitimacy for individuals who manage work teams. "Endorsement" is the support of a manager by one's own team members, whereas "authorization" is the support of a team manager stemming from a higher bureaucratic level.…
Factors affecting fire suppression costs as identified by incident management teams
Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones
2006-01-01
This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...
ERIC Educational Resources Information Center
Foreman, David J.; Dunn, John G.
The management enhancement team approach (META) is a team-driven management development program designed for managers within Australia's National Vocational Education and Training Sector (NVETS). META, which has been piloted at more than 70 sites across Australia, is designed to identify and address management development needs within the context…
Self-Managed Teams for Library Management: Increasing Employee Participation via Empowerment.
ERIC Educational Resources Information Center
Poon-Richards, Craig
1995-01-01
Investigates the growing prevalence of participatory management in libraries. The operation of self-managed teams is discussed both in theory and in practice, the latter with examples from Sterling Library at Yale University. Research is summarized that relates to management teams and how they create a sense of empowerment by building shared…
Difficulties encountered in collaborative care: logistics trumps desire.
Legault, Frances; Humbert, Jennie; Amos, Stephanie; Hogg, William; Ward, Natalie; Dahrouge, Simone; Ziebell, Laura
2012-01-01
This study examines the development of collaborative relationships between family physicians (FPs) and Anticipatory And Preventative Team Care (APTCare) team members providing care to medically complex patients who have been identified as at-risk for negative health outcomes. We undertook a qualitative study of a primary health care intervention in a family practice. Interviews were held with FPs and ATPCare intervention nurse practitioners (NPs) and pharmacists. Focus groups were conducted and a survey was administered to participating FPs, NPs, and pharmacists. NPs and pharmacists maintained a log recording their tasks and moments of collaboration. Scheduling demands rendered face-to-face collaboration difficult, leaving the team to rely on technological tools to keep in touch. Limited space meant the APTCare team had to work out of a downstairs office, limiting informal interactions with the practitioners on the main level. We demonstrate that the difficulties inherent in collaborative care are independent of the patient population being cared for. Regardless of the patient population and sector of health care, developing collaborative relationships and learning to work collaboratively is difficult and takes time. What many of these teams need is ongoing support and education about how to make these collaborative care practices work.
ERIC Educational Resources Information Center
Soos, Frank
1992-01-01
Discusses the importance of high school basketball in rural West Virginia and what it felt like to win and to lose. Reflects on how playing team sports builds character, and suggests that, although life goes on regardless of game outcomes, it is still difficult to think of high school basketball as just a game. (LP)
Stanhope, Victoria; Matejkowski, Jason
2010-08-01
The widespread adoption of assertive community treatment has resulted in a shift from an individual model to a team model of case management. The shift has had implications for individual relationships between case managers and consumers, but still little is known about how these relationships develop in teams. This exploratory mixed methods study looked at how case managers and consumers negotiate individual relationships within a team model. Quantitative methods identified high and low service intensity relationships between consumers and case managers and qualitative methods explored and compared these relationships. Consumers in high service intensity relationships described a preference for certain case managers and the burden of working with multiple people. Case managers invested high service intensity relationships with special therapeutic value, articulated the challenges of coordinating care across the team, and utilized team limit setting techniques. In contrast, low service intensity relationships were more likely to reflect integration with the entire team. Findings suggest that teams need to consider how individual relationships enhance care for their consumers and how to nurture these relationships while maintaining the support necessary for case managers and consumers.
Evaluation of aviation-based safety team training in a hospital in The Netherlands.
De Korne, Dirk F; Van Wijngaarden, Jeroen D H; Van Dyck, Cathy; Hiddema, U Francis; Klazinga, Niek S
2014-01-01
The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture. Pre- and post-assessments of the hospitals' safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice. The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction. The study was observational and the hospital's variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention. Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on "team" instead of "profession" seems both necessary and difficult in hospital care.
ERIC Educational Resources Information Center
Posthuma, Richard; Al-Riyami, Said
2012-01-01
Leaders of higher education institutions can create top management teams of academic administrators to guide and improve their organizations. This study illustrates how the leadership of top management teams can be accomplished successfully through a combination of goal setting (Doran, 1981; Locke & Latham, 1990), understanding of team roles…
NASA Astrophysics Data System (ADS)
Erlick, Katherine
"The stereotype of engineers is that they are not people oriented; the stereotype implies that engineers would not work well in teams---that their task emphasis is a solo venture and does not encourage social aspects of collaboration" (Miner & Beyerlein, 1999, p. 16). The problem is determining the best method of providing a motivating environment where design engineers may contribute within a team in order to achieve higher performance in the organization. Theoretically, self-directed work teams perform at higher levels. But, allowing a design engineer to contribute to the team while still maintaining his or her anonymity is the key to success. Therefore, a motivating environment must be established to encourage greater self-actualization in design engineers. The purpose of this study is to determine the favorable motivational environment for design engineers and describe the comparison between two aerospace design-engineering teams: one self-directed and the other manager directed. Following the comparison, this study identified whether self-direction or manager-direction provides the favorable motivational environment for operating as a team in pursuit of achieving higher performance. The methodology used in this research was the case study focusing on the team's levels of job satisfaction and potential for higher performance. The collection of data came from three sources, (a) surveys, (b) researcher observer journal and (c) collection of artifacts. The surveys provided information regarding personal behavior characteristics, potentiality for higher performance and motivational attributes. The researcher journal provided information regarding team dynamics, individual interaction, conflict and conflict resolution. The milestone for performance was based on the collection of artifacts from the two teams. The findings from this study illustrated that whether the team was manager-directed or self-directed does not appear to influence the needs and wants of the team members. The self-directed team was more motivated to learn their topic than was the manager-directed team, but they struggled with their path in following their vision whereas the manager-directed team kept their focus under the guidance of their manager. Finally, both teams are in fact effective; however specific circumstances may be an important objective when deciding to utilize either a self-directed or manager-directed team.
Understanding medical practice team roles.
Hills, Laura
2015-01-01
Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.
Wainger, Lisa; Mazzotta, Marisa
2011-10-01
Increasingly government agencies are seeking to quantify the outcomes of proposed policy options in terms of ecosystem service benefits, yet conflicting definitions and ad hoc approaches to measuring ecosystem services have created confusion regarding how to rigorously link ecological change to changes in human well-being. Here, we describe a step-by-step framework for producing ecological models and metrics that can effectively serve an economic-benefits assessment of a proposed change in policy or management. A focus of the framework is developing comparable units of ecosystem goods and services to support decision-making, even if outcomes cannot be monetized. Because the challenges to translating ecological changes to outcomes appropriate for economic analyses are many, we discuss examples that demonstrate practical methods and approaches to overcoming data limitations. The numerous difficult decisions that government agencies must make to fairly use and allocate natural resources provides ample opportunity for interdisciplinary teams of natural and social scientists to improve methods for quantifying changes in ecosystem services and their effects on human well-being. This framework is offered with the intent of promoting the success of such teams as they support managers in evaluating the equivalency of ecosystem service offsets and trades, establishing restoration and preservation priorities, and more generally, in developing environmental policy that effectively balances multiple perspectives.
How Systems Engineering and Risk Management Defend Against Murphy's Law and Human Error
NASA Technical Reports Server (NTRS)
Bay, Michael; Connley, Warren
2004-01-01
Systems Engineering and Risk Management processes can work synergistically to defend against the causes of many mission ending failures. Defending against mission ending failures is facilitated by fostering a team that has a healthy respect for Murphy's Law and a team with a of curiosity for how things work, how they can fail, and what they need to know. This curiosity is channeled into making the unknowns known or what is uncertain more certain. Efforts to assure mission success require the expenditure of energy in the following areas: 1. Understanding what defines Mission Success as guided by the customer's needs, objectives and constraints. 2. Understanding how the system is supposed to work and how the system is to be produced, fueled by the curiosity of how the system should work and how it should be produced. 3. Understanding how the system can fail and how the system might not be produced on time and within cost, fueled by the curiosity of how the system might fail and how production might be difficult. 4. Understanding what we need to know and what we need learn for proper completion of the above three items, fueled by the curiosity of what we might not know in order to make the best decisions.
Making Teamwork Work: Team Knowledge for Team Effectiveness.
Guchait, Priyanko; Lei, Puiwa; Tews, Michael J
2016-01-01
This study examined the impact of two types of team knowledge on team effectiveness. The study assessed the impact of taskwork knowledge and teamwork knowledge on team satisfaction and performance. A longitudinal study was conducted with 27 service-management teams involving 178 students in a real-life restaurant setting. Teamwork knowledge was found to impact both team outcomes. Furthermore, team learning behavior was found to mediate the relationships between teamwork knowledge and team outcomes. Educators and managers should therefore ensure these types of knowledge are developed in teams along with learning behavior for maximum effectiveness.
Team behaviors: working effectively in teams.
Wilson, C K
1998-12-01
The work of building and sustaining teams is often underestimated by middle managers. A manager must have the ability to develop and evolve staff toward a new level of competence, required because of radically upgraded expectations. Managers must be clear about what it means to empower teams, to avoid the trappings of giving "lip service" to authority boundaries, which may exist only on paper. Achieving this clarity means understanding the characteristics of effective teams: a high degree of interdependence, strong sense of organizational empowerment, self-determination, competence, commitment, and genuine concern about the quality of work being performed. An important tool for the manager interested in team development is the creation of a performance model, grounded in the foundational relationship competencies necessary for team success. Performance modeling assists not only in identifying of competency gaps that can be addressed by training but also in determining the workplace barriers to team success.
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.
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
The role of management in an in vitro fertilization practice.
Masler, Steve; Strickland, Robert R
2013-05-01
An in vitro fertilization (IVF) practice is an enterprise. Like any enterprise, it has management that plays a major role, forming the structure, framework, and components that make the practice viable. Management of an IVF practice consists of two key teams: the fertility team and the management team. Management activities of the teams fall into eight core areas: business operations, financial, human resources, information technology, organizational governance, risk management, patient care systems, and quality management. Shady Grove Fertility Centers and Huntington Reproductive Center are two examples of professionally managed large fertility practices, one managed mostly centrally and the other largely managed in a decentralized way. Management is what takes a physician's IVF practice and converts it to a professional enterprise. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Distributed Observatory Management
NASA Astrophysics Data System (ADS)
Godin, M. A.; Bellingham, J. G.
2006-12-01
A collection of tools for collaboratively managing a coastal ocean observatory have been developed and used in a multi-institutional, interdisciplinary field experiment. The Autonomous Ocean Sampling Network program created these tools to support the Adaptive Sampling and Prediction (ASAP) field experiment that occurred in Monterey Bay in the summer of 2006. ASAP involved the day-to-day participation of a large group of researchers located across North America. The goal of these investigators was to adapt an array of observational assets to optimize data collection and analysis. Achieving the goal required continual interaction, but the long duration of the observatory made sustained co-location of researchers difficult. The ASAP team needed a remote collaboration tool, the capability to add non-standard, interdisciplinary data sets to the overall data collection, and the ability to retrieve standardized data sets from the collection. Over the course of several months and "virtual experiments," the Ocean Observatory Portal (COOP) collaboration tool was created, along with tools for centralizing, cataloging, and converting data sets into common formats, and tools for generating automated plots of the common format data. Accumulating the data in a central location and converting the data to common formats allowed any team member to manipulate any data set quickly, without having to rely heavily on the expertise of data generators to read the data. The common data collection allowed for the development of a wide range of comparison plots and allowed team members to assimilate new data sources into derived outputs such as ocean models quickly. In addition to the standardized outputs, team members were able to produce their own specialized products and link to these through the collaborative portal, which made the experimental process more interdisciplinary and interactive. COOP was used to manage the ASAP vehicle program from its start in July 2006. New summaries were posted to the COOP tool on a daily basis, and updated with announcements on schedule, system status, voting results from previous day, ocean, atmosphere, hardware, adaptive sampling and coordinated control and forecast. The collection of standardized data files was used to generate daily plots of observed and predicted currents, temperature, and salinity. Team members were able to participate from any internet-accessible location using common Internet browsers, and any team member could add to the day's summary, point out trends and discuss observations, and make an adaptation proposal. If a team member submitted a proposal, team-wide discussion and voting followed. All interactions were archived and left publicly accessible so that future experiments could be made more systematic with increased automation. The need for collaboration and data handling tools is important for future ocean observatories, which will require 24-hour per day, 7-day a week interactions over many years. As demonstrated in the ASAP experiment, the COOP tool and associated data handling tools allowed scientists to coherently and collaboratively manage an ocean observatory, without being co-located at the observatory. Lessons learned from operating these collaborative tools during the ASAP experiment provide an important foundation for creating even more capable portals.
Wooten, Kevin C; Dann, Sara M; Finnerty, Celeste C; Kotarba, Joseph A
2014-07-01
The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle.
Wooten, Kevin C.; Dann, Sara M.; Finnerty, Celeste C.; Kotarba, Joseph A.
2015-01-01
The development of leadership and project management skills is increasingly important to the evolution of translational science and team-based endeavors. Team science is dependent upon individuals at various stages in their careers, inclusive of postdocs. Data from case histories, as well as from interviews with current and former postdocs, and those supervising postdocs, indicate six essential tasks required of project managers in multidisciplinary translational teams, along with eight skill-related themes critical to their success. To optimize the opportunities available and to ensure sequential development of team project management skills, a life cycle model for the development of translational team skills is proposed, ranging from graduate trainees, postdocs, assistant professors, and finally to mature scientists. Specific goals, challenges and project management roles and tasks are recommended for each stage for the life cycle. PMID:25621288
The new science of sales force productivity.
Ledingham, Dianne; Kovac, Mark; Simon, Heidi Locke
2006-09-01
For years, sales managers at many companies have relied on top performers and sheer numbers of sales reps to stay competitive. But while they may have squeaked by on this wing-and-a-prayer technique, their sales teams haven't thrived the way they once did. Today's most successful sales leaders are taking a more scientific approach. Savvy managers are reshaping their tactics in response to changing markets. They are reaching out to new customers in innovative ways. And they are increasing productivity by helping the reps they already have make the most of their skills and resources. Leaders who take a scientific approach to sales force effectiveness have learned to use four levers to boost their reps' productivity in a predictable and manageable way. First, they systematically target their firms' offerings, matching the right products with the right customers. Second, they optimize the automation, tools, and procedures at their disposal, providing reps with the support they need to boost sales.Third, they analyze and manage their reps' performance, measuring both internal processes and results to determine where their teams' strengths and weaknesses are. Fourth, they pay close attention to sales force deployment--how well sales, support, marketing, and delivery resources are matched to customers. These four levers can help sales leaders increase productivity across the board, the authors say, though they have the greatest impact on lower-ranked performers. The overall effect of increasing the average sales per employee can be exponential; it means a company won't have to rely on just a few talented individuals to stay competitive. This is especially important because finding and keeping star salespeople is more difficult than ever. What's more, managers who optimize the sales forces they already have can see returns they never thought possible.
Solanki, Guirish A; Alden, Tord D; Burton, Barbara K; Giugliani, Roberto; Horovitz, Dafne D G; Jones, Simon A; Lampe, Christina; Martin, Kenneth W; Ryan, Maura E; Schaefer, Matthias K; Siddiqui, Aisha; White, Klane K; Harmatz, Paul
2012-09-01
Cervical cord compression is a sequela of mucopolysaccharidosis VI, a rare lysosomal storage disorder, and has devastating consequences. An international panel of orthopedic surgeons, neurosurgeons, anesthesiologists, neuroradiologists, metabolic pediatricians, and geneticists pooled their clinical expertise to codify recommendations for diagnosing, monitoring, and managing cervical cord compression; for surgical intervention criteria; and for best airway management practices during imaging or anesthesia. The recommendations offer ideal best practices but also attempt to recognize the worldwide spectrum of resource availability. Functional assessments and clinical neurological examinations remain the cornerstone for identification of early signs of myelopathy, but magnetic resonance imaging is the gold standard for identification of cervical cord compression. Difficult airways of MPS VI patients complicate the anesthetic and, thus, the surgical management of cervical cord compression. All patients with MPS VI require expert airway management during any surgical procedure. Neurophysiological monitoring of the MPS VI patient during complex spine or head and neck surgery is considered standard practice but should also be considered for other procedures performed with the patient under general anesthesia, depending on the length and type of the procedure. Surgical interventions may include cervical decompression, stabilization, or both. Specific techniques vary widely among surgeons. The onset, presentation, and rate of progression of cervical cord compression vary among patients with MPS VI. The availability of medical resources, the expertise and experience of members of the treatment team, and the standard treatment practices vary among centers of expertise. Referral to specialized, experienced MPS treatment centers should be considered for high-risk patients and those requiring complex procedures. Therefore, the key to optimal patient care is to implement best practices through meaningful communication among treatment team members at each center and among MPS VI specialists worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.
Brown, T J; O'Malley, C; Blackshaw, J; Coulton, V; Tedstone, A; Summerbell, C; Ells, L J
2017-10-01
Specialist weight management services provide a treatment option for severe obesity. The objective of the study is to review the characteristics, impact and practice implications of specialist weight management services for adults in the UK. Systematic review: EMBASE, MEDLINE and PsycINFO were searched from January 2005 to March 2016 with supplementary searches. Adults with a body mass index of ≥40 kg m -2 , or ≥35 kg m -2 with comorbidity or ≥30 kg m -2 with type 2 diabetes and any study of multicomponent interventions, in any UK or Ireland setting, delivered by a specialist multidisciplinary team are the inclusion criteria. Fourteen studies in a variety of settings were included: 1 randomized controlled trial, 3 controlled and 10 observational studies. Mean baseline body mass index and age ranged from 40 to 54 kg m -2 and from 40 to 58 years. The studies were heterogeneous making comparisons of service characteristics difficult. Multidisciplinary team composition and eligibility criteria varied; dropout rates were high (43-62%). Statistically significant reduction in mean body mass index over time ranged from -1.4 to -3.1 kg m -2 and mean weight changes ranged from -2.2 to -12.4 kg. Completers achieving at least 5% reduction of initial body weight ranged from 32 to 51%. There was evidence for improved outcomes in diabetics. Specialist weight management services can demonstrate clinically significant weight loss and have an important role in supporting adults to manage severe and often complex forms of obesity. This review highlights important variations in provision and strongly indicates the need for further research into effective approaches to support severely obese adults. © 2017 World Obesity Federation.
ERIC Educational Resources Information Center
Somech, Anit
2008-01-01
Purpose: Although conflict has traditionally been considered destructive, recent studies have indicated that conflict management can contribute to effective teamwork. The present study explores conflict management as a team phenomenon in schools. The author examined how the contextual variables (task interdependence, goal interdependence) are…
Basart, Hanneke; Kruisinga, Frea H; Breugem, Corstiaan C; Don Griot, J Peter W; Hennekam, Raoul C; Van der Horst, Chantal M A M
2015-01-01
Robin Sequence (RS) is characterized by micrognathia and upper airway obstruction (UAO), with or without cleft palate, causing respiratory and feeding problems. Management options are: positioning; nasopharyngeal airway (NPA); tongue-lip adhesion (TLA); mandibular distraction (MDO); and tracheostomy. Controversy exists in literature regarding RS definition and management. Here we describe definitions, management strategies and criteria in opting for management strategies, used by Dutch and Belgian cleft teams. A specifically designed questionnaire was sent to members of all 16 Dutch and Belgian cleft teams. 14 cleft teams returned 35 questionnaires. All used micrognathia as definition criterion, 93.4% cleft palate, 51.5%glossoptosis and 45.7% UAO. Six different RS definitions were used; even within a single team >1 definition was used. All teams used different management strategies: all used positioning, 10 NPA, 6 TLA, 7 MDO, 8 tracheostomy, 5 refer patients with invasive treatment indication. Criteria in opting management modalities were: O2-saturation (89.3%), clinical presentation (86.2%), growth and feeding problems (69.0%), polysomnography (62.1%), and differed within teams. The Dutch and Belgian cleft teams use variable RS definitions, different management modalities and criteria in choosing management strategies. A single, strict definition and evidence-based management guidelines should be formulated for optimal patient care. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
In Conversation with Tracey McCillen
ERIC Educational Resources Information Center
Holman, Andrew
2012-01-01
Athletes with learning disabilities have had a difficult time being included in the Paralympics. They have faced a lot of discrimination, including from other disabled athletes, and just when they were finally included (at the Sydney games in 2000), the Spanish Basketball team cheated by having players on their team who did not have learning…
What the Stopwatch Doesn't Tell
ERIC Educational Resources Information Center
Strout, Erin
2007-01-01
Lurking behind the championships, trophies, and academic achievements of many top female athletes is a devastating battle with eating disorders--not a new problem, but one that has changed the way coaches talk to their teams about weight and nutrition. The illnesses, which are often difficult to detect, can throw an entire team into a tailspin.…
Staveski, Sandra L; Wu, May; Tesoro, Tiffany M; Roth, Stephen J; Cisco, Michael J
2017-06-01
Pain and agitation are common experiences of patients in pediatric cardiac intensive care units. Variability in assessments by health care providers, communication, and treatment of pain and agitation creates challenges in management of pain and sedation. To develop guidelines for assessment and treatment of pain, agitation, and delirium in the pediatric cardiac intensive unit in an academic children's hospital and to document the effects of implementation of the guidelines on the interprofessional team's perception of care delivery and team function. Before and after implementation of the guidelines, interprofessional team members were surveyed about the members' perception of analgesia, sedation, and delirium management RESULTS: Members of the interprofessional team felt more comfortable with pain and sedation management after implementation of the guidelines. Team members reported improvements in team communication on patients' comfort. Members thought that important information was less likely to be lost during transfer of care. They also noted that the team carried out comfort management plans and used pharmacological and nonpharmacological therapies better after implementation of the guidelines than they did before implementation. Guidelines for pain and sedation management were associated with perceived improvements in team function and patient care by members of the interprofessional team. ©2017 American Association of Critical-Care Nurses.
Head and neck multidisciplinary team meetings: Effect on patient management.
Brunner, Markus; Gore, Sinclair M; Read, Rebecca L; Alexander, Ashlin; Mehta, Ankur; Elliot, Michael; Milross, Chris; Boyer, Michael; Clark, Jonathan R
2015-07-01
The purpose of this study was for us to present our findings on the prospectively audited impact of head and neck multidisciplinary team meetings on patient management. We collected clinical data, the pre-multidisciplinary team meeting treatment plan, the post-multidisciplinary team meeting treatment plans, and follow-up data from all patients discussed at a weekly multidisciplinary team meeting and we recorded the changes in management. One hundred seventy-two patients were discussed in 39 meetings. In 52 patients (30%), changes in management were documented of which 20 (67%) were major. Changes were statistically more likely when the referring physician was a medical or radiation oncologist, when the initial treatment plan did not include surgery, and when the histology was neither mucosal squamous cell cancer nor a skin malignancy. Compliance to the multidisciplinary team meeting treatment recommendation was 84% for all patients and 70% for patients with changes in their treatment recommendation. Head and neck multidisciplinary team meetings changed management in almost a third of the cases. © 2014 Wiley Periodicals, Inc.
VA's expansion of supportive housing: successes and challenges on the path toward Housing First.
Austin, Erika Laine; Pollio, David E; Holmes, Sally; Schumacher, Joseph; White, Bert; Lukas, Carol Vandeusen; Kertesz, Stefan
2014-05-01
The U.S. Department of Veterans Affairs (VA) is transitioning to a Housing First approach to placement of veterans in permanent supportive housing through the use of rental vouchers, an ambitious organizational transformation. This qualitative study examined the experiences of eight VA facilities undertaking this endeavor in 2012. A multidisciplinary team interviewed facility leadership, midlevel managers, and frontline staff (N=95 individuals) at eight VA facilities representing four U.S. regions. The team used a semistructured interview protocol and the constant comparative method to explore how individuals throughout the organizations experienced and responded to the challenges of transitioning to a Housing First approach. Frontline staff faced challenges in rapidly housing homeless veterans because of difficult rental markets, the need to coordinate with local public housing authorities, and a lack of available funds for move-in costs. Staff sought to balance their time spent on housing activities with intensive case management of highly vulnerable veterans. Finding low-demand sheltering options (that is, no expectations regarding sobriety or treatment participation, as in the Housing First model) for veterans waiting for housing presented a significant challenge to implementation of Housing First. Facility leadership supported Housing First implementation through resource allocation, performance monitoring, and reliance on midlevel managers to understand and meet the challenges of implementation. The findings highlight the considerable practical challenges and innovative solutions arising from a large-scale effort to implement Housing First, with particular attention to the experiences of individuals at all levels within an organization.
A Multilevel Analysis of Professional Conflicts in Health Care Teams: Insight for Future Training.
Bochatay, Naike; Bajwa, Nadia M; Cullati, Stéphane; Muller-Juge, Virginie; Blondon, Katherine S; Junod Perron, Noëlle; Maître, Fabienne; Chopard, Pierre; Vu, Nu Viet; Kim, Sara; Savoldelli, Georges L; Hudelson, Patricia; Nendaz, Mathieu R
2017-11-01
Without a proper understanding of conflict between health care professionals, designing effective conflict management training programs for trainees that reflect the complexity of the clinical working environment is difficult. To better inform the development of conflict management training, this study sought to explore health care professionals' experiences of conflicts and their characteristics. Between 2014 and early 2016, 82 semistructured interviews were conducted with health care professionals directly involved in first-line patient care in four departments of the University Hospitals of Geneva. These professionals included residents, fellows, certified nursing assistants, nurses, and nurse supervisors. All interviews were transcribed verbatim, and conventional content analysis was used to derive conflict characteristics. Six conflict sources were identified. Among these sources, disagreements on patient care tended to be the primary trigger of conflict, whereas sources related to communication contributed to conflict escalation without directly triggering conflict. A framework of workplace conflict that integrates its multidimensional and cyclical nature was subsequently developed. This framework suggests that conflict consequences and responses are interrelated, and might generate further tensions that could affect health care professionals, teams, and organizations, as well as patient care. Findings also indicated that supervisors' responses to contentious situations often failed to meet health care professionals' expectations. Understanding conflicts between health care professionals involves several interrelated dimensions, such as sources, consequences, and responses to conflict. There is a need to strengthen health care professionals' ability to identify and respond to conflict and to further develop conflict management programs for clinical supervisors.
Panel management, team culture, and worklife experience.
Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; O'Brien, Bridget; Earnest, Gillian; Gupta, Reena; Shunk, Rebecca; Grumbach, Kevin
2015-09-01
Burnout and professional dissatisfaction are threats to the primary care workforce. We investigated the relationship between panel management capability, team culture, cynicism, and perceived "do-ability" of primary care among primary care providers (PCPs) and staff in primary care practices. We surveyed 326 PCPs and 142 staff members in 10 county-administered, 6 university-run, and 3 Veterans Affairs primary care clinics in a large urban area in 2013. Predictor variables included capability for performing panel management and perception of team culture. Outcome variables included 2 work experience measures--the Maslach Burnout Inventory cynicism scale and a 1-item measure of the "do-ability" of primary care this year compared with last year. Generalized Estimation Equation (GEE) models were used to account for clustering at the clinic level. Greater panel management capability and higher team culture were associated with lower cynicism among PCPs and staff and higher reported "do-ability" of primary care among PCPs. Panel management capability and team culture interacted to predict the 2 work experience outcomes. Among PCPs and staff reporting high team culture, there was little association between panel management capability and the outcomes, which were uniformly positive. However, there was a strong relationship between greater panel management capability and improved work experience outcomes for PCPs and staff reporting low team culture. Team-based processes of care such as panel management may be an important strategy to protect against cynicism and dissatisfaction in primary care, particularly in settings that are still working to improve their team culture. (c) 2015 APA, all rights reserved).
Anesthetic management of spontaneous cervical epidural hematoma during pregnancy: a case report.
Samali, Mehdi; Elkoundi, Abdelghafour; Tahri, Achraf; Bensghir, Mustapha; Haimeur, Charki
2017-06-26
Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression. Anesthetic management should also include measures to maintain the mean arterial pressure to improve spinal cord perfusion. Furthermore, spine surgery in pregnant patients needs special consideration in terms of positioning and in the postoperative period. We present a case of a 35-year-old white woman at 21 weeks of gestation with a spontaneous cervical epidural hematoma. Fiberoptic bronchoscope-guided nasal intubation was a safe option to ensure a higher rate of successful endotracheal intubation while minimizing the risk of aggravating the injury. Her care posed other multiples challenges that required a multidisciplinary team approach. The case of our patient serves as a reminder of this rare condition and its implications regarding anesthesia.
Using collaborative tools for energy corridor planning.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kuiper, J. A.; Cantwell, B.; Hlohowskyj, I.
2008-01-01
In November 2007, the Draft Programmatic Environmental Impact Statement on Designation of Energy Corridors on Federal Land in the Western 11 States was released. The draft proposes a network of 6055 miles of energy corridors on lands managed by seven different federal agencies. Determining the proposed locations of the corridors was a large collaborative effort among the agencies and included local, state, and federal land managers. To connect this geographically dispersed group of people, the project team employed a variety of approaches to communicate corridor siting issues, including sharing GIS layers and electronic maps, a downloadable GIS database and ArcReadermore » project, workshops, and Internet webcast teleconferences. This collaborative approach allowed difficult siting issues to be understood and discussed from many perspectives, which resulted in rapid and effective decision making. The result was a proposed corridor system that avoids many sensitive resources and protected lands while accommodating expected energy development.« less
ERIC Educational Resources Information Center
Benoliel, Pascale
2017-01-01
The present study purpose was to investigate the unique role and activities of school principals in managing their senior management team (SMT) boundaries. The study examined how school principals' internal and external activities mediate the relationship of principals' personal factors from the Big Five typology, the team and contextual…
77 FR 14350 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-09
... Pacific Fishery Management Council Individual Fishing Quota (IFQ) Implementation Team. SUMMARY: The North Pacific Fishery Management Council (Council) IFQ Implementation Team will meet March 26, 2012 in Anchorage...-2809. SUPPLEMENTARY INFORMATION: The Team will review the discussion papers on Vessel Monitoring System...
Liu, Wu; Gong, Yaping; Liu, Jun
2014-05-01
Drawing upon the notion of managerial discretion from upper echelons theory, we theorize which external contingencies moderate the relationship between collective organizational citizenship behavior (COCB) and unit performance. Focusing on business unit (BU) management teams, we hypothesize that COCB of BU management teams enhances BU performance and that this impact depends on environmental uncertainty and BU management-team decision latitude, 2 determinants of managerial discretion. In particular, the positive effect of COCB is stronger when environmental uncertainty or the BU management-team decision latitude is greater. Time-lagged data from 109 BUs of a telecommunications company support the hypotheses. Additional exploratory analysis shows that the positive moderating effect of environmental uncertainty is further amplified at higher levels of BU management-team decision latitude. Overall, this study extends the internally focused view in the micro OCB literature by introducing external contingencies for the COCB-unit-performance relationship. (c) 2014 APA, all rights reserved.
Building an exceptional imaging management team: from theory to practice.
Hogan, Laurie
2010-01-01
Building a strong, cohesive, and talented managerial team is a critical endeavor for imaging administrators, as the job will be enhanced if supported by a group of high-performing, well-developed managers. For the purposes of this article, leadership and management are discussed as two separate, yet equally important, components of an imaging administrator's role. The difference between the two is defined as: leadership relates to people, management relates to process. There are abundant leadership and management theories that can help imaging administrators develop managers and ultimately build a better team. Administrators who apply these theories in practical and meaningful ways will improve their teams' leadership and management aptitude. Imaging administrators will find it rewarding to coach and develop managers and witness transformations that result from improved leadership and management abilities.
Fujita, Junko; Fukui, Sakiko; Ikezaki, Sumie; Otoguro, Chizuru; Tsujimura, Mayuko
2017-11-01
To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis. Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice. It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; 17: 1943-1950. © 2017 Japan Geriatrics Society.
Managing Intercultural Teams: The eOrganization Exercise
ERIC Educational Resources Information Center
Humes, Michelle; Reilly, Anne H.
2008-01-01
In today's global environment, intercultural teams may become the most effective teams in an organization when their diversity is managed as an asset. However, because of miscommunication and conflict, intercultural teams often become dysfunctional. This experiential group exercise demonstrates how cultural dimensions such as individualism and…
ERIC Educational Resources Information Center
Kanaga, Kim; Kossler, Michael E.
This practical guidebook is designed for managers and leaders who have responsibility for the creation and success of teams. First, a team is described as a workgroup whose members are dependent upon one another for the completion of a given task, and whose members possess different but complementary skill sets. A team manages its own work within…
Defense AT&L. Volume 37, Number 4, July-August 2008
2008-08-01
allowed the Greek philosopher to share some tidbits of wisdom regarding pro- gram management and changing the way we view chaos and order. 21...on your team. Virtual teaming is chang- ing the way we develop and work with team members. 37 Project Manager and Program Manager : What’s the...Difference? Jeffrey Peisach and Timothy S. Kroecker Identifying the roles and responsibilities of project managers and program managers will
Self-Managed Career Services: A Team Approach.
ERIC Educational Resources Information Center
Nonnamaker, John; Hagenbaugh, Stacie; Grote, Ann DiMeola; Denon, Gregory; Jessup, Kara
2001-01-01
Taking a lead from corporate culture, many colleges and universities are experimenting with the self-managed team model, an alternative to traditional hierarchical structures. This article discusses Boston's Emerson College career services staff's experience with becoming a self-managed team. They were able to improve service delivery, reduce…
ERIC Educational Resources Information Center
Galagan, Patricia
1986-01-01
Describes a line manager's successful attempt to design an autonomously run plant. The author discusses the assembly of a team of workers to develop the plant, product design, characteristics of the team members, the employee reward system, role of the plant manager, and the manager's evaluation of the plant's success. (CT)
77 FR 15722 - North Pacific Fishery Management Council; Public Notice
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-16
.... SUMMARY: The North Pacific Fishery Management Council's (Council's) Groundfish Plan Teams and Crab Plan Team will hold a workshop on Assessment/Management Issues Related to Recruitment, April 4-5, 2012 at... Council; telephone: (907) 271-2809. SUPPLEMENTARY INFORMATION: The Plan Teams will develop guidelines on...
Martínez-Tur, Vicente; Gracia, Esther; Moliner, Carolina; Molina, Agustín; Kuster, Inés; Vila, Natalia; Ramos, José
2016-06-01
The main goal of this study was to examine the interaction between team members' performance and interactional justice climate in predicting mutual trust between managers and team members. A total of 93 small centers devoted to the attention of people with intellectual disability participated in the study. In each center, the manager (N = 93) and a group of team members (N = 746) were surveyed. On average, team members were 36.2 years old (SD = 9.3), whereas managers were 41.2 years old (SD = 8.8). The interaction between interactional justice climate and performance was statistically significant. Team members' performance strengthened the link from interactional justice climate to mutual trust. © The Author(s) 2016.
Overcoming the ten most common barriers to effective team communication.
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.
Self-managing teams: a strategy for quality improvement.
Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen
2003-01-01
Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.
Self-Assessment of Governance Teams in an Argentine Private University: Adapting to Difficult Times
ERIC Educational Resources Information Center
Durand, Julio; Pujadas, Carlos
2004-01-01
Argentine Universities like similar institutions all around the world are facing a complex and challenging environment that demands a more sophisticated leadership and the development of complex managerial skills. In this paper we propose that enhancing the quality of collective decision making, and building more complex teams as a way to preserve…
Evaluating the Impact and Determinants of Student Team Performance: Using LMS and CATME Data
ERIC Educational Resources Information Center
Braender, Lynn M.; Naples, Michele I.
2013-01-01
Practitioners find it difficult to allocate grades to individual students based on their contributions to the team project. They often use classroom observation of teamwork and student peer evaluations to differentiate an individual's grade from the group's grade, which can be subjective and imprecise. We used objective data from student activity…
Learning for the Frontline: How Fire-Fighters Integrate Learnt Behaviours with Difficult Contexts
ERIC Educational Resources Information Center
Dadich, Ann
2012-01-01
Emergency service teams hold an important role however the stress associated with their position can strain workplace relationships. Although it is not always possible to change the incidents to which teams respond, it is possible to shape the way personnel communicate with each other about these incidents. Yet little is known on how learnt…
Improving supervision: a team approach.
1993-01-01
This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.
NASA Astrophysics Data System (ADS)
Martin, T.; Fox, T.; Peter, G.; Monroe, M.
2012-12-01
The Pine Integrated Network: Education, Mitigation and Adaptation Project ("PINEMAP") was funded by National Institute of Food and Agriculture to produce outcomes of enhanced climate change mitigation and adaptation in planted southern pine ecosystems. The PINEMAP project leverages a strong group of existing networks to produce synergy and cooperation on applied forestry research in the region. Over the last 50 years, cooperative research on planted southern pine management among southeastern U.S. universities, government agencies, and corporate forest landowners has developed and facilitated the widespread implementation of improved genetic and silvicultural technology. The impact of these regional research cooperatives is difficult to overstate, with current members managing 55% of the privately owned planted pine forestland, and producing 95% of the pine seedlings planted each year. The PINEMAP team includes the eight major forestry cooperative research programs, scientists from eleven land grant institutions, the US Forest Service, and climate modeling and adaptation specialists associated with the multi-state SE Climate Consortium and state climate offices. Our goal is to create and disseminate the knowledge that enables landowners to: harness planted pine forest productivity to mitigate atmospheric CO2; more efficiently use nitrogen and other fertilizer inputs; and adapt their forest management to increase resilience in the face of changing climate. We integrate our team's infrastructure and expertise to: 1) develop breeding, genetic deployment and innovative management systems to increase C sequestration and resilience to changing climate of planted southern pine forests ; 2) understand interactive effects of policy, biology, and climate change on sustainable management; 3) transfer new management and genetic technologies to private industrial and non-industrial landowners; and 4) educate a diverse cross-section of the public about the relevance of forests, forest management, and climate change. These efforts will enable our stakeholders to enhance the productivity of southern pine forests, while maintaining social, economic, and ecological sustainability.
Hassell, J T; Games, A D; Shaffer, B; Harkins, L E
1994-09-01
To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P < .001), and complication rate, which was greater in the nonteam group (P < .001). In the nutrition support team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.
Siems, Ashley; Cartron, Alexander; Watson, Anne; McCarter, Robert; Levin, Amanda
2017-02-01
Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively. Multiple quartile (median) and logistic regression models were developed to evaluate change in performance scores or completion of specific tasks. Team leader and team introductions (40% to 90%, P = .004; 7% to 45%, P = .03), floor team presentations in Situation Background Assessment Recommendation format (20% to 65%, P = .01), and confirmation of the plan (7% to 70%, P = .002) improved after training in patients transferred to the ICU (n = 35). The Team Emergency Assessment Measure metric was improved in all 4 categories: leadership (2.5 to 3.5, P < .001), teamwork (2.7 to 3.7, P < .001), task management (2.9 to 3.8, P < .001), and global scores (6.0 to 9.0, P < .001) for teams caring for patients who required transfer to the ICU. Targeted crew resource management training of the team leader resulted in improved team performance and dynamics for patients requiring transfer to the ICU. The intervention demonstrated that training the team leader improved behavior in RRT members who were not trained. Copyright © 2017 by the American Academy of Pediatrics.
THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pemberton, Wendy; Mena, RaJah; Beal, William
The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phasemore » efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.« less
77 FR 65535 - North Pacific Fishery Management Council; Public Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-29
... Islands (BSAI) Groundfish Plan Teams will meet in Seattle, WA. DATES: The meetings will be held November... NE., Building 4, Observer Training Room 1055 (GOA Plan Team) and Traynor Room 2076 (BS/AI Plan Team... Fishery Management Council; telephone: (907) 271-2809. SUPPLEMENTARY INFORMATION: The Plan Teams will...
Managing Team Learning in a Spanish Commercial Bank
ERIC Educational Resources Information Center
Doving, Erik; Martin-Rubio, Irene
2013-01-01
Purpose: The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach: The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings: The…
Power, politics, and top management team characteristics: do they matter?
Gerowitz, M B
1998-01-01
This study assesses the contributions of the leader power and top management team characteristics to perceived strategic capability. Low age heterogeneity and low tenure heterogeneity were found to have a positive association with perceived adaptability. High diversity in educational specialization was also found to be positively associated with adaptability. Top management perceptions of CEO power were, however, lower among high adaptors. Implications for leadership research, senior management recruitment, and the design of management development for top management teams are discussed.
Setting up an energy management team
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mashburn, W.H.
1995-12-31
Many people that are assigned the responsibility of reducing energy costs within an organization are technically inclined, and may have little organizational or management skills. A number of companies have achieved great savings with just a technical energy manager acting in a prima donna role. However, so much more can be achieved if energy management is integrated throughout the whole organization, with input from all levels. The energy management team is the key to an organized approach, and establishing one is the place to start. The Industrial Energy Center at Virginia Tech is sponsored by both electric and natural gasmore » utilities who ask for assistance in conducting energy surveys of industrial firms. One requirement of the companies the author surveys is that they agree to establish an energy management team. During the first few hours with the company he helps organize and train the team. The objective is to have a high implementation rate of the energy conservation opportunities found during the survey. By leaving in place an in-house energy management team, the prospects for this are better. The author has found that most large corporations have some type of energy management program, but not much has transcended to company level. This paper is directed toward establishing an energy management team at company level.« less
The Origins of Team Management
ERIC Educational Resources Information Center
Swift, James S.
1971-01-01
An analysis of the factors that have led to team management, including classical principles of management, the human relations or behavioral school of management, and the systems theory both closed and open. (JF)
Tricco, Andrea C; Zarin, Wasifa; Rios, Patricia; Pham, Ba’; Straus, Sharon E; Langlois, Etienne V
2016-01-01
Introduction Engaging policymakers, healthcare managers and policy analysts in the conduct of knowledge synthesis can help increase its impact. This is particularly important for knowledge synthesis studies commissioned by decision-makers with limited timelines, as well as reviews of health policy and systems research. A scoping review will be conducted to assess barriers, facilitators, strategies and outcomes of engaging these individuals in the knowledge synthesis process. Methods and analysis We will follow the Joanna Briggs Institute guidance for scoping reviews. Literature searches of electronic databases (eg, MEDLINE, EMBASE, Cochrane Library, ERIC, PsycINFO) will be conducted from inception onwards. The electronic search will be supplemented by searching for sources that index unpublished/difficult to locate studies (eg, GreyNet International database), as well as through scanning of reference lists of reviews on related topics. All study designs using either qualitative or quantitative methodologies will be eligible if there is a description of the strategies, barriers or facilitators, and outcomes of engaging policymakers, healthcare managers and policy analysts in the knowledge synthesis process. Screening and data abstraction will be conducted by 2 team members independently after a calibration exercise across the team. A third team member will resolve all discrepancies. We will conduct frequency analysis and thematic analysis to chart and characterise the literature, identifying data gaps and opportunities for future research, as well as implications for policy. Ethics and dissemination This project was commissioned by the Alliance for Health Policy and Systems Research, WHO. The results will be used by Alliance Review Centers of health policy and systems research in low-income and middle-income countries that are conducting knowledge synthesis to inform health policymaking and decision-making. Our results will also be disseminated through conference presentations, train-the-trainer events, peer-reviewed publication and a 1-page policy brief that will be posted on the authors' websites. PMID:28011815
[Risk and risk management in aviation].
Müller, Manfred
2004-10-01
RISK MANAGEMENT: The large proportion of human errors in aviation accidents suggested the solution--at first sight brilliant--to replace the fallible human being by an "infallible" digitally-operating computer. However, even after the introduction of the so-called HITEC-airplanes, the factor human error still accounts for 75% of all accidents. Thus, if the computer is ruled out as the ultimate safety system, how else can complex operations involving quick and difficult decisions be controlled? OPTIMIZED TEAM INTERACTION/PARALLEL CONNECTION OF THOUGHT MACHINES: Since a single person is always "highly error-prone", support and control have to be guaranteed by a second person. The independent work of mind results in a safety network that more efficiently cushions human errors. NON-PUNITIVE ERROR MANAGEMENT: To be able to tackle the actual problems, the open discussion of intervened errors must not be endangered by the threat of punishment. It has been shown in the past that progress is primarily achieved by investigating and following up mistakes, failures and catastrophes shortly after they happened. HUMAN FACTOR RESEARCH PROJECT: A comprehensive survey showed the following result: By far the most frequent safety-critical situation (37.8% of all events) consists of the following combination of risk factors: 1. A complication develops. 2. In this situation of increased stress a human error occurs. 3. The negative effects of the error cannot be corrected or eased because there are deficiencies in team interaction on the flight deck. This means, for example, that a negative social climate has the effect of a "turbocharger" when a human error occurs. It needs to be pointed out that a negative social climate is not identical with a dispute. In many cases the working climate is burdened without the responsible person even noticing it: A first negative impression, too much or too little respect, contempt, misunderstandings, not expressing unclear concern, etc. can considerably reduce the efficiency of a team.
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.
75 FR 11134 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-10
... of the North Pacific Fishery Management Council's Crab Plan Team (CPT). SUMMARY: The Crab Plan Team...- 2809. SUPPLEMENTARY INFORMATION: The Plan Team will address the following issues: Review Essential Fish...
Conservative management of neuromuscular scoliosis: personal experience and review of literature.
Kotwicki, Tomasz; Jozwiak, Marek
2008-01-01
The principles of conservative management of neuromuscular scoliosis in childhood and adolescence are presented. Analysis of personal experience and literature review. The topic is discussed separately for patients with flaccid or spastic paresis. These demonstrate that conservative management might be proposed for patients with neuromuscular scoliosis in many clinical situations. In spastic disorders, it maintains the symmetry around the hip joints. Bracing is technically difficult and often is not tolerated well by cerebral palsy children. In patients with flaccid paresis, the fitting and the use of brace is easier than in spastic patients. The flexibility of the spinal curvature is more important. Functional benefits of conservative management of neuromuscular scoliosis comprise stable sitting, easier use of upper limbs, discharge of the abdomen from the collapsing trunk, increased diaphragm excursion, and, not always, prevention of curve progression. Specific natural history and multiple medical problems associated with the disease make the treatment of children with neuromuscular scoliosis an extremely complex issue, best addressed when a team approach is applied. Continuously improving techniques of conservative management, comprising bracing and physiotherapy, together with correctly timed surgery incorporated in the process of rehabilitation, provide the optimal care for patients.
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.
The Perspective of Women Managing Research Teams in Social Sciences
ERIC Educational Resources Information Center
Tomas, Marina; Castro, Diego
2013-01-01
This article presents a research study that focuses on how women manage research teams. More specifically, the study aims to ascertain the perception of female researchers who are leaders of research groups in social sciences with regard to the formation, operation and management of their research teams. Fifteen interviews were carried out, eight…
NREL: U.S. Life Cycle Inventory Database - Project Management Team
Project Management Team Information about the U.S. Life Cycle Inventory (LCI) Database project management team is listed on this page. Additional project information is available about the U.S. LCI Mechanical Engineering, Colorado State University Professional History Michael has worked as a Senior
A Mirror for Managers: Using Simulation to Develop Management Teams. Technical Report 23.
ERIC Educational Resources Information Center
Kaplan, Robert E.; And Others
Although simulation is among the least common of the many methods consultants employ to stimulate team development, realistic simulation can help in the diagnosis of management teams. Simulations fill a gap in the repertoire of data collection methods for organizational diagnosis and development by affording an opportunity for direct observation…
Rokach, Ariel; Pinkert, Moshe; Nemet, Dani; Goldberg, Avishay; Bar-Dayan, Yaron
2008-01-01
During the last few decades, various global disasters have rendered nations helpless (such as Thailand's tsunami and earthquakes in Turkey, Pakistan, Iran, and India). A lack of knowledge and resources make it difficult to address such disasters. Preparedness for a national disaster is expensive, and in most cases, unachievable even for modern countries. International collaboration might be useful for coping with large-scale disasters. Preparedness for international collaboration includes drills. Two such drills held by the Israeli Home Front Command and other military and civilian bodies with the nations of Greece and Turkey are described in this article. The data were gathered from formal debriefings of the Israeli teams collaborating in two separate drills with Greek and Turkish teams. Preparations began four months before the drills were conducted and included three meetings between Israeli and foreign officials. The Israeli and foreign officials agreed upon the drill layout, logistics, communications, residence, real-time medicine, hardware, and equipment. The drills took place in Greece and Turkey and lasted four days. The first day included meetings between the teams and logistics preparations. The second and third days were devoted to exercises. The drills included evacuating casualties from a demolition zone and treating typical injuries such as crush syndrome. Every day ended with a formal debriefing by the teams' commanders. The fourth day included a ceremony and transportation back home. Members in both teams felt the drills improved their skills and had an important impact on creating common language that would enhance cooperation during a real disaster. A key factor in the management of large-scale disasters is coordination between countries. International drills are important to create common language within similar regulations.
NASA Technical Reports Server (NTRS)
Grimaldi, Rebecca; Horvath, Tim; Morris, Denise; Willis, Emily; Stacy, Lamar; Shell, Mike; Faust, Mark; Norwood, Jason
2011-01-01
Payload science operations on the International Space Station (ISS) have been conducted continuously twenty-four hours per day, 365 days a year beginning February, 2001 and continuing through present day. The Payload Operations Integration Center (POIC), located at the Marshall Space Flight Center in Huntsville, Alabama, has been a leader in integrating and managing NASA distributed payload operations. The ability to conduct science operations is a delicate balance of crew time, onboard vehicle resources, hardware up-mass to the vehicle, and ground based flight control team manpower. Over the span of the last ten years, the POIC flight control team size, function, and structure has been modified several times commensurate with the capabilities and limitations of the ISS program. As the ISS vehicle has been expanded and its systems changed throughout the assembly process, the resources available to conduct science and research have also changed. Likewise, as ISS program financial resources have demanded more efficiency from organizations across the program, utilization organizations have also had to adjust their functionality and structure to adapt accordingly. The POIC has responded to these often difficult challenges by adapting our team concept to maximize science research return within the utilization allocations and vehicle limitations that existed at the time. In some cases, the ISS and systems limitations became the limiting factor in conducting science. In other cases, the POIC structure and flight control team size were the limiting factors, so other constraints had to be put into place to assure successful science operations within the capabilities of the POIC. This paper will present the POIC flight control team organizational changes responding to significant events of the ISS and Shuttle programs.
76 FR 22677 - Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-22
... Groundfish Management Team (GMT). The meeting is open to the public. DATES: The conference call will be held... the Groundfish Management Team to review the developing Ecosystem Fishery Management Plan. The GMT...
Gilpin, R. E.
1963-01-01
The types of prostheses available for treatment of congenital amputations in children, and the assistance in habilitation which can be expected from their use, are described in this communication. The limb deformities in children commonly associated with the drug thalidomide are phocomelia and amelia. Prosthetic treatment of these is difficult, but in almost every case some assistance can be offered. The degree of this assistance will depend to a large extent on (1) the number of limbs involved, (2) the site of the deformity, (3) the intellectual capacity of the child. These factors are evaluated by a clinic team, consisting of a prosthetist, a therapist, a social worker, and a doctor, who acts as the clinical chief. They are also embodied into a prescription for a prosthesis and into a program of management. Subsequently, the clinic team also carry out an assessment of the result. The prosthetist makes available his knowledge of present-day appliances, and assures that the way is left open for use of new, and perhaps revolutionary prostheses, in the future. ImagesFig. 1(a)-1(b)Fig. 2Fig. 3Fig. 4 PMID:13947980
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…
Palliative care consultation in the process of organ donation after cardiac death.
Kelso, Catherine McVearry; Lyckholm, Laurie J; Coyne, Patrick J; Smith, Thomas J
2007-02-01
Palliative care consultation has been demonstrated to be useful in many situations in which expert symptom management, communication around sensitive issues, and family support may serve to enhance or improve care. The process of organ donation is an example of this concept, specifically the process of donation after cardiac death (DCD). DCD allows patients with severe, irreversible brain injuries that do not meet standard criteria for brain death to donate organs when death is declared by cardiopulmonary criteria. The DCD method of donation has been deemed an ethically appropriate means of organ donation and is supported by the organ procurement and medical communities, as well as the public. The palliative care (PC) team can make a significant contribution to the care of the patient and family in the organ donation process. In this paper we describe the controlled DCD process at one institution that utilizes the PC team to provide expert end-of-life care, including comprehensive medical management and family support. PC skills and principles applicable to the DCD process include communication, coordination of care, and skillful ventilator withdrawal. If death occurs within 90 minutes of withdrawal of life support, organs may be successfully recovered for transplantation. If the patient survives longer than 90 minutes, his or her care continues to be provided by the PC team. Palliative care can contribute to standardizing quality end-of-life care practices in the DCD process and provide education for involved personnel. Further experience, research and national discussions will be helpful in refining these practices, to make this difficult and challenging experience as gentle and supportive as possible for the courageous families who participate in this process.
A Positive Behavioral Approach for Aggression in Forensic Psychiatric Settings.
Tolisano, Peter; Sondik, Tracey M; Dike, Charles C
2017-03-01
Aggression toward self and others by complex patients admitted to forensic psychiatric settings is a relatively common yet extremely difficult behavior to treat. Traditional interventions in forensic inpatient settings have historically emphasized control and management over treatment. Research over the past several years has demonstrated the value of behavioral and psychosocial treatment interventions to reduce aggression and to increase prosocial skill development in inpatient forensic population. Positive behavioral support (PBS) offers a comprehensive approach that incorporates the science of applied behavioral analysis (ABA) in support of patients with challenging behaviors, including aggression and violence. In this article, we describe a PBS model to treat aggression in forensic settings. PBS includes a comprehensive functional assessment, along with four basic elements: ecological strategies, positive programming, focused support strategies, and reactive strategies. Other key components are described, including data collection, staff training, fidelity checks to ensure correct implementation of the plan, and ongoing monitoring and revision of PBS strategies, according to treatment outcomes. Finally, a behavioral consultation team approach within the inpatient forensic setting is recommended, led by an assigned doctoral-level psychologist with specialized knowledge and training in behavioral methods. The behavioral consultation team works directly with the unit treatment team and the identified patient to develop, implement, and track a plan that may extend over several weeks to several months including transition into the community. PBS can offer a positive systemic impact in forensic inpatient settings, such as providing a nonpharmacologic means to address aggression, reducing the incidences of restraint and seclusion, enhancing staff proficiency in managing challenging patient presentations, and reducing recidivism when used as part of the bridge to community re-entry. © 2017 American Academy of Psychiatry and the Law.
Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott
2015-01-01
Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.
A model for the submarine depthkeeping team
NASA Technical Reports Server (NTRS)
Ware, J. R.; Best, J. F.; Bozzi, P. J.; Kleinman, D. W.
1981-01-01
The most difficult task the depthkeeping team must face occurs during periscope-depth operations during which they may be required to maintain a submarine several hundred feet long within a foot of ordered depth and within one-half degree of ordered pitch. The difficulty is compounded by the facts that wave generated forces are extremely high, depth and pitch signals are very noisy and submarine speed is such that overall dynamics are slow. A mathematical simulation of the depthkeeping team based on the optimal control models is described. A solution of the optimal team control problem with an output control restriction (limited display to each controller) is presented.
Gillmann, Fanchon; Cordier, Christophe; Taris, Nicolas; Mathelin, Carole; Maugard, Christine M
2016-06-01
In France, 126 centers for cancer genetics coordinate genetic testing and high-risk cancer surveillance for individuals and their families with hereditary cancer syndromes. Since 2012, the French National Cancer Institute (INCa) supports 17 projects to promote and manage the monitoring of individuals genetically predisposed to cancer. They were assigned 4 missions by INCa including expertise for difficult cases. We initiated a national survey to assess how the oncogenetic clinics responded to the 4th mission for women at high risk of developing breast cancers. We sent the survey to all the French oncogeneticists. We aimed at evaluating the modalities and the extent of implementation of the Multidisciplinary team (MDT) meetings regarding the management of women who have genetically higher risks to develop breast cancer. Fourteen people from 12 administrative regions, who represent 10 of the 17 projects, answered the form. Eleven participants reported the submission of medical cases in Oncogenetics MDT meetings (79 %), 5 in senology MDT meetings (36 %), 5 in MDT meetings dedicated to patients at high risk for breast cancer (36 %) and 2 in network meetings (14 %). Some structures discuss medical cases through different MDT meetings. Although MDT meetings are valuable practices to optimize treatment or management options for patients, its settings might be subject to difficulties to federate the appropriate-number of participants as well as cost-effectiveness issues. This survey thus suggests the need of a standardized process of MDT meetings while taking account specificities of oncogenetics. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
Zieleskiewicz, Laurent; Chantry, Anne; Duclos, Gary; Bourgoin, Aurelie; Mignon, Alexandre; Deneux-Tharaux, Catherine; Leone, Marc
2016-10-01
In developed countries, the rate of obstetric ICU admissions (admission during pregnancy or the postpartum period) is between 0.5 and 4 per 1000 deliveries and the overall case-fatality rate is about 2%. The most two common causes of obstetric ICU admissions concerned direct obstetric pathologies: obstetric hemorrhage and hypertensive disorders of pregnancy. This review summarized the principles of management of critically ill pregnant patient. Its imply taking care of two patients in the same time. A coordinated multidisciplinary team including intensivists, anesthesiologists, obstetricians, pediatricians and pharmacists is therefore necessary. This team must work effectively together with regular staff aiming to evaluate daily the need to maintain the patient in intensive care unit or to prompt delivery. Keeping mother and baby together and fetal well-being must be balanced with the need of specialized advanced life support for the mother. The maternal physiological changes imply various consequences on management. The uterus aorto-caval compression implies tilting left the parturient. In case of cardiac arrest, uterus displacement and urgent cesarean delivery are needed. The high risk of aspiration and difficult tracheal intubation must be anticipated. Even during acute respiratory distress syndrome, hypoxemia and permissive hypercapnia must be avoided due to their negative impact on the fetus. Careful analysis of the benefit-risk ratio is needed before all drug administration. Streptococcal toxic shock syndrome and perineal fasciitis must be feared and a high level of suspicion of sepsis must be maintained. Finally the potential benefits of an ultrasound-based management are detailed. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri
2018-01-01
The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group. Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety. © 2017 John Wiley & Sons Ltd.
Occupational therapists in the interdisciplinary team setting.
Reed, S M
1984-01-01
The interdisciplinary team approach to patient care provides an answer to the fragmentation and confusion patients feel when dealing with our complex healthcare system. Even though the team approach has been in use for the past two decades, implementation of a successful team is very difficult and rarely sustained over a significant period of time. This is especially true in general hospitals and in physical rehabilitation programs that spring from general hospitals where the physician and the nurse are the traditional care group. Occupational therapists, as they establish roles on interdisciplinary teams as staff members and team leaders, will require a knowledge of what makes a team function effectively. They can use this knowledge to evaluate the status of their own team and contribute to changes that will insure its long-term success. Six key issues should be addressed during the planning stage of any new healthcare team to insure its continued viability. These issues are: program philosophy, client focus, role clarification, collaboration and information sharing, policies and procedures, and staff supportiveness.
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.
Interdiscplinary team processes within an in-home service delivery organization.
Gantert, Thomas W; McWilliam, Carol L
2004-01-01
Interdisciplinary teamwork is particularly difficult to achieve in the community context where geographical separateness and solo practices impede face to face contact and collaborative practice. Understanding the processes that occur within interdisciplinary teams is imperative, since client outcomes are influenced by interdisciplinary teamwork. The purpose of this exploratory study was to describe the processes that occur within interdisciplinary teams that deliver in-home care. Applying grounded theory methodology, the researcher conducted unstructured in-depth interviews with a purposeful sample of healthcare providers and used constant comparative analysis to elicit the findings. Findings revealed three key team processes: networking, navigating, and aligning. The descriptions afford several insights that are applicable to in-home healthcare agencies attempting to achieve effective interdisciplinary team functioning.
Effective team management by district nurses.
Bliss, Julie
2004-12-01
This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.
A suite of fire, fuels, and smoke management tools
Roger D. Ottmar; Clint S. Wright; Susan J. Prichard
2009-01-01
The Fire and Environmental Research Applications Team (FERA) of the Forest Service, Pacific Northwest Research Station, is an interdisciplinary team of scientists that conduct primary research on wildland fire and provide decision support for fire hazard and smoke management. The team is committed to providing easy-to-use tools that help managers in their fire and...
Optimism Bias in Fans and Sports Reporters.
Love, Bradley C; Kopeć, Łukasz; Guest, Olivia
2015-01-01
People are optimistic about their prospects relative to others. However, existing studies can be difficult to interpret because outcomes are not zero-sum. For example, one person avoiding cancer does not necessitate that another person develops cancer. Ideally, optimism bias would be evaluated within a closed formal system to establish with certainty the extent of the bias and the associated environmental factors, such that optimism bias is demonstrated when a population is internally inconsistent. Accordingly, we asked NFL fans to predict how many games teams they liked and disliked would win in the 2015 season. Fans, like ESPN reporters assigned to cover a team, were overly optimistic about their team's prospects. The opposite pattern was found for teams that fans disliked. Optimism may flourish because year-to-year team results are marked by auto-correlation and regression to the group mean (i.e., good teams stay good, but bad teams improve).
2015-11-02
External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team N O V E M B E R 2 , 2 0 1 5... MANAGEMENT AGENCY SUBJECT: External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment Internal Review Team...Report No. DODIG-2016-007) Attached is the External Peer Review Report on the Defense Contract Management Agency Office of Independent Assessment
Idiom of distress or delusional state? Cultural clash as the cause of misdiagnosis: a case report.
Ulman, Anne-Marie; Bar, Faina
2011-01-01
The Beta Israel (House of Israel) represent a total number of more than 100,000 individuals. Ethiopian Jewish culture is based on a tribal cultural model. With their arrival in Israel, many difficulties surfaced. Ethiopian Jews had to deal with cultural choices that challenged their traditions. It has been suggested that the trauma of their journey coupled to the difficulties of the adaptation process to Israeli society, ( the culture shock), was directly responsible for psychopathology found among this population. It also appeared that culture plays a central role in the construction of the clinical picture, blurring at times the boundary between expressions of distress and pathology. It became increasingly difficult to draw the line between culturally normative behavior and psychopathology. The following case report underlines the importance of socio cultural considerations in both staff and patients, and illustrates the dangers of misdiagnosis due to patient therapeutic team cultural clash. A 41 year old woman of Ethiopian origin was hospitalized for suspected schizophrenia. Because of the striking contrast between the patients behavior, responses and so called psychotic content, possible misunderstanding based on cultural differences was considered by the clinical management team. This case underlines the dangers of the psychiatric diagnostic process, emphasizes the important role of sociocultural backgrounds of both staff and patients in patient management and encourages the consideration of cultural factors in all patient evaluations.
Reducing Amputations in People with Diabetes (RAPID): Evaluation of a New Care Pathway
MacRury, Sandra; Main, Fiona; Gorman, Jane; Jones, Sandra; Macfarlane, David
2018-01-01
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study. Omni-HubTM enabled a face-to-face consultation by the community podiatrist to be enhanced by virtual consultation with members of the multidisciplinary foot team, including specialist diabetes podiatrists and a diabetes consultant. The technical feasibility study provided recommended changes focused around adaptations to the equipment used and the best means to gain successful connectivity. The process enhancement study demonstrated positive outcomes in the process with positive effects both in the service received by patients and experiences of healthcare professionals involved. The RAPID project provides evidence and justification for a larger-scale empirical study to test an embedded pathway and technology solution, which will inform policy change and a paradigm shift in the management of foot ulceration in the community. PMID:29772673
Humphris, G
2016-05-01
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and interventions for the psychological management in this patient group. Recommendations • Audit of information supplied to patients and carers should be conducted on an annual basis to update and review content and media presentation. (G) • Patients and carers should be invited to discuss treatment options and relate possible outcomes to functional retention or loss to provide a patient-centred approach. (G) • Clinical staff should inspect their systems of assessment to make them sensitive enough to identify patients with psychological difficulties. (G) • Flexibility, rather than rigid formulation is required to assess patients frequently, and to allow for change in circumstances to be noted. (G) • Multidisciplinary teams should determine the supportive care services available and commission extra assistance to provide patients and carers with timely information, education or brief supportive advice. (G) • Multidisciplinary teams need to inspect specialist services for mental health interventions at structured and complex levels for the small proportion of patients with more serious, but rarer, psychological difficulties. (G) • Clinical staff at all levels should receive communication skills training to raise and maintain consultation expertise with difficult patient and/or carer interactions. (G).
Reducing Amputations in People with Diabetes (RAPID): Evaluation of a New Care Pathway.
MacRury, Sandra; Stephen, Kate; Main, Fiona; Gorman, Jane; Jones, Sandra; Macfarlane, David
2018-05-16
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study. Omni-Hub TM enabled a face-to-face consultation by the community podiatrist to be enhanced by virtual consultation with members of the multidisciplinary foot team, including specialist diabetes podiatrists and a diabetes consultant. The technical feasibility study provided recommended changes focused around adaptations to the equipment used and the best means to gain successful connectivity. The process enhancement study demonstrated positive outcomes in the process with positive effects both in the service received by patients and experiences of healthcare professionals involved. The RAPID project provides evidence and justification for a larger-scale empirical study to test an embedded pathway and technology solution, which will inform policy change and a paradigm shift in the management of foot ulceration in the community.
Stewart, Greg L; Courtright, Stephen H; Barrick, Murray R
2012-03-01
The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how peer-based rational control, which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and interacts with the more commonly studied normative control force of group cohesion to explain both individual and collective performance in teams. On the basis of data from 587 factory workers in 45 self-managing teams at 3 organizations, peer-based rational control corresponded with higher performance for both individuals and collective teams. Results further demonstrated that the rational and normative mechanism of peer-based control interacted to explain performance at both the individual and team levels. Increased peer-based rational control corresponded with higher individual and collective performance in teams with low cohesion, but the positive effects on performance were attenuated in cohesive teams.
Enteral nutritional support management in a university teaching hospital: team vs nonteam.
Brown, R O; Carlson, S D; Cowan, G S; Powers, D A; Luther, R W
1987-01-01
Current hospital cost containment pressures have prompted a critical evaluation of whether nutritional support teams render more clinically effective and efficient patient care than nonteam management. To address this question with regard to enteral feeding, 102 consecutive hospitalized patients who required enteral nutritional support (ENS) by tube feeding during a 3 1/2-month period were prospectively studied. Fifty patients were managed by a nutritional support team; the other 52 were managed by their primary physicians. Choice of enteral formula, formula modifications, frequency of laboratory tests, and amounts of energy and protein received were recorded daily. In addition, each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. Team-managed (T) and nonteam-managed (NT) patients received ENS for 632 and 398 days, respectively. The average time period for ENS was significantly longer in the team-managed patients (12.6 +/- 12.1 days vs 7.7 +/- 6.2 days, p less than 0.01). Significantly more of the team patients attained 1.2 X basal energy expenditure (BEE) (37 vs 26, p less than 0.05). Total number of abnormalities in each group was similar (T = 398, NT = 390); however, the abnormalities per day were significantly lower in the team group (T = 0.63 vs NT = 0.98, p less than 0.01). Mechanical (T = 0.05 vs NT = 0.11, p less than 0.01), gastrointestinal (T = 0.99 vs NT = 0.14, p less than 0.05), and metabolic (T = 0.49 vs NT = 0.72, p less than 0.01) abnormalities per day all were significantly lower in the team-managed patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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.
A methodology and supply chain management inspired reference ontology for modeling healthcare teams.
Kuziemsky, Craig E; Yazdi, Sara
2011-01-01
Numerous studies and strategic plans are advocating more team based healthcare delivery that is facilitated by information and communication technologies (ICTs). However before we can design ICTs to support teams we need a solid conceptual model of team processes and a methodology for using such a model in healthcare settings. This paper draws upon success in the supply chain management domain to develop a reference ontology of healthcare teams and a methodology for modeling teams to instantiate the ontology in specific settings. This research can help us understand how teams function and how we can design ICTs to support teams.
ERIC Educational Resources Information Center
Aquino, Karl; Serva, Mark A.
2005-01-01
This article describes a project that simulates the interplay between management and development project teams in a business environment. Each student team was assigned a management role supervising one project and a development role implementing another project. Results indicate that teams that communicate regularly and interact socially outside…
77 FR 51521 - North Pacific Fishery Management Council; Public Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-24
.../Aleutian Islands (BS/AI) groundfish plan teams will meet in Seattle, WA. DATES: The meetings will begin at... Marine Mammal Lab Room 2039 (GOA Plan Team) and Traynor Room 2076 (BS/AI Plan Team), Seattle, WA. Council... for 2013/14. The teams also will review status reports on various management actions, review the draft...
Buttigieg, Sandra C; Cassar, Vincent; Scully, Judy W
2013-01-01
The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. The authors draw on solid theoretical frameworks--the complexity theory, team effectiveness model and the social identity theory--to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level.
Team research at the biology-mathematics interface: project management perspectives.
Milton, John G; Radunskaya, Ami E; Lee, Arthur H; de Pillis, Lisette G; Bartlett, Diana F
2010-01-01
The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics background and an experimentally oriented biology student. The team mentors typically ranked the students' performance very good to excellent over a range of attributes that included creativity and ability to conduct independent research. However, the research teams experienced problems meeting prespecified deadlines due to poor time and project management skills. Because time and project management skills can be readily taught and moreover typically reflect good research practices, simple modifications should be made to undergraduate curricula so that the promise of initiatives, such as MATH-BIO 2010, can be implemented.
Bosch, Marije; Halfens, Ruud J G; van der Weijden, Trudy; Wensing, Michel; Akkermans, Reinier; Grol, Richard
2011-03-01
Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score ≤ 18) and preventive quality management at ward level. No associations were found between organizational culture, team climate, or preventive quality management at the ward level and the prevalence of nosocomial pressure ulcers. Institutional quality management was positively correlated with preventive quality management at ward level (adj. β 0.32; p < 0.001). Although the prevalence of nosocomial pressure ulcers varied considerably across wards, it did not relate to organizational culture, team climate, or preventive quality management at the ward level. These results would therefore not subscribe the widely suggested importance of these factors in improving health care. However, different designs and research methods (that go beyond the cross-sectional design) may be more informative in studying relations between such complex factors and outcomes in a more meaningful way. Copyright ©2010 Sigma Theta Tau International.
Li, Huayan; Fuller, Jeffrey; Sun, Mei; Wang, Yong; Xu, Shuang; Feng, Hui
2014-11-01
To evaluate the situation for chronic disease management in China, and to seek the method for improving the collaborative management for chronic diseases in community. We searched literature between January 2008 and November 2013 from the Database, such as China Academic Journal Full-Text Database, and PubMed. The screening was strictly in accordance with the inclusion and exclusion criteria and a summary was made among the selected literature based on a collaboration model. We got 698 articles after rough screen and finally selected 33. All studies were involved in patient's self-management support, but only 9 studies mentioned the communication within the team, and 11 showed a clear team division of labor. Chronic disease community management in China displays some disadvantages. It really needs a general service team with clear roles and responsibilities for team members to improve the service ability of team members and provide patients with various forms of self management services.
Team Resilience as a Second-Order Emergent State: A Theoretical Model and Research Directions
Bowers, Clint; Kreutzer, Christine; Cannon-Bowers, Janis; Lamb, Jerry
2017-01-01
Resilience has been recognized as an important phenomenon for understanding how individuals overcome difficult situations. However, it is not only individuals who face difficulties; it is not uncommon for teams to experience adversity. When they do, they must be able to overcome these challenges without performance decrements.This manuscript represents a theoretical model that might be helpful in conceptualizing this important construct. Specifically, it describes team resilience as a second-order emergent state. We also include research propositions that follow from the model. PMID:28861013
Nursing's new frontier: reinventing our practice in a restructured health care system.
Barter, M; Furmidge, M L
1995-12-01
Nurse managers who are faced with the challenge of maintaining productivity in today's turbulent health care environment need new strategies for managing a redesigned workforce. Registered nurses have assumed leadership responsibilities in work teams that include other nurses, licensed personnel from other disciplines, and unlicensed assistive personnel (UAP). Myths, rumors, and questions deserve thoughtful consideration and response if managers want full cooperation from team leaders. Legal and professional issues relating to assignment, delegation, and supervision of a multidisciplinary team must be understood by everyone. Team leaders must have clearly defined boundaries of authority and an understanding of the competencies of each team member to be effective.
The Gulf of Mexico Research Initiative: Building a Big Data System
NASA Astrophysics Data System (ADS)
Howard, M. K.; Gayanilo, F. C.; Gibeaut, J. C.
2012-12-01
On April 20, 2010 the Deepwater Horizon drilling unit located in the northeastern Gulf of Mexico experienced a catastrophic wellhead blowout. Billions of barrels of oil and roughly 1 million U.S. gallons of dispersant were released near the wellhead over the subsequent three months. On May 24, 2010 BP announced the Gulf of Mexico Research Initiative (GoMRI) and pledged 500M over 10 years toward independent scientific research on the spill's impact on the ecosystem. Data collection began immediately. By summer 2012 nearly 200M will have been committed to this research. Five hundred and seventy researchers from 114 institutions in 30 states and 4 countries are involved. Research activities include substantial numerical modeling, field and laboratory investigations of the environment and biota, and chemical studies of oil and dispersants. An additional $300M will be competed in subsequent years. The administrative and data management elements of the enterprise began to build in earnest in mid 2011. The last position in the GoMRI Information and Data Cooperative (GRIIDC) team was filled in July 2012. Due to the rapid evolution of the program in the first year, few data management requirements were imposed on the Year-One researchers. Proposal guidance for the Year 2-4 Research Consortia (RC) programs asked proposers to address data management questions but expressed few mandates. GRIIDC is charged with providing a portal to GoMRI data and metadata. Researchers are required to provide their data to GRIIDC and to national digital repositories with a minimum delay. Almost everything else was left to evolve through human networks. The GRIIDC team is composed of a System Architect, a Database Administrator, Software Engineers, a GIS specialist, a Technical Coordinator and several subject matter experts. The team faces the usual choices related to building a new cyberinfrastructure (e.g., metadata, ontologies, file formats, web services, etc.). However, the human element is the more important challenge and provides the solution. Human networking (word of mouth) during the time RC were preparing their proposals lead most RCs to designate and provision for a project-level data manager. A regular line of communication between the GRIIDC and the RC data managers was established early through face-to-face workshops and regular teleconferences. This greatly enhanced community acceptance of employing community standards and practices. GRIIDC underwent a multi-day "Planning, Scoping, Visioning and Team-building" activity designed to bring team members together and quickly establish roles and shared understanding of terminology. GRIIDC networks with previous programs such as the Marine Metadata Data Interoperability Program, NOAA and NSF data-centric groups, and established regional entities such as the Gulf of Mexico Coastal Ocean Observing System (GCOOS). Several GRIIDC staff also work for GCOOS or its observing system partners. Networking brings expertise to bear on difficult issues to reach solutions sooner than detailed independent study.
Goicolea, Isabel; Vives-Cases, Carmen; San Sebastian, Miguel; Marchal, Bruno; Kegels, Guy; Hurtig, Anna-Karin
2013-03-23
Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues-such as IPV management-get integrated into health systems, and that focuses on healthcare teams' learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.
13 CFR 108.110 - Qualified management.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Qualified management. 108.110... management. An Applicant must show, to the satisfaction of SBA, that its current or proposed management team... or proposed management team has sufficient qualifications, SBA will consider information provided by...
13 CFR 108.110 - Qualified management.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Qualified management. 108.110... management. An Applicant must show, to the satisfaction of SBA, that its current or proposed management team... or proposed management team has sufficient qualifications, SBA will consider information provided by...
13 CFR 108.110 - Qualified management.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Qualified management. 108.110... management. An Applicant must show, to the satisfaction of SBA, that its current or proposed management team... or proposed management team has sufficient qualifications, SBA will consider information provided by...
13 CFR 108.110 - Qualified management.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Qualified management. 108.110... management. An Applicant must show, to the satisfaction of SBA, that its current or proposed management team... or proposed management team has sufficient qualifications, SBA will consider information provided by...
13 CFR 108.110 - Qualified management.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Qualified management. 108.110... management. An Applicant must show, to the satisfaction of SBA, that its current or proposed management team... or proposed management team has sufficient qualifications, SBA will consider information provided by...
White, Matthew R; Braund, Heather; Howes, Daniel; Egan, Rylan; Gegenfurtner, Andreas; van Merrienboer, Jeroen J G; Szulewski, Adam
2018-04-23
Crisis resource management skills are integral to leading the resuscitation of a critically ill patient. Despite their importance, crisis resource management skills (and their associated cognitive processes) have traditionally been difficult to study in the real world. The objective of this study was to derive key cognitive processes underpinning expert performance in resuscitation medicine, using a new eye-tracking-based video capture method during clinical cases. During an 18-month period, a sample of 10 trauma resuscitations led by 4 expert trauma team leaders was analyzed. The physician team leaders were outfitted with mobile eye-tracking glasses for each case. After each resuscitation, participants were debriefed with a modified cognitive task analysis, based on a cued-recall protocol, augmented by viewing their own first-person perspective eye-tracking video from the clinical encounter. Eye-tracking technology was successfully applied as a tool to aid in the qualitative analysis of expert performance in a clinical setting. All participants stated that using these methods helped uncover previously unconscious aspects of their cognition. Overall, 5 major themes were derived from the interviews: logistic awareness, managing uncertainty, visual fixation behaviors, selective attendance to information, and anticipatory behaviors. The novel approach of cognitive task analysis augmented by eye tracking allowed the derivation of 5 unique cognitive processes underpinning expert performance in leading a resuscitation. An understanding of these cognitive processes has the potential to enhance educational methods and to create new assessment modalities of these previously tacit aspects of expertise in this field. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
75 FR 80470 - Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-22
... Pacific Fishery Management Council's (Council) Groundfish Management Team (GMT) will hold a working... session is to review team roles and responsibilities, conduct workload planning for 2011, review the...
searchSCF: Using MongoDB to Enable Richer Searches of Locally Hosted Science Data Repositories
NASA Astrophysics Data System (ADS)
Knosp, B.
2016-12-01
Science teams today are in the unusual position of almost having too much data available to them. Modern sensors and models are capable of outputting terabytes of data per day, which can make it difficult to find specific subsets of data. The sheer size of files can also make it time consuming to retrieve this big data from national data archive centers. Thus, many science teams choose to store what data they can on their local systems, but they are not always equipped with tools to help them intelligently organize and search their data. In its local data repository, the Aura Microwave Limb Sounder (MLS) science team at NASA's Jet Propulsion Laboratory has collected over 300TB of atmospheric science data from 71 missions/models that aid in validation, algorithm development, and research activities. When the project began, the team developed a MySQL database to aid in data queries, but this database was only designed to keep track of MLS and a few ancillary data sets, leving much of the data uncatalogued. The team has also seen database query time rise over the life of the mission. Even though the MLS science team's data holdings are not the size of a national data center's, team members still need tools to help them discover and utilize the data that they have on-hand. Over the past year, members of the science team have been looking for solutions to (1) store information on all the data sets they have collected in a single database, (2) store more metadata about each data file, (3) develop queries that can find relationships among these disparate data types, and (4) plug any new functions developed around this database into existing analysis, visualization, and web tools, transparently to users. In this presentation, I will discuss the searchSCF package that is currently under development. This package includes a NoSQL database management system (MongoDB) and a set of Python tools that both ingests data into the database and supports user queries. I will also highlight case studies of how this system could be used by the MLS science team, and how it could be implemented by other science teams with local data repositories.
The Role of the Facilitator on Total Quality Management Teams.
ERIC Educational Resources Information Center
Eakin, William L.
1993-01-01
As Total Quality Management teams work to improve organizational processes, several types of facilitators emerge: the director, the workhorse, and the cheerleader. Experience at the University of Kansas illustrates how different facilitator styles can affect team learning. (MSE)
An Algorithm for Neuropathic Pain Management in Older People.
Pickering, Gisèle; Marcoux, Margaux; Chapiro, Sylvie; David, Laurence; Rat, Patrice; Michel, Micheline; Bertrand, Isabelle; Voute, Marion; Wary, Bernard
2016-08-01
Neuropathic pain frequently affects older people, who generally also have several comorbidities. Elderly patients are often poly-medicated, which increases the risk of drug-drug interactions. These patients, especially those with cognitive problems, may also have restricted communication skills, making pain evaluation difficult and pain treatment challenging. Clinicians and other healthcare providers need a decisional algorithm to optimize the recognition and management of neuropathic pain. We present a decisional algorithm developed by a multidisciplinary group of experts, which focuses on pain assessment and therapeutic options for the management of neuropathic pain, particularly in the elderly. The algorithm involves four main steps: (1) detection, (2) evaluation, (3) treatment, and (4) re-evaluation. The detection of neuropathic pain is an essential step in ensuring successful management. The extent of the impact of the neuropathic pain is then assessed, generally with self-report scales, except in patients with communication difficulties who can be assessed using behavioral scales. The management of neuropathic pain frequently requires combination treatments, and recommended treatments should be prescribed with caution in these elderly patients, taking into consideration their comorbidities and potential drug-drug interactions and adverse events. This algorithm can be used in the management of neuropathic pain in the elderly to ensure timely and adequate treatment by a multidisciplinary team.
Aziz, Kamran M A
2012-05-01
Better control of the diabetic metabolic state will prevent the diabetes complications. However in current clinical practice, it is sometimes difficult to achieve this goal. Additionally, physicians find themselves in an equivocal position to initiate insulin therapy, its selection, combining with Oral agents and further management. The current article was written to focus on diabetes pathogenesis at molecular level, its classification and management by insulin injections. Knowledge of basic biochemistry, pharmacology with kinetics of Insulin is essential for diabetes management. Nonetheless, it should be a priority to search for evidence based clinical methodologies for selecting the patients for initiating, modifying or combining the insulin therapy. Type-1 diabetic patients are best controlled on basal bolus insulin regimens. However in type-2 diabetes, metformin with lifestyle modifications should be the first line therapy, thereafter combined with oral hypoglycemic agents or shifting to insulin gradually if diabetes remains uncontrolled. Metformin is recommended to be prescribed with insulin as compared to oral hypoglycemic agents which should be discontinued while starting insulin. Monitoring the insulin therapy on regular visits to diabetologist and diabetes multidisciplinary team remains the integral part of diabetes management. The review also outlines relevant and recent insulin analogue patents for the management of Diabetes.
Developing Expert Teams with a Strong Safety Culture
NASA Technical Reports Server (NTRS)
Rogers, David G.
2010-01-01
Would you like to lead a world renowned team that draws out all the talents and expertise of its members and consistently out performs all others in the industry? Ever wonder why so many organizations fail to truly learn from past mistakes only to repeat the same ones at a later date? Are you a program/project manager or team member in a high-risk organization where the decisions made often carry the highest of consequences? Leadership, communication, team building, critical decision-making and continuous team improvement skills and behaviors are mere talking points without the attitudes, commitment and strategies necessary to make them the very fabric of a team. Developing Expert Teams with a Strong Safety Culture, will provide you with proven knowledge and strategies to take your team soaring to heights you may have not thought possible. A myriad of teams have applied these strategies and techniques within their organization team environments: military and commercial aviation, astronaut flight crews, Shuttle flight controllers, members of the Space Shuttle Program Mission Management Team, air traffic controllers, nuclear power control teams, surgical teams, and the fire service report having spectacular success. Many industry leaders are beginning to realize that although the circumstances and environments of these teams may differ greatly to their own, the core elements, governing principles and dynamics involved in managing and building a stellar safety conscious team remain identical.
The (mis)use of subjective process measures in software engineering
NASA Technical Reports Server (NTRS)
Valett, Jon D.; Condon, Steven E.
1993-01-01
A variety of measures are used in software engineering research to develop an understanding of the software process and product. These measures fall into three broad categories: quantitative, characteristics, and subjective. Quantitative measures are those to which a numerical value can be assigned, for example effort or lines of code (LOC). Characteristics describe the software process or product; they might include programming language or the type of application. While such factors do not provide a quantitative measurement of a process or product, they do help characterize them. Subjective measures (as defined in this study) are those that are based on the opinion or opinions of individuals; they are somewhat unique and difficult to quantify. Capturing of subjective measure data typically involves development of some type of scale. For example, 'team experience' is one of the subjective measures that were collected and studied by the Software Engineering Laboratory (SEL). Certainly, team experience could have an impact on the software process or product; actually measuring a team's experience, however, is not a strictly mathematical exercise. Simply adding up each team member's years of experience appears inadequate. In fact, most researchers would agree that 'years' do not directly translate into 'experience.' Team experience must be defined subjectively and then a scale must be developed e.g., high experience versus low experience; or high, medium, low experience; or a different or more granular scale. Using this type of scale, a particular team's overall experience can be compared with that of other teams in the development environment. Defining, collecting, and scaling subjective measures is difficult. First, precise definitions of the measures must be established. Next, choices must be made about whose opinions will be solicited to constitute the data. Finally, care must be given to defining the right scale and level of granularity for measurement.
Medical student resilience and stressful clinical events during clinical training.
Houpy, Jennifer C; Lee, Wei Wei; Woodruff, James N; Pincavage, Amber T
2017-01-01
Medical students face numerous stressors during their clinical years, including difficult clinical events. Fostering resilience is a promising way to mitigate negative effects of stressors, prevent burnout, and help students thrive after difficult experiences. However, little is known about medical student resilience. To characterize medical student resilience and responses to difficult clinical events during clinical training. Sixty-two third-year (MS3) and 55 fourth-year (MS4) University of Chicago medical students completed surveys in 2016 assessing resilience (Connor Davidson Resilience Scale, CD-RISC 10), symptoms of burnout, need for resilience training, and responses to difficult clinical events. Medical student mean resilience was lower than in a general population sample. Resilience was higher in males, MS4s, those without burnout symptoms, and students who felt able to cope with difficult clinical events. When students experienced difficult events in the clinical setting, the majority identified poor team dynamics among the most stressful, and agreed their wellbeing was affected by difficult clinical events. A majority also would prefer to discuss these events with their team later that day. Students discussed events with peers more than with attendings or residents. Students comfortable discussing stress and burnout with peers had higher resilience. Most students believed resilience training would be helpful and most beneficial during MS3 year. Clinical medical student resilience was lower than in the general population but higher in MS4s and students reporting no burnout. Students had some insight into their resilience and most thought resilience training would be helpful. Students discussed difficult clinical events most often with peers. More curricula promoting medical student resilience are needed.
Designing Student Groupwork in Management Education: Widening the Palette of Options
ERIC Educational Resources Information Center
Holtham, Clive W.; Melville, Robert R.; Sodhi, ManMohan S.
2006-01-01
The authors describe innovation in practice through the unusual deployment of teams in a master's in management core course. Two parallel uses of teams were made, both drawing on the jigsaw team method, in one case with the team supporting individual work. The experiences support the idea of widening the palette of types of groupwork used in…
Still a difficult business? Negotiating alcohol-related problems in general practice consultations.
Rapley, Tim; May, Carl; Frances Kaner, Eileen
2006-11-01
This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.
Team Risk Management: A New Model for Customer-Supplier Relationships
1994-07-01
Management : A New Model for Customer - Supplier Relationships Ronald P. Higuera "Audrey J. Dorofee Julie A. Walker Ray C. Williams July 1994 ""•// 94...N/A N/A N/A 11. TITLE (Include Secuity Claaaificatioa) Team Risk Management : A New Model for Customer -Supplier Relationships 12. PERSONAL AUTHOR(S...by block number) FIELD GROUP SUB. GR. Customer - Supplier Relationships Risk Team Risk Management 19. ABSTRACT (cominus on = if necesaryd id’y by block
Cost implications of organizing nursing home workforce in teams.
Mukamel, Dana B; Cai, Shubing; Temkin-Greener, Helena
2009-08-01
To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs.
A case for safety leadership team training of hospital managers.
Singer, Sara J; Hayes, Jennifer; Cooper, Jeffrey B; Vogt, Jay W; Sales, Michael; Aristidou, Angela; Gray, Garry C; Kiang, Mathew V; Meyer, Gregg S
2011-01-01
Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety. The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training. Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity. Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas. Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.
Delivering team training to medical home staff to impact perceptions of collaboration.
Treadwell, Janet; Binder, Brenda; Symes, Lene; Krepper, Rebecca
2015-01-01
The purpose of this study was to explore whether an evidence-based educational and experiential intervention to develop team skills in medical homes would positively affect team members' perceptions of interprofessional collaboration. The study population consisted of primary care medical home practices associated with the health plan sponsor of this research. All practices were located within the greater Houston region of Texas and had more than 500 patients. A cluster design experimental study was conducted between August 2013 and June 2014. Fifty medical home practices, 25 intervention and 25 attention control, were recruited as study sites. Results indicate that individual team members in the medical homes receiving the intervention were significantly more likely than the individual team members in the attention control groups to report higher levels of positive perception of team collaboration after the 12-week intervention. This research indicates that educating teams about interprofessional collaboration tools and supporting technique use may be an effective strategy to assist medical homes in developing collaborative environments. Case management experience in collaboration supports the role facilitating team training. Transforming culture from hierarchical to team-based care supports the case management approach of collaborative practice. In addition, role satisfaction attained through the respect and communication of team-based care delivery may influence retention within the case management profession. As case managers in primary care settings assume roles of embedded care coordinators, program leaders, and transition facilitators, an understanding of collaboration techniques is needed to support the entire care team to achieve desired outcomes.
Management team learning orientation and business unit performance.
Bunderson, J Stuart; Sutcliffe, Kathleen M
2003-06-01
Although research has suggested that teams can differ in the extent to which they encourage proactive learning and competence development among their members (a team learning orientation), the performance consequences of these differences are not well understood. Drawing from research on goal orientation and team learning, this article suggests that, although a team learning orientation can encourage adaptive behaviors that lead to improved performance, it is also possible for teams to compromise performance in the near term by overemphasizing learning, particularly when they have been performing well. A test of this proposition in a sample of business unit management teams provides strong support. The results confirm that an appropriate emphasis on learning can have positive consequences for team effectiveness.
2003-02-05
KENNEDY SPACE CENTER, FLA. - Don Maxwell, Safety, United Space Alliance, checks a map of Texas during a meeting of the Recovery Management Team at KSC. The team is part of the investigation into the accident that claimed orbiter Columbia and her crew of seven on Feb. 1, 2003, over East Texas as they returned to Earth after a 16-day research mission. Other team members are Russ DeLoach, chief, Shuttle Mission Assurance Branch, NASA; George Jacobs, Shuttle Engineering; Jeff Campbell, Shuttle Engineering; Dave Rainer, Launch and Landing Operations; the two co-chairs of the Response Management Team, Denny Gagen, Landing Recovery Manager, Chris Hasselbring, Landing Operations, USA; and Larry Ulmer, Safety, NASA. The team is coordinating KSC technical support and assets to the Mishap Investigation Team in Barksdale, La., and providing support for the Recovery teams in Los Angeles, Texas, New Mexico, Arizona and California. In addition, the team is following up on local leads pertaining to potential debris in the KSC area. .
Risk Identification and Visualization in a Concurrent Engineering Team Environment
NASA Technical Reports Server (NTRS)
Hihn, Jairus; Chattopadhyay, Debarati; Shishko, Robert
2010-01-01
Incorporating risk assessment into the dynamic environment of a concurrent engineering team requires rapid response and adaptation. Generating consistent risk lists with inputs from all the relevant subsystems and presenting the results clearly to the stakeholders in a concurrent engineering environment is difficult because of the speed with which decisions are made. In this paper we describe the various approaches and techniques that have been explored for the point designs of JPL's Team X and the Trade Space Studies of the Rapid Mission Architecture Team. The paper will also focus on the issues of the misuse of categorical and ordinal data that keep arising within current engineering risk approaches and also in the applied risk literature.
Neuroergonomics: Quantitative Modeling of Individual, Shared, and Team Neurodynamic Information.
Stevens, Ronald H; Galloway, Trysha L; Willemsen-Dunlap, Ann
2018-06-01
The aim of this study was to use the same quantitative measure and scale to directly compare the neurodynamic information/organizations of individual team members with those of the team. Team processes are difficult to separate from those of individual team members due to the lack of quantitative measures that can be applied to both process sets. Second-by-second symbolic representations were created of each team member's electroencephalographic power, and quantitative estimates of their neurodynamic organizations were calculated from the Shannon entropy of the symbolic data streams. The information in the neurodynamic data streams of health care ( n = 24), submarine navigation ( n = 12), and high school problem-solving ( n = 13) dyads was separated into the information of each team member, the information shared by team members, and the overall team information. Most of the team information was the sum of each individual's neurodynamic information. The remaining team information was shared among the team members. This shared information averaged ~15% of the individual information, with momentary levels of 1% to 80%. Continuous quantitative estimates can be made from the shared, individual, and team neurodynamic information about the contributions of different team members to the overall neurodynamic organization of a team and the neurodynamic interdependencies among the team members. Information models provide a generalizable quantitative method for separating a team's neurodynamic organization into that of individual team members and that shared among team members.
Virtual Team Governance: Addressing the Governance Mechanisms and Virtual Team Performance
NASA Astrophysics Data System (ADS)
Zhan, Yihong; Bai, Yu; Liu, Ziheng
As technology has improved and collaborative software has been developed, virtual teams with geographically dispersed members spread across diverse physical locations have become increasingly prominent. Virtual team is supported by advancing communication technologies, which makes virtual teams able to largely transcend time and space. Virtual teams have changed the corporate landscape, which are more complex and dynamic than traditional teams since the members of virtual teams are spread on diverse geographical locations and their roles in the virtual team are different. Therefore, how to realize good governance of virtual team and arrive at good virtual team performance is becoming critical and challenging. Good virtual team governance is essential for a high-performance virtual team. This paper explores the performance and the governance mechanism of virtual team. It establishes a model to explain the relationship between the performance and the governance mechanisms in virtual teams. This paper is focusing on managing virtual teams. It aims to find the strategies to help business organizations to improve the performance of their virtual teams and arrive at the objectives of good virtual team management.
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)
Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa
2016-10-01
Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group. Qualitative analysis highlighted the perceived benefits of LTC staff about having access to a nurse practitioner and benefits of the pain team, along with barriers to managing pain in LTC. The findings from this study showed that implementing a nurse practitioner-led pain team can significantly improve resident pain and functional status as well as clinical practice behaviours of LTC staff. LTC homes should employ a nurse practitioner, ideally located onsite as opposed to an offsite consultative role, to enhance inter-professional collaboration and facilitate more consistent and timely access to pain management. Copyright © 2016 Elsevier Ltd. All rights reserved.
The mapping competences of the nurse Case/Care Manager in the context of Intensive Care.
Alfieri, Emanuela; Ferrini, Anna Chiara; Gianfrancesco, Francesca; Lise, Gianluca; Messana, Giovanni; Tirelli, Lorenzo; Lorenzo, Ana; Sarli, Leopoldo
2017-03-15
Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager. In particular, it has been compared the experience of an Intensive Care Units where the Case/Care Manager's profile is operational to a different Unit where a Case/Care Manager is not yet in force. a Levati's model was used to map the Case/Care Manager's skills, involving each unit whole working staff, executives and caregivers through semi-structured interviews. It has been taken into consideration the Anaesthesia Unit and Emergency Unit of Cesena's healthcare organisation (AUSL of Romagna) and a Cardiology Intensive Care Unit of Piacenza's healthcare organisation, where the Case/Care Manager's profile has not been experimented yet. Firstly, it a data collection in each healthcare organization has been organised. Subsequently, semi-structured interviews to doctors, unit nurses, caregivers, nurses' coordinators and medical staff have been used to compare each healthcare system. The interviewees' described their expectations in relation to the Case/Care Manager working in a critical area. Then, every data collected during interviews has been organised to map a Case/Care Manager's essential professional profile to work in a critical area together with medical staff. Piacenza's O.U. critical area experience reported a major demand for patients' and patient's families' assistance. On the other hand, the very same aspects seem to have been better achieved in Cesena's O.U., where a Case/Care Manager's recent introduction has actually helped to overcome the void in organising systems. a Case/Care Manager's profile has been drafted on the basis of the comparative analysis conducted. It has been noted how the Case/Care Manager's professional profile can really improve relationships and communications between medical staff and patients, promoting a major unity among the working team. According to the present research, the Case/Care Manager's profile has been proved helpful in positively influencing the team activity and to elicit major satisfaction both in patients and their family.
Moosa, Shabir; Derese, Anselme; Peersman, Wim
2017-01-21
Primary health care (PHC) outreach teams are part of a policy of PHC re-engineering in South Africa. It attempts to move the deployment of community health workers (CHWs) from vertical programmes into an integrated generalised team-based approach to care for defined populations in municipal wards. There has little evaluation of PHC outreach teams. Managers' insights are anecdotal. This is descriptive qualitative study with focus group discussions with health district managers of Johannesburg, the largest city in South Africa. This was conducted in a sequence of three meetings with questions around implementation, human resources, and integrated PHC teamwork. There was a thematic content analysis of validated transcripts using the framework method. There were two major themes: leadership-management challenges and human resource challenges. Whilst there was some positive sentiment, leadership-management challenges loomed large: poor leadership and planning with an under-resourced centralised approach, poor communications both within the service and with community, concerns with its impact on current services and resistance to change, and poor integration, both with other streams of PHC re-engineering and current district programmes. Discussion by managers on human resources was mostly on the plight of CHWs and calls for formalisation of CHWs functioning and training and nurse challenges with inappropriate planning and deployment of the team structure, with brief mention of the extended team. Whilst there is positive sentiment towards intent of the PHC outreach team, programme managers in Johannesburg were critical of management of the programme in their health district. Whilst the objective of PHC reform is people-centred health care, its implementation struggles with a centralising tendency amongst managers in the health service in South Africa. Managers in Johannesburg advocated for decentralisation. The implementation of PHC outreach teams is also limited by difficulties with formalisation and training of CHWs and appropriate task shifting to nurses. Change management is required to create true integrate PHC teamwork. Policy review requires addressing these issues.
Dufour, Sinéad Patricia; Brown, Judith; Deborah Lucy, S
2014-09-01
The international literature suggests a number of benefits related to integrating physiotherapists into primary health care (PHC) teams. Considering the mandate of PHC teams in Canada, emphasizing healthy living and chronic disease management, a broad range of providers, inclusive of physiotherapists is required. However, physiotherapists are only sparsely integrated into these teams. This study explores the perspectives of "core" PHC team members, family physicians and nurse practitioners, regarding the integration of physiotherapists within Ontario (Canada) PHC teams. Twenty individual semi-structured in-depth interviews were conducted, transcribed verbatim, and then analyzed following an iterative process drawing from an interpretive phenomenological approach. Five key themes emerged which highlighted "how physiotherapists could and do contribute as team members within PHC teams particularly related to musculoskeletal health and chronic disease management". The perceived value of physiotherapists within Ontario, Canada PHC teams was a unanimous sentiment particularly in terms of musculoskeletal health, chronic disease management and maximizing health human resources efficiency to ensure the right care, is delivered by the right practitioner, at the right time.
ERIC Educational Resources Information Center
Cabrera, Susan F.; Sauer, Stephen J.; Thomas-Hunt, Melissa C.
2009-01-01
This study examined how external evaluators' assessments of a management team and its leader are impacted by congruence between the leader's gender and the gender typing of the industry in which the team works. We experimentally tested our theory using industries that are either male typed or gender neutral, with teams led by male and female…
Optimism Bias in Fans and Sports Reporters
Love, Bradley C.
2015-01-01
People are optimistic about their prospects relative to others. However, existing studies can be difficult to interpret because outcomes are not zero-sum. For example, one person avoiding cancer does not necessitate that another person develops cancer. Ideally, optimism bias would be evaluated within a closed formal system to establish with certainty the extent of the bias and the associated environmental factors, such that optimism bias is demonstrated when a population is internally inconsistent. Accordingly, we asked NFL fans to predict how many games teams they liked and disliked would win in the 2015 season. Fans, like ESPN reporters assigned to cover a team, were overly optimistic about their team’s prospects. The opposite pattern was found for teams that fans disliked. Optimism may flourish because year-to-year team results are marked by auto-correlation and regression to the group mean (i.e., good teams stay good, but bad teams improve). PMID:26352146
Implementation of critical care response team.
Al Shimemeri, Abdullah
2014-04-01
Analyses of hospital deaths have indicated that a significant proportion of the reported deaths might have been prevented had the patients received intensive level care early enough. Over the past few decades the critical care response team has become an important means of preventing these deaths. As the proactive arm of intensive care delivery, the critical care response team places emphasis on early identification of signs of clinical deterioration, which then prompts the mobilization of intensive care brought right to the patient's bedside. However, the setting up of a critical care response team is a difficult undertaking involving different levels of cooperation between all service stakeholders, and a bringing together of professional expertise and experience in its operations. The implementation of a critical care response team often involves a high-level restructuring of a hospital's service orientation. In the present work, the various factors and different models to be considered in implementing a critical care response team are addressed.
Polanco, Frinny R.; Dominguez, Dinora C.; Grady, Christine; Stoll, Pamela; Ramos, Catalina; Mican, JoAnn M.; Miranda-Acevedo, Robert; Morgan, Marcela; Aizvera, Jeasmine; Purdie, Lori; Koziol, Deloris; Rivera-Goba, Migdalia V.
2011-01-01
HIV infection occurs in disproportionately high rates among racial and ethnic minorities in the United States, making it imperative that individuals from these groups be included in research studies. Unfortunately, it is often difficult to recruit HIV-infected Hispanics and African Americans into clinical trials, but a skilled interdisciplinary team that includes researchers with racial and ethnic diversity can help. This article describes a successful approach for building an interdisciplinary team that values the participation of racial and ethnic minorities in clinical trials and that has the skills to work with these groups. The success of the Adelante (a Spanish word meaning forward) Team can be attributed to team members who actively participate in decision-making, are empowered, and function in a cohesive manner. Successful research teams build relationships with research participants in order to increase the probability that racial and ethnic minorities will enroll and participate fully in research. PMID:21277228
Polanco, Frinny R; Dominguez, Dinora C; Grady, Christine; Stoll, Pamela; Ramos, Catalina; Mican, Joann M; Miranda-Acevedo, Robert; Morgan, Marcela; Aizvera, Jeasmine; Purdie, Lori; Koziol, Deloris; Rivera-Goba, Migdalia V
2011-01-01
HIV infection occurs in disproportionately high rates among racial and ethnic minorities in the United States, making it imperative that individuals from these groups be included in research studies. However, it is often difficult to recruit HIV-infected Hispanics and African Americans in clinical trials, but a skilled interdisciplinary team that includes researchers with racial and ethnic diversity can help. This article describes a successful approach for building an interdisciplinary team that values the participation of racial and ethnic minorities in clinical trials and has the skills to work with these groups. The success of the Adelante (a Spanish word meaning forward) Team can be attributed to team members who actively participate in decision-making, are empowered, and function in a cohesive manner. Successful research teams build relationships with research participants to increase the probability that racial and ethnic minorities will enroll and participate fully in research. Published by Elsevier Inc.
Snyderman, Carl H; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A
2017-04-01
The management of sinonasal and ventral skull base malignancies is best performed by a team. Although the composition of the team may vary, it is important to have multidisciplinary representation. There are multiple obstacles, both individual and institutional, that must be overcome to develop a highly functioning team. Adequate training is an important part of team-building and can be fostered with surgical telementoring. A quality improvement program should be incorporated into the activities of a skull base team. Copyright © 2016 Elsevier Inc. All rights reserved.
How management teams can have a good fight.
Eisenhardt, K M; Kahwajy, J L; Bourgeois, L J
1997-01-01
Top-level managers know that conflict over issues is natural and even necessary. Management teams that challenge one another's thinking develop a more complete understanding of their choices, create a richer range of options, and make better decisions. But the challenge--familiar to anyone who has ever been part of a management team--is to keep constructive conflict over issues from degenerating into interpersonal conflict. From their research on the interplay of conflict, politics, and speed in the decision--making process of management teams, the authors have distilled a set of six tactics characteristic of high-performing teams: They work with more, rather than less, information. They develop multiple alternatives to enrich debate. The establish common goals. They make an effort to inject humor into the workplace. They maintain a balanced corporate power structure. They resolve issues without forcing a consensus. These tactics work because they keep conflict focused on issues; foster collaborative, rather than competitive, relations among team members; and create a sense of fairness in the decision-making process. Without conflict, groups lose their effectiveness. Managers often become withdrawn and only superficially harmonious. The alternative to conflict is not usually agreement but rather apathy and disengagement, which open the doors to a primary cause of major corporate debacles: groupthink.
Seifert, Ana María
2007-01-01
The educational sector exposes its primarily female work force to numerous psychosocial risk factors. At the request of the education workers', ergonomists developed a participatory research project in order to understand the determinants of the difficulties experienced by special education technicians. These technicians work with students presenting behavioral and learning difficulties as well as developmental and mental health problems. Eighteen technicians were interviewed and the work of seven technicians and two teachers was observed. Technicians prevent and manage crisis situations and help students acquire social skills. Coordination with teachers is made difficult by the fact that most technicians work part time, part year, and many technicians' work areas and classrooms are physically distant one from another. Most technicians change schools each year and must continually reconstruct work teams. Management strategies and poorly adapted working spaces can have important repercussions on coordination among educators and on technicians' capacity to help students and prevent aggressive behavior.
Comparative analysis of data base management systems
NASA Technical Reports Server (NTRS)
Smith, R.
1983-01-01
A study to determine if the Remote File Inquiry (RFI) system would handle the future requirements of the user community is discussed. RFI is a locally written and locally maintained on-line query/update package. The current and future on-line requirements of the user community were studied. Additional consideration was given to the types of data structuring the users required. The survey indicated the features of greatest benefit were: sort, subtotals, totals, record selection, storage of queries, global updating and the ability to page break. The major deficiencies were: one level of hierarchy, excessive response time, software unreliability, difficult to add, delete and modify records, complicated error messages and the lack of ability to perform interfield comparisons. Missing features users required were: formatted screens, interfield comparions, interfield arithmetic, multiple file access, security and data integrity. The survey team recommended Kennedy Space Center move forward to state-of-the-art software, a Data Base Management System which is thoroughly tested and easy to implement and use.
Goal-directed-perfusion in neonatal aortic arch surgery.
Cesnjevar, Robert Anton; Purbojo, Ariawan; Muench, Frank; Juengert, Joerg; Rueffer, André
2016-07-01
Reduction of mortality and morbidity in congenital cardiac surgery has always been and remains a major target for the complete team involved. As operative techniques are more and more standardized and refined, surgical risk and associated complication rates have constantly been reduced to an acceptable level but are both still present. Aortic arch surgery in neonates seems to be of particular interest, because perfusion techniques differ widely among institutions and an ideal form of a so called "total body perfusion (TBP)" is somewhat difficult to achieve. Thus concepts of deep hypothermic circulatory arrest (DHCA), regional cerebral perfusion (RCP/with cardioplegic cardiac arrest or on the perfused beating heart) and TBP exist in parallel and all carry an individual risk for organ damage related to perfusion management, chosen core temperature and time on bypass. Patient safety relies more and more on adequate end organ perfusion on cardiopulmonary bypass, especially sensitive organs like the brain, heart, kidney, liver and the gut, whereby on adequate tissue protection, temperature management and oxygen delivery should be visualized and monitored.
Managing Conversations: The Medium for Achieving "Breakthrough" Results.
ERIC Educational Resources Information Center
Bolton, Robert
1998-01-01
Unlike traditional management development, use of conversations in coaching high-performance work teams addresses core processes of speaking and listening. Management of conversations aims to create learning that will lead to breakthroughs in team performance. (SK)
Challenges and leadership strategies for managers of nurse practitioners.
Reay, Trish; Golden-Biddle, Karen; Germann, Kathy
2003-11-01
The aim of this paper is to report on the findings from our research into the recent introduction of nurse practitioners in Alberta, Canada. Through an organizational research perspective, we identify the critical role of health care managers in developing a sustainable nurse practitioner role. Previous literature has focused on nurse practitioners themselves as the key factor in their integration into the health care system. Although they are qualified and organizationally well placed, managers of nurse practitioners have been overlooked as a critical part of implementation strategies. We interviewed 25 nurse practitioners and seven of their managers. Through our data analysis we identified three major challenges for managers: (1) clarifying the reallocation of tasks; (2) managing altered working relationships within the team; (3) continuing to manage the team in an evolving situation. Associated with these challenges, we propose leadership strategies that managers may find useful as they work through the consequences of introducing the nurse practitioner role. These strategies are: * encourage all team members to sort out 'who does what'; * ensure that task reallocation preserves job motivating properties; * give consideration to how tasks have been allocated when issues identified as 'personal conflict' arise; * pay attention to all perspectives of the working relationships within the team; * facilitate positive relationships between team members; * lead from a 'balcony' perspective; * work with the team to develop goals that are not over focused on the nurse practitioner; * regularly share with other managers the experiences and lessons learned in introducing nurse practitioners. For managers to be most effective, they need to address three challenges that are of a managerial, not clinical, nature. By implementing specific leadership strategies, managers of nurse practitioners can facilitate the introduction of the new role and improve its sustainability in health organizations.
Role Allocation and Team Structure in Command and Control Teams
2014-06-01
organizational psychology and management sciences literature show concepts such as empowered self-management and self-regulating work teams (see Cooney, 2004...tankers (FT), search units (S) and rescue units (R). Each unit is represented on the map by a numbered icon. Each type of unit is colour -coded and...Understanding team adaptation: A conceptual analysis and model. Journal of Applied Psychology , 91, 1189-1207. Cannon-Bowers, J. A., Tannenbaum
Team Development for High Performance Management.
ERIC Educational Resources Information Center
Schermerhorn, John R., Jr.
1986-01-01
The author examines a team development approach to management that creates shared commitments to performance improvement by focusing the attention of managers on individual workers and their task accomplishments. It uses the "high-performance equation" to help managers confront shared beliefs and concerns about performance and develop realistic…
Feldman, Kira; Berall, Anna; Karuza, Jurgis; Senderovich, Helen; Perri, Giulia-Anna; Grossman, Daphna
2016-11-01
Management of pain in the frail elderly presents many challenges in both assessment and treatment, due to the presence of multiple co-morbidities, polypharmacy, and cognitive impairment. At Baycrest Health Sciences, a geriatric care centre, pain in its acute care unit had been managed through consultations with the pain team on a case-by-case basis. In an intervention informed by knowledge translation (KT), the pain specialists integrated within the social network of the acute care team for 6 months to disseminate their expertise. A survey was administered to staff on the unit before and after the intervention of the pain team to understand staff perceptions of pain management. Pre- and post-comparisons of the survey responses were analysed by using t-tests. This study provided some evidence for the success of this interprofessional education initiative through changes in staff confidence with respect to pain management. It also showed that embedding the pain team into the acute care team supported the KT process as an effective method of interprofessional team building. Incorporating the pain team into the acute care unit to provide training and ongoing decision support was a feasible strategy for KT and could be replicated in other clinical settings.
Cost Implications of Organizing Nursing Home Workforce in Teams
Mukamel, Dana B; Cai, Shubing; Temkin-Greener, Helena
2009-01-01
Objective To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. Data Sources/Study Setting Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. Study Design A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. Data Collection Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. Principal Findings Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. Conclusions Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs. PMID:19486181
Exploring Academics' Approaches to Managing Team Assessment
ERIC Educational Resources Information Center
Augar, Naomi; Woodley, Carolyn J.; Whitefield, Despina; Winchester, Maxwell
2016-01-01
Purpose: The purpose of this paper is to develop an understanding of academics' approaches to managing team assessment at an Australian University with a view to informing policy development and assessment design. Design/methodology/approach: The research was conducted using a single exploratory case study approach focussing on the team assessment…
Team-Building Success: It's in the Cards
ERIC Educational Resources Information Center
Scarfino, Deborah; Roever, Carol
2009-01-01
Successful team outcomes frequently--if not always--rely upon proven techniques for managing diverse styles and strengths. In this article, the authors describe the Diversity Card Game and the benefits it offers for students and instructors. Building teams using Diversity gives students the knowledge to manage clashes that might otherwise create…
Functional Heterogeneity and Senior Management Team Effectiveness
ERIC Educational Resources Information Center
Benoliel, Pascale; Somech, Anit
2016-01-01
Purpose: There has been an increasing trend toward the creation of senior management teams (SMTs) which are characterized by a high degree of functional heterogeneity. Although such teams may create better linkages to information, along with the benefits of functional heterogeneity comes the potential for conflicts that stem from the value…
77 FR 22286 - Western Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-13
... Team (PPT) in Honolulu, HI to discuss fishery issues and develop recommendations for future management... and Central Pacific Fishery Commission 8. Other business 9. Public comment 10. Pelagic Plan Team... meetings. Plan Team action will be restricted to those issues specifically listed in this document and any...
75 FR 17902 - Western Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-08
... Team (PPT) in Honolulu, HI to discuss fishery issues and develop recommendations for future management... a tuna longline fishery 6. False Killer Whale Take Reduction Team 7. Annual Catch Limit Ecosystem.... Public comments 11. Pelagic Plan Team Recommendations The order in which the agenda items are addressed...
From Zero to Integration in Eight Months, the Dawn Ground Data System Engineering Challenge
NASA Technical Reports Server (NTRS)
Dubon, Lydia P.
2006-01-01
The Dawn GDS Team met the SC Sim integration challenge in eight months. The GDS System Engineering approach in response to the SC Simintegration challenge, focused on a set of key practices: decomposition of project request into manageable requirements; integration of multiple ground disciplines and experts into a focused team effort; risk management thru management of expectations; and aggregation of intermediate products into a final product. By maintaining a a system-level focus, the overall systems engineering process unified team GDS Team members with a common goal: the success of the ground system as a whole and not just the success of their individual expert contributions. Incorporation of Agile-type development efforts were aligned with a risk strategy based on team-oriented principles and expectations management, thus achieving a more stable baseline solution without compromising the integrity of the GDS design.
Conflict management: importance and implications.
McKibben, Laurie
2017-01-26
Conflict is a consistent and unavoidable issue within healthcare teams. Despite training of nurse leaders and managers around areas of conflict resolution, the problem of staff relations, stress, sickness and retention remain. Conflict arises from issues with interpersonal relationships, change and poor leadership. New members of staff entering an already established healthcare team should be supported and integrated, to encourage mutual role respect between all team members and establish positive working relationships, in order to maximise patient care. This paper explores the concept of conflict, the importance of addressing causes of conflict, effective management, and the relevance of positive approaches to conflict resolution. Good leadership, nurturing positive team dynamics and communication, encourages shared problem solving and acceptance of change. Furthermore mutual respect fosters a more positive working environment for those in healthcare teams. As conflict has direct implications for patients, positive resolution is essential, to promote safe and effective delivery of care, whilst encouraging therapeutic relationships between colleagues and managers.
EPA’s Role in Emergency Response - Special Teams
The Environmental Response Team; Radiological Response Team; Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division; and National Criminal Enforcement Response Team provide specialized support.
Penny, Daniel J
2017-12-01
The importance of teamwork is being increasingly recognised in healthcare. Nonetheless, it is equally recognised that teamwork is difficult. In this article, I explore whether we can learn lessons from musicians, orchestras, and conductors as we build our teams. The evolution of the role of the conductor provides useful lessons on leadership and the evolving role of the members of the orchestra on how team members can contribute to a shared outcome. The uncertainty of jazz provides useful lessons for innovation in an increasingly turbulent healthcare environment.
Team knowledge representation: a network perspective.
Espinosa, J Alberto; Clark, Mark A
2014-03-01
We propose a network perspective of team knowledge that offers both conceptual and methodological advantages, expanding explanatory value through representation and measurement of component structure and content. Team knowledge has typically been conceptualized and measured with relatively simple aggregates, without fully accounting for differing knowledge configurations among team members. Teams with similar aggregate values of team knowledge may have very different team dynamics depending on how knowledge isolates, cliques, and densities are distributed across the team; which members are the most knowledgeable; who shares knowledge with whom; and how knowledge clusters are distributed. We illustrate our proposed network approach through a sample of 57 teams, including how to compute, analyze, and visually represent team knowledge. Team knowledge network structures (isolation, centrality) are associated with outcomes of, respectively, task coordination, strategy coordination, and the proportion of team knowledge cliques, all after controlling for shared team knowledge. Network analysis helps to represent, measure, and understand the relationship of team knowledge to outcomes of interest to team researchers, members, and managers. Our approach complements existing team knowledge measures. Researchers and managers can apply network concepts and measures to help understand where team knowledge is held within a team and how this relational structure may influence team coordination, cohesion, and performance.
Wright, J; Elwell, L; McDonagh, J E; Kelly, D A; Wray, J
2017-02-01
Predictors of successful transition from pediatric to adult services include ability to self-manage and engage with healthcare services. Parents have a key role in healthcare management throughout childhood and adolescence including encouraging development of self-management skills in their children. Transition to adult services can be challenging for parents and young people, yet parents' views regarding transition remain largely unexplored. Nine parents of pediatric liver transplant recipients (15.2-25.1 yr) participated in semistructured interviews. Interviews were analyzed using IPA. Analysis revealed three key themes: "emotional impact of transplantation," "protection vs. independence," and "ending relationships and changing roles." Parents expressed the dichotomous nature of the desire to promote independence in their child while still maintaining control and protection, and discussed how changing roles and relationships were difficult to navigate. Parents are important facilitators of young people's development of self-management skills for successful transfer to adult services. Parents should be supported to move from a "managerial" to a "supervisory" role during transition to help young people engage independently with the healthcare team. Findings support the development of interventions for parents to emphasize their role in transition and guide the transfer of self-management skills from parent to young person. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Process' standardization and change management in higher education. The case of TEI of Athens
NASA Astrophysics Data System (ADS)
Chalaris, Ioannis; Chalaris, Manolis; Gritzalis, Stefanos; Belsis, Petros
2015-02-01
The establishment of mature operational procedures and the effort of standardizing and certifying these procedures is a particularly arduous and demanding task which requires strong commitment from management to the existing objectives, administrative stability and continuity, availability of resources, an adequate implementation team with support from all stakeholders and of course great tolerance until tangible results of the investment are shown. Ensuring these conditions, particularly in times of economic crisis, is an extremely difficult task for large organizations such as TEI of Athens where there is heterogeneity in personnel and changes in the administrative hierarchy arise plethora of additional difficulties and require an effective change management. In this work we depict the path of standardization and certification of administrative functions of TEI of Athens, with emphasis on difficulties encountered and how to address them and in particular issues of change management and the culture related to this effort. The requirement for infrastructure needed to be maintained in processes and tools process & strategic management is embodied, in order to evolve mechanisms for continuous improvement processes and storage / recovery of the resulting knowledge. The work concludes with a general design of a road map of internal audit and continuous improvement processes for a large institution of higher education.
Adams, David; Suhr, Ole B.; Hund, Ernst; Obici, Laura; Tournev, Ivailo; Campistol, Josep M.; Slama, Michel S.; Hazenberg, Bouke P.; Coelho, Teresa
2016-01-01
Purpose of review Early and accurate diagnosis of transthyretin familial amyloid polyneuropathy (TTR-FAP) represents one of the major challenges faced by physicians when caring for patients with idiopathic progressive neuropathy. There is little consensus in diagnostic and management approaches across Europe. Recent findings The low prevalence of TTR-FAP across Europe and the high variation in both genotype and phenotypic expression of the disease means that recognizing symptoms can be difficult outside of a specialized diagnostic environment. The resulting delay in diagnosis and the possibility of misdiagnosis can misguide clinical decision-making and negatively impact subsequent treatment approaches and outcomes. Summary This review summarizes the findings from two meetings of the European Network for TTR-FAP (ATTReuNET). This is an emerging group comprising representatives from 10 European countries with expertise in the diagnosis and management of TTR-FAP, including nine National Reference Centres. The current review presents management strategies and a consensus on the gold standard for diagnosis of TTR-FAP as well as a structured approach to ongoing multidisciplinary care for the patient. Greater communication, not just between members of an individual patient's treatment team, but also between regional and national centres of expertise, is the key to the effective management of TTR-FAP. PMID:26734952
Nurse Scientists Overcoming Challenges to Lead Transdisciplinary Research Teams
Kneipp, Shawn M.; Gilleskie, Donna; Sheely, Amanda; Schwartz, Todd; Gilmore, Robert M.; Atkinson, Daryl
2017-01-01
Increasingly, scientific funding agencies are requiring that researchers move toward an integrated, transdisciplinary team science paradigm. While the barriers to and rewards of conducting this type of research have been discussed in the literature, examples of how nurse investigators have led these teams to reconcile the differences in theoretical, methodological, and/or analytic perspectives that inevitably exist are lacking. In this article, we describe these developmental trajectory challenges through a case study of one transdisciplinary team, focusing on team member characteristics and the leadership tasks associated with successful transdisciplinary science teams in the literature. Specifically, we describe how overcoming these challenges has been essential to examining the complex, and potentially cumulative effects that key intersections between legal, social welfare, and labor market systems may have on the health of disadvantaged women. Finally, we discuss this difficult, but rewarding work within the context of lessons learned and transdisciplinary team research in relation to the future of nursing science. PMID:25015404
Conflict Management and Decision Making. Symposium.
ERIC Educational Resources Information Center
2002
This symposium on conflict management and decision making is comprised of three papers. "Two Approaches to Conflict Management in Teams: A Case Study" (Mychal Coleman, Gary N. McLean) describes a study that provided conflict management training to two employee teams using the traditional lecture method and cooperative learning (CL).…
Müller, C; Plewnia, A; Becker, S; Rundel, M; Zimmermann, L; Körner, M
2015-08-19
Interdisciplinary teamwork and team interventions are highly valued in the rehabilitation sector because they can improve outcomes of care for persons with complex health problems. However, little is known about expectations and requests regarding team interventions, especially in medical rehabilitation. This study aimed to explore how clinical managers and health professionals within multidisciplinary rehabilitation teams describe their expectations and requests regarding team-training interventions in the field of medical rehabilitation. Considering the methodology of qualitative research, data were collected using semi-structured interviews and focus groups at five rehabilitation clinics in Germany. We conducted face-to-face interviews with 5 clinical managers and 13 department heads of health care teams as well as five focus groups with a total of 35 members of interdisciplinary rehabilitation teams. Afterwards, the data were analyzed through qualitative content analysis encompassing data coding and using inductive thematic analysis. The exploration of team members' and clinical managers' descriptions showed that, to them, interdisciplinary team training programs should include a wide array of training contents. Seven common core themes emerged from the interviews, including participation of employees, leadership, communication, team meetings, team composition, coordination, and equal esteem. Additionally, 13 themes were identified by either managers or team members. The body of expectations regarding team training content in healthcare spans the continuum of changes on the team and organizational levels. On the organizational level, a number of structural factors were mentioned (e.g. improving the general conditions for team meetings, organized workshops to exchange interdisciplinary experiences, and leadership training), and on the team level, changes in procedural factors were listed (e.g. optimizing the consecutive planning and coordination of patient treatments, clarity with regard to roles and responsibilities of team members, and mutual esteem and appreciation between different professions). The synthesis underscores that there is meaningful heterogeneity in team training needs; training interventions should be locally adapted for each clinic in terms of training content and training strategies. Tailored team interventions are important for rehabilitation clinics. Future work should evaluate employed team training concepts over time as well as training contents, implementation strategies, and learning outcomes. This includes using robust study designs and evaluating team-training effects.
2003-02-05
KENNEDY SPACE CENTER, FLA. -- Members of the Recovery Management Team at KSC are at work in the Operations Support Building. They are part of the investigation into the accident that claimed orbiter Columbia and her crew of seven on Feb. 1, 2003, over East Texas as they returned to Earth after a 16-day research mission. Seated around the table (clockwise from far left) are Chris Hasselbring, Landing Operations, USA (co-chair of the Response Management Team); Don Maxwell, Safety, United Space Alliance (USA); Russ DeLoach, chief, Shuttle Mission Assurance Branch, NASA; George Jacobs, Shuttle Engineering; Jeff Campbell, Shuttle Engineering; Denny Gagen, Landing Recovery Manager (second co-chair of the team); and Dave Rainer, Launch and Landing Operations. The team is coordinating KSC technical support and assets to the Mishap Investigation Team in Barksdale, La., and providing support for the Recovery teams in Los Angeles, Texas, New Mexico, Arizona and California. In addition, the team is following up on local leads pertaining to potential debris in the KSC area. .
2003-02-05
KENNEDY SPACE CENTER, FLA. - Two members of the Recovery Management Team at KSC are at work in the Operations Support Building. At left is Don Maxwell, Safety, United Space Alliance, and at right is Larry Ulmer, Safety, NASA. They are part of the investigation into the accident that claimed orbiter Columbia and her crew of seven on Feb. 1, 2003, over East Texas as they returned to Earth after a 16-day research mission. Other team members are Russ DeLoach, chief, Shuttle Mission Assurance Branch, NASA; George Jacobs, Shuttle Engineering; Jeff Campbell, Shuttle Engineering; Dave Rainer, Launch and Landing Operations; and the two co-chairs of the Response Management Team, Denny Gagen, Landing Recovery Manager, and Chris Hasselbring, Landing Operations, USA. The team is coordinating KSC technical support and assets to the Mishap Investigation Team in Barksdale, La., and providing support for the Recovery teams in Los Angeles, Texas, New Mexico, Arizona and California. In addition, the team is following up on local leads pertaining to potential debris in the KSC area. .
The Resource Team: an innovative service delivery support model for mental health services.
O'Sullivan, Julie; Powell, Jacinta; Gibbon, Peter; Emmerson, Brett
2009-04-01
This paper outlines the development of the Resource Team, an innovative service delivery model supporting clinical services at the Inner North Brisbane Mental Health Service, Royal Brisbane and Women's Hospital Health Service District. The team aims to provide a base for specialist mental health support staff, improve knowledge management and support the development of meaningful community partnerships. Development of the team included a literature review and consultation with internal and external stakeholders. From this, the objectives, roles and functions of the team were clarified and disseminated to stakeholders. The team currently encompasses 12 positions and has initiated a number of programs and service developments. These include improved IT management of clinical resources and the development of partnerships with the community and non-government sectors. The Resource Team effectively coordinates specialist clinical support positions, addresses knowledge management issues and facilitates meaningful engagement with the community and non-government sectors. The model could easily be applied in other mental health and general health services.
Implementing Extreme Programming in Distributed Software Project Teams: Strategies and Challenges
NASA Astrophysics Data System (ADS)
Maruping, Likoebe M.
Agile software development methods and distributed forms of organizing teamwork are two team process innovations that are gaining prominence in today's demanding software development environment. Individually, each of these innovations has yielded gains in the practice of software development. Agile methods have enabled software project teams to meet the challenges of an ever turbulent business environment through enhanced flexibility and responsiveness to emergent customer needs. Distributed software project teams have enabled organizations to access highly specialized expertise across geographic locations. Although much progress has been made in understanding how to more effectively manage agile development teams and how to manage distributed software development teams, managers have little guidance on how to leverage these two potent innovations in combination. In this chapter, I outline some of the strategies and challenges associated with implementing agile methods in distributed software project teams. These are discussed in the context of a study of a large-scale software project in the United States that lasted four months.
Transforming Multidisciplinary Customer Requirements to Product Design Specifications
NASA Astrophysics Data System (ADS)
Ma, Xiao-Jie; Ding, Guo-Fu; Qin, Sheng-Feng; Li, Rong; Yan, Kai-Yin; Xiao, Shou-Ne; Yang, Guang-Wu
2017-09-01
With the increasing of complexity of complex mechatronic products, it is necessary to involve multidisciplinary design teams, thus, the traditional customer requirements modeling for a single discipline team becomes difficult to be applied in a multidisciplinary team and project since team members with various disciplinary backgrounds may have different interpretations of the customers' requirements. A new synthesized multidisciplinary customer requirements modeling method is provided for obtaining and describing the common understanding of customer requirements (CRs) and more importantly transferring them into a detailed and accurate product design specifications (PDS) to interact with different team members effectively. A case study of designing a high speed train verifies the rationality and feasibility of the proposed multidisciplinary requirement modeling method for complex mechatronic product development. This proposed research offersthe instruction to realize the customer-driven personalized customization of complex mechatronic product.
Team-Based Interprofessional Competency Training for Dementia Screening and Management.
Tan, Zaldy S; Damron-Rodriguez, JoAnn; Cadogan, Mary; Gans, Daphna; Price, Rachel M; Merkin, Sharon S; Jennings, Lee; Schickedanz, Heather; Shimomura, Sam; Osterweil, Dan; Chodosh, Joshua
2017-01-01
As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress. Registrants were organized into teams of five members, with at least one member of each profession per team. The teams rotated through all stations, completing assigned tasks through interprofessional collaboration. A total of 117 professionals (51 physicians, 11 nurses, 20 pharmacists, 24 social workers, 11 others) successfully completed the program. Change scores showed significant improvements in overall competence in dementia assessment and intervention (very low = 1; very high = 5; average change 1.12, P < .001), awareness of importance of dementia screening (average change 0.85, P < .001), and confidence in managing medication (average change 0.86, P < .001). Eighty-seven participants (82.9%) reported feeling confident or very confident using the dementia toolkit at their home institution. In a survey administered 3 months after the session, 48 respondents reported that they had changed their approach to administering the Mini-Cog test (78%), differential diagnosis (49%), assessment of caregiver stress (74%), and accessing community support and services (69%). In conclusion, team-based interprofessional competency training is a team teaching model that can be used to enhance competency in dementia screening and management in medical, nursing, pharmacy, and social work practitioners. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
[The zoological garden of Amsterdam Natura Artis Magistra during world War II].
Frankenhuis, Maarten Th
2009-01-01
Thanks to the wise management of its director, dr. Armand Sunier, and his team, 'Artis' survived the difficult war period without great losses of its animals and only material damage to some buildings. Artis has meant very much for the inhabitants of the city of Amsterdam during the war. In the first place for the employees and their families, that were kept for starvation and forced labour by extra rations of food and safe hiding places. But also for jewish persons in hiding, who could escape from a certain death by hiding in animal houses or other buildings in the garden. And also for hundreds of thousands people of Amsterdam who found in their zoological garden an oasis of relaxation in a town full of threat and violence.
NASA Astrophysics Data System (ADS)
Zhang, L.; Li, Y.; Wu, Q.
2013-05-01
Integrated Project Delivery (IPD) is a newly-developed project delivery approach for construction projects, and the level of collaboration of project management team is crucial to the success of its implementation. Existing research has shown that collaborative satisfaction is one of the key indicators of team collaboration. By reviewing the literature on team collaborative satisfaction and taking into consideration the characteristics of IPD projects, this paper summarizes the factors that influence collaborative satisfaction of IPD project management team. Based on these factors, this research develops a fuzzy linguistic method to effectively evaluate the level of team collaborative satisfaction, in which the authors adopted the 2-tuple linguistic variables and 2-tuple linguistic hybrid average operators to enhance the objectivity and accuracy of the evaluation. The paper demonstrates the practicality and effectiveness of the method through carrying out a case study with the method.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Klasky, Hilda B.; Williams, Paul T.; Bass, Bennett Richard
ORNL was tasked by xLPR project management to propose a team calendar for use within the xLPR consortium. Among various options that were considered, the approach judged by ORNL to best fit the needs of the xLPR project is presented in this document. The Atlassian Team Calendars plug-in used with the Confluence collaboration tool was recommended for several reasons, including the advantage that it provides for a tight integration between Confluence (found at https://xlpr.ornl.gov/wiki ) and xLPR s JIRA issue tracking system (found at https://xlpr.ornl.gov/jira ). This document is divided into two parts. The first part (Sections 1-6) consists ofmore » the white paper, which highlights some of the ways that Team Calendars can improve com mun ication between xLPR project managers, group leads, and team members when JIRA is applied for both issue tracking and change-management activities. Specific points emphasized herein are as follows: The Team Calendar application greatly enhances the added value that the JIRA and Confluence tools bring to the xLPR Project. The Team Calendar can improve com mun ication between xLPR project managers, group leads, and team members when JIRA is applied for both issue tracking and change-management activities. The Team Calendar works across different email tools such as Outlook 2011, Outlook 2010, Outlook 2007, Google Calendars and Mac s iCalendar to name a few. xLPR users can now access the wiki Confluence (with embedded Team Calendars) directly from JIRA without having to re-validate their login. The second part consists of an Annex (Section 7), which describes how users can subscribe to Team Calendars from different calendar applications. Specific instructions are given in the Annex that describe how to Import xLPR Team Calendar to Outlook Version Office 2010 Import xLPR Team Calendar to Outlook Version Office 2007 Subscribe to Team Calendar from Google Calendar The reader is directed to Section 4 for instructions on adding events to the Team Calendar or accessing ORNL staff for assistance with such additions. To seek help with your questions and problems regarding the content of this document, please contact Hilda Klasky at klaskyhb@ornl.gov« less
Implementing Total Quality Management in a University Setting.
ERIC Educational Resources Information Center
Coate, L. Edwin
1991-01-01
Oregon State University implemented Total Quality Management in nine phases: exploration; establishing a pilot study team; defining customer needs; adopting the breakthrough planning process; performing breakthrough planning in divisions; forming daily management teams; initiating cross-functional pilot projects; implementing cross-functional…
ERIC Educational Resources Information Center
Choi, Youngsoo; Ro, Heejung
2012-01-01
The development of positive attitudes in team-based work is important in management education. This study investigates hospitality students' attitudes toward group projects by examining instructional factors and team problems. Specifically, we examine how the students' perceptions of project appropriateness, instructors' support, and evaluation…
No More Heroes: Entrepreneurial Learning in the SME Management Team
ERIC Educational Resources Information Center
Mckeown, Ian
2010-01-01
Entrepreneurship is increasingly viewed as a plural rather than singular endeavour. This paper develops a conceptual framework of team-based entrepreneurial learning, challenging the myth of the entrepreneurial "Lone Ranger" and revealing the significance of power structures in the SME management team in mediating what is and is not learnt.…
ERIC Educational Resources Information Center
Thomas, Jennifer D. E.
2007-01-01
This paper investigates students' perceptions of their acquisition of knowledge management skills, namely thinking and team-building skills, resulting from the integration of various resources and technologies into an entirely team-based, online upper level distributed computing (DC) information systems (IS) course. Results seem to indicate that…
78 FR 65292 - North Pacific Fishery Management Council (NPFMC); Public Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-31
..., 7600 Sand Point Way NE., Building 4, Observer Training Room 1055 (GOA Plan Team) and Traynor Room 2076 (BS/AI Plan Team), Seattle, WA. Council address: North Pacific Fishery Management Council, 605 W. 4th... Sea/Aleutian Islands (BSAI) Groundfish Plan Teams will meet in Seattle, WA. DATES: The meetings will...
From Quick Start Teams to Home Teams: The Duke TQM Experience.
ERIC Educational Resources Information Center
Lubans, John; Gordon, Heather
This paper describes the Duke University Libraries' transition in early 1994 from its traditional hierarchical model to an organization emphasizing Total Quality Management (TQM) concepts such as self-managing teams and continuous improvement. Existing conditions at the libraries that played a role in the decision to switch included: (1) rising…
What Are the Attributes and Duties of the School Crisis Intervention Team?
ERIC Educational Resources Information Center
Gullatt, David E.; Long, Douglas
1996-01-01
Physical measures such as weapons checks and metal detectors are inadequate to forestall school violence. The key to managing crises is a trained, broad-based crisis-intervention team and a crisis-management plan. Team responsibilities include developing an intervention plan, coordinating with community services, educating and training staff, and…
77 FR 23662 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-20
.... SUMMARY: The North Pacific Fishery Management Council's (NPFMC) Crab Plan Team (CPT) will meet in May in.... SUPPLEMENTARY INFORMATION: The Plan Team meeting agenda includes: Review of workshop reports on modeling and... will be posted at http://www.fakr.noaa.gov/npfmc/PDFdocuments/membership/PlanTeam/Crab/CPTagenda512.pdf...
76 FR 58533 - Powder River Regional Coal Team Activities; Notice of Public Meeting in Casper, WY
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-21
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLWYP00000-L13200000-EL0000] Powder River Regional Coal Team Activities; Notice of Public Meeting in Casper, WY AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Public Meeting. SUMMARY: The Powder River Regional Coal Team (RCT) has...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-23
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLWY922000-L13200000-EL0000] Powder River Regional Coal Team Activities: Notice of Public Meeting in Casper, Wyoming AGENCY: Bureau of Land Management, Interior. ACTION: Notice of public meeting. SUMMARY: The Powder River Regional Coal Team (RCT...
Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain
2016-09-01
This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.
A quantitative perspective on ethics in large team science.
Petersen, Alexander M; Pavlidis, Ioannis; Semendeferi, Ioanna
2014-12-01
The gradual crowding out of singleton and small team science by large team endeavors is challenging key features of research culture. It is therefore important for the future of scientific practice to reflect upon the individual scientist's ethical responsibilities within teams. To facilitate this reflection we show labor force trends in the US revealing a skewed growth in academic ranks and increased levels of competition for promotion within the system; we analyze teaming trends across disciplines and national borders demonstrating why it is becoming difficult to distribute credit and to avoid conflicts of interest; and we use more than a century of Nobel prize data to show how science is outgrowing its old institutions of singleton awards. Of particular concern within the large team environment is the weakening of the mentor-mentee relation, which undermines the cultivation of virtue ethics across scientific generations. These trends and emerging organizational complexities call for a universal set of behavioral norms that transcend team heterogeneity and hierarchy. To this end, our expository analysis provides a survey of ethical issues in team settings to inform science ethics education and science policy.
Using Modern Methodologies with Maintenance Software
NASA Technical Reports Server (NTRS)
Streiffert, Barbara A.; Francis, Laurie K.; Smith, Benjamin D.
2014-01-01
Jet Propulsion Laboratory uses multi-mission software produced by the Mission Planning and Sequencing (MPS) team to process, simulate, translate, and package the commands that are sent to a spacecraft. MPS works under the auspices of the Multi-Mission Ground Systems and Services (MGSS). This software consists of nineteen applications that are in maintenance. The MPS software is classified as either class B (mission critical) or class C (mission important). The scheduling of tasks is difficult because mission needs must be addressed prior to performing any other tasks and those needs often spring up unexpectedly. Keeping track of the tasks that everyone is working on is also difficult because each person is working on a different software component. Recently the group adopted the Scrum methodology for planning and scheduling tasks. Scrum is one of the newer methodologies typically used in agile development. In the Scrum development environment, teams pick their tasks that are to be completed within a sprint based on priority. The team specifies the sprint length usually a month or less. Scrum is typically used for new development of one application. In the Scrum methodology there is a scrum master who is a facilitator who tries to make sure that everything moves smoothly, a product owner who represents the user(s) of the software and the team. MPS is not the traditional environment for the Scrum methodology. MPS has many software applications in maintenance, team members who are working on disparate applications, many users, and is interruptible based on mission needs, issues and requirements. In order to use scrum, the methodology needed adaptation to MPS. Scrum was chosen because it is adaptable. This paper is about the development of the process for using scrum, a new development methodology, with a team that works on disparate interruptible tasks on multiple software applications.
Teaching operating room conflict management to surgeons: clarifying the optimal approach.
Rogers, David; Lingard, Lorelei; Boehler, Margaret L; Espin, Sherry; Klingensmith, Mary; Mellinger, John D; Schindler, Nancy
2011-09-01
Conflict management has been identified as an essential competence for surgeons as they work in operating room (OR) teams; however, the optimal approach is unclear. Social science research offers two alternatives, the first of which recommends that task-related conflict be managed using problem-solving techniques while avoiding relationship conflict. The other approach advocates for the active management of relationship conflict as it almost always accompanies task-related conflict. Clarity about the optimal management strategy can be gained through a better understanding of conflict transformation, or the inter-relationship between conflict types, in this specific setting. The purpose of this study was to evaluate conflict transformation in OR teams in order to clarify the approach most appropriate for an educational conflict management programme for surgeons. A constructivist grounded theory approach was adopted to explore the phenomenon of OR team conflict. Narratives were collected from focus groups of OR nurses and surgeons at five participating centres. A subset of these narratives involved transformation between and within conflict types. This dataset was analysed. The results confirm that misattribution and the use of harsh language cause conflict transformation in OR teams just as they do in stable work teams. Negative emotionality was found to make a substantial contribution to responses to and consequences of conflict, notably in the swiftness with which individuals terminated their working relationships. These findings contribute to a theory of conflict transformation in the OR team. There are a number of behaviours that activate conflict transformation in the OR team and a conflict management education programme should include a description of and alternatives to these behaviours. The types of conflict are tightly interwoven in this setting and thus the most appropriate management strategy is one that assumes that both types of conflict will exist and should be managed actively. © Blackwell Publishing Ltd 2011.
Spits, Christine; Wallace, Luke; Reinke, Karin
2017-04-20
Visual assessment, following guides such as the Overall Fuel Hazard Assessment Guide (OFHAG), is a common approach for assessing the structure and hazard of varying bushfire fuel layers. Visual assessments can be vulnerable to imprecision due to subjectivity between assessors, while emerging techniques such as image-based point clouds can offer land managers potentially more repeatable descriptions of fuel structure. This study compared the variability of estimates of surface and near-surface fuel attributes generated by eight assessment teams using the OFHAG and Fuels3D, a smartphone method utilising image-based point clouds, within three assessment plots in an Australian lowland forest. Surface fuel hazard scores derived from underpinning attributes were also assessed. Overall, this study found considerable variability between teams on most visually assessed variables, resulting in inconsistent hazard scores. Variability was observed within point cloud estimates but was, however, on average two to eight times less than that seen in visual estimates, indicating greater consistency and repeatability of this method. It is proposed that while variability within the Fuels3D method may be overcome through improved methods and equipment, inconsistencies in the OFHAG are likely due to the inherent subjectivity between assessors, which may be more difficult to overcome. This study demonstrates the capability of the Fuels3D method to efficiently and consistently collect data on fuel hazard and structure, and, as such, this method shows potential for use in fire management practices where accurate and reliable data is essential.
Blum, Ronja; Gairing Bürglin, Anja; Gisin, Stefan
2008-11-01
In medical specialties, such as anaesthesia, the use of simulation has increased over the past 15 years. Medical simulation attempts to reproduce important clinical situations to practise team training or individual skills in a risk free environment. For a long time simulators have only been used by the airline industry and the military. Simulation as a training tool for practicing critical situations in obstetrics is not very common yet. Experience and routine are crucial to evaluate a medical emergency correctly and to take the appropriate measures. Nowadays the obstetrician requires a combination of manual and communication skills, fast emergency management and decision-making skills. Therefore simulation may help to attain these skills. This may not only satisfy the high expectations and demands of the patients towards doctors and midwives but would also help to keep calm in difficult situations and avoid mistakes. The goal is a risk free delivery for mother and child. Therefore we developed a simulation- based curricular unit for hands-on training of four different obstetric emergency scenarios. In this paper we describe our results about the feedback of doctors and midwives on their personal experiences due to this simulation-based curricular unit. The results indicate that simulation seems to be an accepted method for team training in emergency situations in obstetrics. Whether patient security increases after the regularly use of drill training needs to be investigated in further studies.
Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D
2016-04-01
Increasingly, research is directed at advancing methods to address obesity management in primary care. In this paper we describe the role of interdisciplinary collaboration, or lack thereof, in patient weight management within 12 teams in a large primary care network in Alberta, Canada. Qualitative data for the present analysis were derived from the 5As Team (5AsT) trial, a mixed-method randomized control trial of a 6-month participatory, team-based educational intervention aimed at improving the quality and quantity of obesity management encounters in primary care practice. Participants (n = 29) included in this analysis are healthcare providers supporting chronic disease management in 12 family practice clinics randomized to the intervention arm of the 5AsT trial including mental healthcare workers (n = 7), registered dietitians (n = 7), registered nurses or nurse practitioners (n = 15). Participants were part of a 6-month intervention consisting of 12 biweekly learning sessions aimed at increasing provider knowledge and confidence in addressing patient weight management. Qualitative methods included interviews, structured field notes and logs. Four common themes of importance in the ability of healthcare providers to address weight with patients within an interdisciplinary care team emerged, (i) Availability; (ii) Referrals; (iii) Role perception and (iv) Messaging. However, we find that what was key to our participants was not that these issues be uniformly agreed upon by all team members, but rather that communication and clinic relationships support their continued negotiation. Our study shows that firm clinic relationships and deliberate communication strategies are the foundation of interdisciplinary care in weight management. Furthermore, there is a clear need for shared messaging concerning obesity and its treatment between members of interdisciplinary teams. © 2016 World Obesity.
Kitzmiller, Rebecca R; McDaniel, Reuben R; Johnson, Constance M; Lind, E Allan; Anderson, Ruth A
2013-01-01
We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project. Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens. We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger. Leaders must enact voice-promoting behaviors and use them throughout a team's engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation. Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking. Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes. We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders' behaviors might facilitate or impeded speaking up among project teams in health care settings.
A Human-Autonomy Teaming Approach for a Flight-Following Task
NASA Technical Reports Server (NTRS)
Brandt, Summer L.; Russell, Ricky; Lachter, Joel; Shively, Robert
2017-01-01
Managing aircraft is becoming more complex with increasingly sophisticated automation responsible for more flight tasks. With this increased complexity, it is becoming more difficult for operators to understand what the automation is doing and why. Human involvement with increasingly autonomous systems must adjust to allow for a more dynamic relationship involving cooperation and teamwork. As part of an ongoing project to develop a framework for human-autonomy teaming (HAT) in aviation, a part-task study was conducted to demonstrate, evaluate and refine proposed critical aspects of HAT. These features were built into an automated recommender system on a ground station available from previous studies. Participants performed a flight-following task once with the original ground station (i.e., No HAT condition) and once with the HAT features enabled (i.e., HAT condition). Behavioral and subjective measures were collected; subjective measures are presented here. Overall, participants preferred the ground station with HAT features enabled compared to the station without the HAT features. Participants reported that the HAT displays and automation were preferred for keeping up with operationally important issues. Additionally, participants reported that the HAT displays and automation provided enough situation awareness to complete the task and reduced workload relative to the No HAT baseline.
The impact of team building on communication and job satisfaction of nursing staff.
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.
Curriculum Management: "Driving the School Management Team Frantic"
ERIC Educational Resources Information Center
Lumadi, M. W.
2012-01-01
This study explores factors which have a negative impact, on the role of the School Management Team (SMT) that serves as the fulcrum of the curriculum management process. The SMT is compelled to execute its responsibilities in an efficient and effective manner thus keeping a delicate balance between the often-conflicting pressures from parents,…
ERIC Educational Resources Information Center
Platte Technical Community Coll., Columbus, NE.
These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training health care administrators. Unit 1 contains materials designed to help the health care administrators increase their management skills in regard to self-awareness, time management, problem solving,…
Messy world: managing dynamic landscape.
Sally Duncan
1999-01-01
What lessons does historical disturbance hold for the management of future landscapes? Fred Swanson, a researcher at the Pacific Northwest Research Station and John Cissel, research liaison for the Willamette NF, are members of a team of scientists and land managers who are examining the way we think about and manage landscapes.The team found that past...
ERIC Educational Resources Information Center
Platte Technical Community Coll., Columbus, NE.
These Project TEAMS (Techniques and Education for Achieving Managerial Skills) instructional materials consist of five units for use in training independent business owner/managers. The first unit contains materials which deal with management skills relating to personal characteristics of successful business people, knowledge of self and chosen…
ERIC Educational Resources Information Center
Platte Technical Community Coll., Columbus, NE.
These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training business and industrial supervisors. Unit 1 is designed to help managers in business or industry increase management skills in regard to leadership techniques, problem solving and decision making, and…
STS-114 Mission Management Team Meeting
2005-08-04
JSC2005-E-32012 (4 August 2005) --- John Muratore, Manager of Space Shuttle Systems Engineering & Integration Office, discusses a key STS-114 issue during the Mission Management Team (MMT) session of the afternoon of August 4. The MMT meets daily in Houston's Mission Control Center.
NASA Astrophysics Data System (ADS)
Mandala, Mahender Arjun
A cornerstone of design and design education is frequent situated feedback. With increasing class sizes, and shrinking financial and human resources, providing rich feedback to students becomes increasingly difficult. In the field of writing, web-based peer review--the process of utilizing equal status learners within a class to provide feedback to each other on their work using networked computing systems--has been shown to be a reliable and valid source of feedback in addition to improving student learning. Designers communicate in myriad ways, using the many languages of design and combining visual and descriptive information. This complex discourse of design intent makes peer reviews by design students ambiguous and often not helpful to the receivers of this feedback. Furthermore, engaging students in the review process itself is often difficult. Teams can complement individual diversity and may assist novice designers collectively resolve complex task. However, teams often incur production losses and may be impacted by individual biases. In the current work, we look at utilizing a collaborative team of reviewers, working collectively and synchronously, in generating web based peer reviews in a sophomore engineering design class. Students participated in a cross-over design, conducting peer reviews as individuals and collaborative teams in parallel sequences. Raters coded the feedback generated on the basis of their appropriateness and accuracy. Self-report surveys and passive observation of teams conducting reviews captured student opinion on the process, its value, and the contrasting experience they had conducting team and individual reviews. We found team reviews generated better quality feedback in comparison to individual reviews. Furthermore, students preferred conducting reviews in teams, finding the process 'fun' and engaging. We observed several learning benefits of using collaboration in reviewing including improved understanding of the assessment criteria, roles, expectations, and increased team reflection. These results provide insight into how to improve the review process for instructors and researchers, and forms a basis for future research work in this area. With respect to facilitating peer review process in design based classrooms, we also present recommendations for creating effective review system design and implementation in classroom supported by research and practical experience.
Powers, D A; Brown, R O; Cowan, G S; Luther, R W; Sutherland, D A; Drexler, P G
1986-01-01
One hundred one patients receiving enteral nutritional support (ENS) by tube feeding during a 5-month period were prospectively studied. Fifty patients were managed by a nutritional support team (T) and 51 patients were managed by the nonteam approach (NT). Demographics, primary diagnosis, chronic diseases, medical service, calculated basal energy expenditure (BEE), duration of ENS, and final patient disposition were recorded. Enteral formula, formula modifications, results of laboratory tests and calories delivered were obtained daily. Results of nitrogen balance studies were obtained when available and each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. No significant difference was found between the team and nonteam managed groups in regard to total feeding days, mean feeding days per patient, total laboratory tests, laboratory tests per patient or laboratory tests per day. Significantly more team patients attained 1.2 times BEE (T = 47, NT = 38, p less than 0.05) for a significantly greater period of time (T = 398 days, NT = 281 days, p less than 0.05). Significantly more team patients achieved a measured positive nitrogen balance than nonteam patients (T = 42, NT = 1, p less than 0.05). Formula modifications to correct nutritional or metabolic aberrations were made in 15 (30%) team patients and five (9.8%) nonteam patients (p less than 0.05). The number of individual abnormalities (pulmonary, mechanical, gastrointestinal, and metabolic), as well as total abnormalities occurring in the team-managed group, was significantly lower than in the nonteam managed group (160 vs 695, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Blunt chest trauma in a non-specialist centre: Right treatment, right place?
Maher, Lesley; Jayathissa, Sisira
2016-12-01
To compare patient characteristics, management and outcomes for patients admitted with isolated blunt chest trauma, managed by medical or surgical teams. We reviewed adult patients admitted with blunt chest trauma between 1 September 2006 and 31 August 2011 to a secondary hospital in New Zealand. Inclusion criteria were: blunt chest trauma, with at least one radiologically demonstrated rib fracture. The primary outcome was in-hospital mortality, and secondary outcomes were development of pneumonia, and use of analgesia. Seventy-two patients were included. Thirty-three patients were managed by medical teams and 39 by surgical teams. In-hospital mortality was greater amongst medical patients 5/33 (15%) versus surgical 0/39 (0%); P = 0.012. Pneumonia occurred in 15/33 (45%); medical patients versus surgical 2/39 (5%), P <0.001. Use of epidural, regional or patient-controlled analgesia was greater in the group managed by surgical teams (12/39 [30.7%] vs 1/33 [3%] P = 0.002). Medically managed patients were older (median 73 vs 63 years; P = 0.02), had a higher Charlson Comorbidity Index (median 5 vs 3; P = 0.013). The mechanism of injury for medically managed patients was more likely to be low trauma fall compared to surgically managed patients (28/33 [85%] vs 9/39 [27%]; P <0.0001). Amongst patients with isolated blunt chest trauma, those managed by medical teams were older, had more comorbidities and were more likely to have become injured with a low trauma fall than those managed by surgical teams. They had less access to analgesic options, developed pneumonia more often and had higher mortality. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Peek-Asa, Corinne; Casteel, Carri; Rugala, Eugene; Romano, Steve; Ramirez, Marizen
2013-11-01
We examined threat management investigations conducted by a large multinational company. The company provided a database, removing any identifiers, of investigations by the corporate Threat Management Teams in 2009 and 2010. Rates were calculated using worker population data. During the 2-year study period, the company investigated threat management cases at a rate of 13.9 per 10,000 employees per year. Cases that activated a Threat Management Team were more likely to lead to corrective action (odds ratio = 2.0; 95% confidence interval = 1.08 to 3.87) and referral to the Employee Assistance Program (odds ratio = 4.8; 95% confidence interval = 3.00 to 7.77), but were not related to likelihood of termination. When the multidisciplinary teams were involved, cases were more likely to result in some type of action but were not more likely to lead to termination.
Building team adaptive capacity: the roles of sensegiving and team composition.
Randall, Kenneth R; Resick, Christian J; DeChurch, Leslie A
2011-05-01
The current study draws on motivated information processing in groups theory to propose that leadership functions and composition characteristics provide teams with the epistemic and social motivation needed for collective information processing and strategy adaptation. Three-person teams performed a city management decision-making simulation (N=74 teams; 222 individuals). Teams first managed a simulated city that was newly formed and required growth strategies and were then abruptly switched to a second simulated city that was established and required revitalization strategies. Consistent with hypotheses, external sensegiving and team composition enabled distinct aspects of collective information processing. Sensegiving prompted the emergence of team strategy mental models (i.e., cognitive information processing); psychological collectivism facilitated information sharing (i.e., behavioral information processing); and cognitive ability provided the capacity for both the cognitive and behavioral aspects of collective information processing. In turn, team mental models and information sharing enabled reactive strategy adaptation.
Flabouris, Arthas; Nocera, Antony; Garner, Alan
2004-01-01
Multiple casualty incidents (MCI) are infrequent events for medical systems. This renders audit and quality improvement of the medical responses difficult. Quality tools and use of such tools for improvement is necessary to ensure that the design of medical systems facilitates the best possible response to MCI. To describe the utility of incident reporting as a quality monitoring and improvement tool during the deployment of medical teams for mass gatherings and multiple casualty incidents. Voluntary and confidential reporting of incidents was provided by members of the disaster medical response teams during the period of disaster medical team deployment for the 2000 Sydney Olympic Games. Qualitative evaluations were conducted of reported incidents. The main outcome measures included the nature of incident and associated contributing factors, minimization factors, harm potential, and comparison with the post-deployment, cold debriefings. A total of 53 incidents were reported. Management-based decisions, poor or non-existent protocols, and equipment and communication-related issues were the principal contributing factors. Eighty nine percent of the incidents were considered preventable. A potential for harm to patients and/or team members was documented in 58% of reports, of which 76% were likely to cause at least significant harm. Of equipment incidents, personal protective equipment (33%), medical equipment (27%), provision of equipment (22%), and communication equipment (17%) predominated. Personal protective equipment (50%) was reported as the most frequent occupational health and safety incident followed by fatigue (25%). Pre-deployment planning was the most important factor for future incident impact minimization. Incident monitoring was efficacious as a quality tool in identifying incident contributing factors. Incident monitoring allowed for greater systems evaluation. Further evaluation of this quality tool within different disaster settings is required.
Routt, M L; Simonian, P T; Defalco, A J; Miller, J; Clarke, T
1996-05-01
Associated urological and orthopedic injuries of the pelvic ring are complex with numerous potential complications. These patients are treated optimally using a team approach. The combined expertise is not only helpful initially when managing these difficult patients, but also later as problems develop. This study describes a treatment protocol and reports the early results of 23 patients with unstable pelvic fractures and associated bladder or urethral disruptions, or both, treated surgically with open reduction and internal fixation of the anterior pelvic ring injuries at the same anesthetic and using the same surgical exposure as the urethral realignments or bladder repairs or both. Early complications occurred in four patients (17%): one patient sustained a fifth lumbar nerve injury caused by the pelvic reduction procedure, and three patients had anterior pelvic internal fixation failures. Late complications occurred in eight patients (35%). There was one deep wound infection (4.3%) that presented 6 weeks after injury. Late urological complications occurred in seven patients (30%). Four of the nine male patients with urethral disruptions had urethral stricture after their primary urethral realignments (44%). Three of the 18 male patients admitted to impotence (16.7%). One of the three had a residual thoracic paraplegia caused by a burst fracture. One of the five female patients had urinary incontinence and required a bladder suspension operation to restore normal function (20%). A low infection rate can be expected despite the use of internal fixation. Early urethral "indirect" realignments avoid more difficult delayed open repairs; however, late urological complication rates are still high. Early "direct" bladder repairs are easily performed at the time of anterior pelvic open reduction and internal fixation. Suprapubic tubes are not necessary to adequately divert the urine when large diameter urethral catheters are used in these patients.
Leading Teams of Leaders: What Helps Team Member Learning?
ERIC Educational Resources Information Center
Higgins, Monica; Young, Lissa; Weiner, Jennie; Wlodarczyk, Steven
2010-01-01
School districts are moving toward a new form of management in which superintendents need to form and nurture leadership teams. A study of 25 such teams in Connecticut suggests that a team's effectiveness is maximized when the team members are coached by other team members, not the superintendent, and when they are coached on task-related…
Tricco, Andrea C; Zarin, Wasifa; Rios, Patricia; Pham, Ba'; Straus, Sharon E; Langlois, Etienne V
2016-12-23
Engaging policymakers, healthcare managers and policy analysts in the conduct of knowledge synthesis can help increase its impact. This is particularly important for knowledge synthesis studies commissioned by decision-makers with limited timelines, as well as reviews of health policy and systems research. A scoping review will be conducted to assess barriers, facilitators, strategies and outcomes of engaging these individuals in the knowledge synthesis process. We will follow the Joanna Briggs Institute guidance for scoping reviews. Literature searches of electronic databases (eg, MEDLINE, EMBASE, Cochrane Library, ERIC, PsycINFO) will be conducted from inception onwards. The electronic search will be supplemented by searching for sources that index unpublished/difficult to locate studies (eg, GreyNet International database), as well as through scanning of reference lists of reviews on related topics. All study designs using either qualitative or quantitative methodologies will be eligible if there is a description of the strategies, barriers or facilitators, and outcomes of engaging policymakers, healthcare managers and policy analysts in the knowledge synthesis process. Screening and data abstraction will be conducted by 2 team members independently after a calibration exercise across the team. A third team member will resolve all discrepancies. We will conduct frequency analysis and thematic analysis to chart and characterise the literature, identifying data gaps and opportunities for future research, as well as implications for policy. This project was commissioned by the Alliance for Health Policy and Systems Research, WHO. The results will be used by Alliance Review Centers of health policy and systems research in low-income and middle-income countries that are conducting knowledge synthesis to inform health policymaking and decision-making. Our results will also be disseminated through conference presentations, train-the-trainer events, peer-reviewed publication and a 1-page policy brief that will be posted on the authors' websites. 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/.
Pregnancy across the spectrum of chronic kidney disease.
Hladunewich, Michelle A; Melamad, Nir; Bramham, Kate
2016-05-01
Management of the pregnant woman with chronic kidney disease is difficult for both nephrologists and obstetricians. Prepregnancy counselling with respect to risk stratification, optimization of maternal health prior to pregnancy, as well as management of the many potential pregnancy-associated complications in this complex patient population remains challenging due to the paucity of large, well-designed clinical studies. Furthermore, the heterogeneity of disease and the relative infrequency of pregnancy, particularly in more advanced stages of chronic kidney disease, leaves many clinicians feeling ill prepared to manage these pregnancies. As such, counselling is imprecise and management varies substantially across centers. All pregnancies in women with chronic kidney disease can benefit from a collaborative multidisciplinary approach with a team that consists of nephrologists experienced in the management of kidney disease in pregnancy, maternal-fetal medicine specialists, high-risk pregnancy nursing staff, dieticians, and pharmacists. Further access to skilled neonatologists and neonatal intensive care unit support is essential given the risks for preterm delivery in this patient population. The goal of this paper is to highlight some of the data that currently exist in the literature, provide management strategies for the practicing nephrologist at all stages of chronic kidney disease, and explore some of the knowledge gaps where future multinational collaborative research efforts should concentrate to improve pregnancy outcomes in women with kidney disease across the globe. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
Interdisciplinary collaboration within project-level NEPA teams in the US Forest Service
James W. Freeman; Marc J. Stern; Michael Mortimer; Dale J. Blahna; Lee K. Cerveny
2011-01-01
Interdisciplinary teamwork has become a foundation of natural resources planning and management in the US. Yet, we know little about the degree of interdisciplinary collaboration of natural resource planning teams. We conducted 10 case studies of Forest Service NEPA (National Environmental Policy Act) teams working on projects related to the 2005 Travel Management Rule...
ERIC Educational Resources Information Center
Stewart, Greg L.; Courtright, Stephen H.; Barrick, Murray R.
2012-01-01
The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how "peer-based rational control", which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and…
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.
The science of team science: overview of the field and introduction to the supplement.
Stokols, Daniel; Hall, Kara L; Taylor, Brandie K; Moser, Richard P
2008-08-01
The science of team science encompasses an amalgam of conceptual and methodologic strategies aimed at understanding and enhancing the outcomes of large-scale collaborative research and training programs. This field has emerged rapidly in recent years, largely in response to growing concerns about the cost effectiveness of public- and private-sector investments in team-based science and training initiatives. The distinctive boundaries and substantive concerns of this field, however, have remained difficult to discern. An important challenge for the field is to characterize the science of team science more clearly in terms of its major theoretical, methodologic, and translational concerns. The articles in this supplement address this challenge, especially in the context of designing, implementing, and evaluating cross-disciplinary research initiatives. This introductory article summarizes the major goals and organizing themes of the supplement, draws links between the constituent articles, and identifies new areas of study within the science of team science.
[Laboratory and Team-Based Medicine--From the Standpoint of JSLM].
Matsuo, Shuji
2014-11-01
The Japanese Society of Laboratory Medicine (JSLM) organized a working group to promote team-based medicine 2 years ago. The Japan Society for Clinical Laboratory Automation (JSCLA) formed a committee for team-based medicine and it was active for five years from 2006 to 2011. The author, an officer of the JSCLA, presents previous activities and policies for the future. The three main activities were as follows: Firstly, a seminar with a lecture and practice was held at meetings of the JSCLA. Secondly, Internet services were set up to introduce action programs and promote team-based medicine. Thirdly, the guidebook was edited, written from the point of view of laboratory medicine. The committee worked hard and produced favorable results. It is difficult with the present circumstances to organize a committee for team-based medicine in the JSCLA again. We expect cooperation in seminars and meetings.
Profile of an excellent nurse manager: identifying and developing health care team leaders.
Kallas, Kathryn D
2014-01-01
The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.
Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori
2017-01-01
To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.
Toderi, Stefano; Balducci, Cristian
2018-02-26
The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors' stress-preventive management competencies, as measured by the Stress Management Competencies Indicator Tool (SMCIT), are related to employees' affective well-being through psychosocial work environmental factors. To this end, multilevel structural equation modelling (MSEM) was developed and tested, including data provided by both supervisors and employees. Supervisors ( n = 84) self-assessed their stress-preventive management competencies (i.e., being respectful and responsible, managing and communicating existing and future work, reasoning and managing difficult situations, and managing the individual within the team) with a previously validated reduced version of the SMCIT. The supervised employees ( n = 584) rated job content (e.g., job demands) and work context (e.g., role clarity) psychosocial factors and their job-related affective well-being. Supervisors' job-related affective well-being was also included in the tested model. The results revealed that the stress-preventive competencies factor was related to employees' affective well-being through the psychosocial work environment only when the latter was operationalized by means of contextual work factors. Supervisors' affective well-being was related to their stress-preventive competencies, but it was not related to employees' affective well-being. We discuss the implications of the results obtained.
Advanced Diagnostic and Prognostic Testbed (ADAPT) Testability Analysis Report
NASA Technical Reports Server (NTRS)
Ossenfort, John
2008-01-01
As system designs become more complex, determining the best locations to add sensors and test points for the purpose of testing and monitoring these designs becomes more difficult. Not only must the designer take into consideration all real and potential faults of the system, he or she must also find efficient ways of detecting and isolating those faults. Because sensors and cabling take up valuable space and weight on a system, and given constraints on bandwidth and power, it is even more difficult to add sensors into these complex designs after the design has been completed. As a result, a number of software tools have been developed to assist the system designer in proper placement of these sensors during the system design phase of a project. One of the key functions provided by many of these software programs is a testability analysis of the system essentially an evaluation of how observable the system behavior is using available tests. During the design phase, testability metrics can help guide the designer in improving the inherent testability of the design. This may include adding, removing, or modifying tests; breaking up feedback loops, or changing the system to reduce fault propagation. Given a set of test requirements, the analysis can also help to verify that the system will meet those requirements. Of course, a testability analysis requires that a software model of the physical system is available. For the analysis to be most effective in guiding system design, this model should ideally be constructed in parallel with these efforts. The purpose of this paper is to present the final testability results of the Advanced Diagnostic and Prognostic Testbed (ADAPT) after the system model was completed. The tool chosen to build the model and to perform the testability analysis with is the Testability Engineering and Maintenance System Designer (TEAMS-Designer). The TEAMS toolset is intended to be a solution to span all phases of the system, from design and development through health management and maintenance. TEAMS-Designer is the model-building and testability analysis software in that suite.
Åvik Persson, Helene; Sandgren, Anna; Fürst, Carl-Johan; Ahlström, Gerd; Behm, Lina
2018-06-04
Nursing home residents in Sweden are old, frail and usually have multiple morbidities which often make dying a prolonged suffering. It has been found that older persons at nursing homes receive far less palliative care than younger persons, partly because it is difficult to identify when the final stage of life begins. The identification may help the staff to enable the older person and their families to participate in planning the care in accordance with their own preferences and values. With this in mind the aim was to explore the experiences of early and late signs preceding dying in older persons in nursing homes from the multidisciplinary team's perspective. The focus group method was used to interview 20 health-care professionals on the basis of semi-structured questions. Four focus groups were conducted at four nursing homes in two counties in southern Sweden. The groups included different professionals such as assistant nurses, registered nurses, occupational therapists, physiotherapists, social workers and unit managers. The analysis was conducted according to the focus group method developed by Kruger and Casey. The analysis revealed one major theme, from unawareness to obviousness, which illustrates that the participants experienced dying as a happening, not a process, and found it difficult to identify early signs. Even though it was a new way of thinking, several suggestions of early signs were presented. The main category "Going into a bubble" illustrates early signs, which meant that the older person showed signs of wanting to withdraw from the outside world. The main category "The body begins to shut down" illustrates late signs, which meant that the older person showed signs that indicate that the body starts to prepare for death. This study conveys new knowledge concerning the multidisciplinary team's collective experience of early and late signs that precede dying. This knowledge can increase the understanding of when a palliative care approach needs to be in place at nursing homes. The use of a palliative care approach in care planning requires consensus in the perception of the dying process of frail older persons.
ERIC Educational Resources Information Center
Murphy, Linda; Della Corte, Suzanne
1990-01-01
This newsletter issue focuses on ways parents can manage the difficult child with special needs. Characteristics of the difficult child are listed including poor listening skills, irritableness, impulsivity, and tendency to have tantrums. Typical reactions to the difficult child by parents, siblings, other relatives, neighbors, the school, and…
Quality improvement in physiotherapy services.
Boak, George; Sephton, Ruth; Hough, Elaine; Ten Hove, Ruth
2017-06-12
Purpose The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach This is a multiple case study and information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications The findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of the authors' knowledge, no other longitudinal process change study in therapy services has been published.
Implementation of Task-Tracking Software for Clinical IT Management.
Purohit, Anne-Maria; Brutscheck, Clemens; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Schneider, Martin
2017-01-01
Often in clinical IT departments, many different methods and IT systems are used for task-tracking and project organization. Based on managers' personal preferences and knowledge about project management methods, tools differ from team to team and even from employee to employee. This causes communication problems, especially when tasks need to be done in cooperation with different teams. Monitoring tasks and resources becomes impossible: there are no defined deliverables, which prevents reliable deadlines. Because of these problems, we implemented task-tracking software which is now in use across all seven teams at the University Hospital Erlangen. Over a period of seven months, a working group defined types of tasks (project, routine task, etc.), workflows, and views to monitor the tasks of the 7 divisions, 20 teams and 340 different IT services. The software has been in use since December 2016.
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.
Multidisciplinary chronic pain management in a rural Canadian setting.
Burnham, Robert; Day, Jeremiah; Dudley, Wallace
2010-01-01
Chronic pain is prevalent, complex and most effectively treated by a multidisciplinary team, particularly if psychosocial issues are dominant. The limited access to and high costs of such services are often prohibitive for the rural patient. We describe the development and 18-month outcomes of a small multidisciplinary chronic pain management program run out of a physician's office in rural Alberta. The multidisciplinary team consisted of a family physician, physiatrist, psychologist, physical therapist, kinesiologist, nurse and dietician. The allied health professionals were involved on a part-time basis. The team triaged referral information and patients underwent either a spine or medical care assessment. Based on the findings of the assessment, the team managed the care of patients using 1 of 4 methods: consultation only, interventional spine care, supervised medication management or full multidisciplinary management. We prospectively and serially recorded self-reported measures of pain and disability for the supervised medication management and full multidisciplinary components of the program. Patients achieved clinically and statistically significant improvements in pain and disability. Successful multidisciplinary chronic pain management services can be provided in a rural setting.
Llewellyn-Jones, Glyn; Pereira, John
2016-04-01
There is little information about the role of the radiologist at multidisciplinary team meetings; in particular their influence on patient management. To evaluate the influence of radiologists on clinical patient management during multidisciplinary meetings. Prospective data were collected over a 5-week period from multidisciplinary team meetings across four paediatric clinical domains. Radiological input was recorded for each case discussion, including the type of influence and its potential effect on clinical patient management. One hundred and forty paediatric cases were reviewed. Radiological advice was requested from the radiologist for 25.7% (N = 36) of cases. In 17.9% (N = 25) this advice was judged to have influenced clinical patient management. There were two cases where new imaging findings were discovered. Radiologists influence clinical patient management during multidisciplinary team meetings primarily by providing differential diagnoses and guidance regarding future imaging, with respect to both the necessity and the modality. Occasionally, when imaging is reviewed at these meetings, new findings are discovered that impact on patient management. © 2016 The Royal Australian and New Zealand College of Radiologists.
Interprofessional Education in Neonatal Care.
Kenner, Carole
2016-01-01
Interprofessional education is not a new concept. Yet, the operationalization of interprofessional education with related competencies for collaborative team-based practice in neonatal units is often difficult. Changes in healthcare with an emphasis on patient-focused care and the concern for patient safety and quality care are accelerating the need for more interprofessional education. This article briefly outlines the evolution of interprofessional education to support collaborative team-based practice and how that facilitates safety and quality care in neonatal units.
Homan, Astrid C; Buengeler, Claudia; Eckhoff, Robert A; van Ginkel, Wendy P; Voelpel, Sven C
2015-09-01
Attaining value from nationality diversity requires active diversity management, which organizations often employ in the form of diversity training programs. Interestingly, however, the previously reported effects of diversity training are often weak and, sometimes, even negative. This situation calls for research on the conditions under which diversity training helps or harms teams. We propose that diversity training can increase team creativity, but only for teams with less positive pretraining diversity beliefs (i.e., teams with a greater need for such training) and that are sufficiently diverse in nationality. Comparing the creativity of teams that attended nationality diversity training versus control training, we found that for teams with less positive diversity beliefs, diversity training increased creative performance when the team's nationality diversity was high, but undermined creativity when the team's nationality diversity was low. Diversity training had less impact on teams with more positive diversity beliefs, and training effects were not contingent upon these teams' diversity. Speaking to the underlying process, we showed that these interactive effects were driven by the experienced team efficacy of the team members. We discuss theoretical and practical implications for nationality diversity management. (c) 2015 APA, all rights reserved).
76 FR 22081 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-20
... (CPT). SUMMARY: The North Pacific Fishery Management Council's (NPFMC) Crab Plan Team (CPT) will meet.... SUPPLEMENTARY INFORMATION: The Plan Team will discuss: Election of officers, catch accounting for groundfish...
77 FR 53179 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-31
.... SUMMARY: The North Pacific Fishery Management Council's (NPFMC) Crab Plan Team (CPT) will meet in Seattle.... SUPPLEMENTARY INFORMATION: The Plan Team meeting agenda includes: Final stock assessments and harvest...
Interprofessional management of concussion in sport.
Pabian, Patrick S; Oliveira, Leonardo; Tucker, Jennifer; Beato, Morris; Gual, Carlos
2017-01-01
Due to the high incidence of sports concussion, various health and medical providers are likely to encounter athletes who have sustained such an injury. Management of concussion necessitates coordinated care by the members of the sports medicine team due to its pathophysiology and complexity of management during recovery. All members of the sports medicine team must possess contemporary knowledge of concussion management as well as strong interprofessional communication skills to ensure effective care and safe return to sports participation. Therefore, the aim of this manuscript is to review the current best practices in interdisciplinary management of sports concussion with a special emphasis on the required interprofessional communication among the sports medicine team. Copyright © 2016 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Shaw, James B.
2004-01-01
A longitudinal study of 390 students in 64 Practical Organizational Behavior Education (PROBE) project teams was conducted on the effects of intragroup diversity and student diversity-management skills. The impact of gender, age, and nationality variables on student grades, cognitive processes, perceptions of team effectiveness, and satisfaction…
ERIC Educational Resources Information Center
Van Der Voort, Geoffrey; Wood, Lesley
2014-01-01
This article reports on a first cycle of a larger action research study conducted to determine how Circuit Teams could support School Management Teams of underperforming high schools towards whole-school development. Although it is a mandated requirement by the Department of Education, none of the four schools involved in the study had developed a…
Reengineering of waste management at the Oak Ridge National Laboratory. Volume 1
DOE Office of Scientific and Technical Information (OSTI.GOV)
Myrick, T.E.
1997-08-01
A reengineering evaluation of the waste management program at the Oak Ridge National Laboratory (ORNL) was conducted during the months of February through July 1997. The goal of the reengineering was to identify ways in which the waste management process could be streamlined and improved to reduce costs while maintaining full compliance and customer satisfaction. A Core Team conducted preliminary evaluations and determined that eight particular aspects of the ORNL waste management program warranted focused investigations during the reengineering. The eight areas included Pollution Prevention, Waste Characterization, Waste Certification/Verification, Hazardous/Mixed Waste Stream, Generator/WM Teaming, Reporting/Records, Disposal End Points, and On-Sitemore » Treatment/Storage. The Core Team commissioned and assembled Process Teams to conduct in-depth evaluations of each of these eight areas. The Core Team then evaluated the Process Team results and consolidated the 80 process-specific recommendations into 15 overall recommendations. Benchmarking of a commercial nuclear facility, a commercial research facility, and a DOE research facility was conducted to both validate the efficacy of these findings and seek additional ideas for improvement. The outcome of this evaluation is represented by the 15 final recommendations that are described in this report.« less
2003-02-05
KENNEDY SPACE CENTER, FLA. -- Members of the Recovery Management Team at KSC are at work in the Operations Support Building. They are part of the investigation into the accident that claimed orbiter Columbia and her crew of seven on Feb. 1, 2003, over East Texas as they returned to Earth after a 16-day research mission. From left around the table are Don Maxwell, Safety, United Space Alliance (USA); Russ DeLoach, chief, Shuttle Mission Assurance Branch, NASA; George Jacobs, Shuttle Engineering; Jeff Campbell, Shuttle Engineering; Dave Rainer, Launch and Landing Operations; and the two co-chairs of the Response Management Team, Denny Gagen, Landing Recovery Manager, and Chris Hasselbring, Landing Operations, USA. The team is coordinating KSC technical support and assets to the Mishap Investigation Team in Barksdale, La., and providing support for the Recovery teams in Los Angeles, Texas, New Mexico, Arizona and California. In addition, the team is following up on local leads pertaining to potential debris in the KSC area. .
STS-121: Discovery Mission Management Team Briefing
NASA Technical Reports Server (NTRS)
2006-01-01
The briefing opened with Bruce Buckingham (NASA Public Affairs) introducing John Shannon (Chairman, Mission Management Team, JSC), John Chapman (External Tank Project Manager), Mike Leinbach (Shuttle Launch Director), and 1st Lt. Kaleb Nordgren (USAF 45th Weather Squadron). John Shannon reported that the team for hydrogen loading was proceeding well and the external tank detanking was completed. During detanking the inspection team cracked foam caused by condensation and ice formation as the tank expanded and contracted. Aerothermal analysis and analysis fro ice formation will be completed before launch. John Chapman explained the mechanics of the external tank design, the foam cracking, bracket design, etc. Mike Leinbach discussed the inspection teams and their inspection final inspection for ice formation before and after external tank filling. The inspection team of eight very experienced personnel also use telescopes with cameras to find any problems before launch. Kaleb Nordgren discussed weather and said there was a 40% chance of weather prohibiting launch. The floor was the opened for questions from the press.
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.
44 CFR 206.43 - Emergency support teams.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...
44 CFR 206.43 - Emergency support teams.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...
44 CFR 206.43 - Emergency support teams.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...
44 CFR 206.43 - Emergency support teams.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...
44 CFR 206.43 - Emergency support teams.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under the...
Prevention and Screening in Hereditary Breast and Ovarian Cancer.
Zeichner, Simon B; Stanislaw, Christine; Meisel, Jane L
2016-10-15
In recent years, we have learned a great deal about pathogenic mutations that increase the risk of breast and ovarian cancer, particularly mutations in the BRCA1 and BRCA2 genes. Here we review current guidelines on breast and ovarian cancer screening, prophylactic surgery, and other risk-reduction strategies in patients with these mutations, and we detail the data that drive these recommendations. We also discuss guidelines on screening and management for other cancers associated with BRCA1 and BRCA2, such as male breast cancer, pancreatic cancer, and prostate cancer. Discussions about genetic testing have become more complex with the advent of panel testing, which often allows for testing of a more comprehensive panel of genes than traditional BRCA1 and BRCA2 testing, but which is also associated with a higher likelihood of obtaining results with less clear data to inform management. It is difficult to come to a consensus on how best to address the varied and potentially challenging situations that may arise from genetic testing. The complexity inherent in managing these cases makes a multidisciplinary team-including medical oncologists, surgical oncologists, genetic counselors, reproductive endocrinologists, and medical ethicists-critical to optimization of care.
Gastric neuroendocrine tumours.
Crosby, David A; Donohoe, Claire L; Fitzgerald, Louise; Muldoon, Cian; Hayes, Brian; O'Toole, Dermot; Reynolds, John V
2012-01-01
Gastric neuroendocrine tumours (NETs) are increasingly recognised, and management decisions may be difficult due to an incomplete understanding of aetiology, natural history and optimum therapy. This article presents a current understanding based on recent advances in epidemiology, classification, molecular profiling, and treatment. Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles identified. Selection of articles was based on peer review, journal and relevance. Gastric NETs may be divided into three clinical prognostic groups: type I is associated with autoimmune atrophic gastritis and hypergastrinaemia, type II is associated with Zollinger-Ellison syndrome, and type III lesions are gastrin-independent, have the greatest metastatic potential and poorest prognosis. There has been an increased frequency of gastric NETs reported. Management approaches have evolved in parallel with advances in endoscopic staging and surgery, as well as improved understanding of the biology and natural history of NETs. Gastric NETs present a spectrum of activity from indolent tumours to metastatic malignancy. Treatment decisions for patients must be individualised and are best managed by a multidisciplinary team approach. The current evidence base is limited to small series and efforts to treat patients within clinical networks of expertise are warranted. Copyright © 2012 S. Karger AG, Basel.
Using Agile Project Management to Enhance the Performance of Instructional Design Teams
ERIC Educational Resources Information Center
Sweeney, David S.; Cifuentes, Lauren
2010-01-01
Instructional design models describe in detail methodologies for designing effective instruction. Several widely adopted models include suggestions for managing instructional design projects. However, these suggestions focus on how to manage the instructional design steps rather than the instructional design and development team process. The…
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...
76 FR 42684 - Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-19
... project team working meeting is to consider the scope of action for the 2013-14 harvest specifications and... groundfish project team responsible for drafting and analyzing the 2013-14 harvest specification and management measures for the Pacific Fishery Management Council (Council) will hold a working meeting, which...
75 FR 62507 - New England Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-12
... Committee and Plan Development Team in October 2010 to consider actions affecting New England fisheries in... jointly with the Habitat Plan Development Team to discuss management alternatives related to minimizing... Council's EFH Omnibus Amendment 2. The goal of the meeting is to craft a series of management alternatives...
von Kodolitsch, Yskert; Rybczynski, Meike; Vogler, Marina; Mir, Thomas S; Schüler, Helke; Kutsche, Kerstin; Rosenberger, Georg; Detter, Christian; Bernhardt, Alexander M; Larena-Avellaneda, Axel; Kölbel, Tilo; Debus, E Sebastian; Schroeder, Malte; Linke, Stephan J; Fuisting, Bettina; Napp, Barbara; Kammal, Anna Lena; Püschel, Klaus; Bannas, Peter; Hoffmann, Boris A; Gessler, Nele; Vahle-Hinz, Eva; Kahl-Nieke, Bärbel; Thomalla, Götz; Weiler-Normann, Christina; Ohm, Gunda; Neumann, Stefan; Benninghoven, Dieter; Blankenberg, Stefan; Pyeritz, Reed E
2016-01-01
Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS. First, we show how the initiative and collaboration of patient representatives, scientists, and physicians resulted in the foundation of Marfan centers, initially in the US and later in Germany, and how and why such centers evolved over time. Then, we elucidate the three main structural elements; a team of coordinators, core disciplines, and auxiliary disciplines of health care. Moreover, we explain how a multidisciplinary health care team integrates into many other health care structures of a university medical center, including external quality assurance; quality management system; clinical risk management; center for rare diseases; aorta center; health care teams for pregnancy, for neonates, and for rehabilitation; and in structures for patient centeredness. We provide accounts of medical goals and standards for each core discipline, including pediatricians, pediatric cardiologists, cardiologists, human geneticists, heart surgeons, vascular surgeons, vascular interventionists, orthopedic surgeons, ophthalmologists, and nurses; and of auxiliary disciplines including forensic pathologists, radiologists, rhythmologists, pulmonologists, sleep specialists, orthodontists, dentists, neurologists, obstetric surgeons, psychiatrist/psychologist, and rehabilitation specialists. We conclude that a multidisciplinary health care team is a means to maximize therapeutic success. PMID:27843325
Experience as Knowledge in a New Product Development Team: Implications for Knowledge Management
NASA Technical Reports Server (NTRS)
Cooper, Lynne P.
2009-01-01
This study was conducted to better understand how New Product Development (NPD) team members apply their experiences to meet the task needs of their project. Although "experience" is highly valued in team members, little research has looked specifically at experiences as a type of knowledge, and how this knowledge is used in work settings. This research evaluated nearly 200 instances where team members referenced past experiences during team meetings. During these experience exchanges, team members structured the sharing of their experiences to include three common elements: the source of the experience, the nature of the experience, and the degree of relevance to the current work of the team. The experiences fell into four categories: people (relationships), process, product, and politics. This paper describes how team members structured, applied, and integrated their individual experiences and presents the resulting implications for knowledge management systems that wish to exploit experience knowledge.
Morgeson, Frederick P
2005-05-01
Relatively little empirical research has been conducted on external leaders of self-managing teams. The integration of functional leadership theory with research on team routines suggests that leaders can intervene in teams in several different ways, and the effectiveness of this intervention depends on the nature of the events the team encounters. External team leaders from 3 organizations first described a series of events (N=117), and leaders and team members then completed surveys to quantitatively describe the events. Results indicated that leader preparation and supportive coaching were positively related to team perceptions of leader effectiveness, with preparation becoming more strongly related to effectiveness as event novelty increased. More active leader intervention activities (active coaching and sense making) were negatively related to satisfaction with leadership yet were positively related to effectiveness as events became more disruptive.
France, Daniel J; Leming-Lee, Susie; Jackson, Tom; Feistritzer, Nancye R; Higgins, Michael S
2008-04-01
Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings. Direct observational analyses were performed on 30 surgical teams (15 neurosurgery cases and 15 cardiac cases) to evaluate surgical team compliance with integrated safety and CRM practices after extensive CRM training. Observed surgical teams were compliant with only 60% of the CRM and perioperative safety practices emphasized in the training program. The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.
Interprofessional team management in pediatric critical care: some challenges and possible solutions
Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H
2016-01-01
Background Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. Methods We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. Findings The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one’s own unit, engagement of health care professionals occurs and projects become accepted. Conclusion Bottom–up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety. PMID:26955279
Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H
2016-01-01
Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.
NASA Astrophysics Data System (ADS)
Sanger, Denise; Hernandez, Debra; Libes, Susan; Voulgaris, George; Davis, Braxton; Smith, Erik; Shuford, Rebecca; Porter, Dwayne; Koepfler, Eric; Bennett, Joseph
2010-09-01
Communication of knowledge between the scientific and management communities is a difficult process complicated by the distinctive nature of professional career goals of scientists and decision-makers. This article provides a case history highlighting a collaboration between the science and management communities that resulted from a response to a 2004 hypoxia, or low dissolved oxygen, event in Long Bay, off Myrtle Beach, South Carolina. A working group of scientists and decision-makers was established at the time of the event and has continued to interact to develop a firm understanding of the drivers responsible for hypoxia formation in Long Bay. Several factors were found to be important to ensure that these collaborative efforts were productive: (1) genuine interest in collaboratively working across disciplines to examine a problem; (2) commitment by agency leadership, decision-makers, and researchers to create successful communication mechanisms; (3) respect for each others’ perspectives and an understanding how science and management are performed and that they are not mutually exclusive; (4) networking among researchers and decision-makers to ensure appropriate team members are involved in the process; (5) use of decision-maker input in the formulation of research and monitoring projects; and (6) commitment of resources for facilitation to ensure that researchers and decision-makers are communicating effectively.
Using Team-based Learning to teach a Large-enrollment Environmental Science Course Online
NASA Astrophysics Data System (ADS)
Harder, V.
2013-12-01
Student enrollment in many online courses is usually limited to small classes, ranging from 20-25 students. Over two summers Environmental Science 1301, with an enrollment of 50, has been piloted online using team-based learning (TBL) methods. Teams, consisting of 7 members, were assigned randomly using the group manager tool found in the learning management system. The course was organized around Learning Modules, which consisted of a quiz (individual) over the reading, a team assignment, which covered a topic from one of the chapters was completed for each learning module, and a class/group discussion. The discussion usually entailed a presentation of findings to the class by each team. This allowed teams to interact with one another and was also designed to encourage competition among the teams. Over the course of the class it was observed that as the students became comfortable with the course procedures they developed a commitment to the goals and welfare of their team. They found that as a team they could accomplish much more than an individual; they discovered strengths in their team mates that they, themselves, lacked, and they helped those team mates who struggled with the material. The teams tackled problems that would be overwhelming to an individual in the time allotted, such as running multiple scenarios with the simulations and tackling a large amount of data. Using TBL shifted the majority of responsibility of learning the material to the student with the instructor functioning as a facilitator instead of dispenser of knowledge. Dividing the class into teams made the course load manageable for the instructor while at the same time created a small-class environment for the students. In comparing this course to other, nonTBL-based online courses taught, the work load was very manageable. There were only 7-10 items to be graded per Learning Module and only 7-10 teams to monitor and provide guidance to instead of 50 individuals. Retention rates (86%) were much higher for this course than for nonTBL-based online courses taught by the same instructor and students didn't fall behind.
[Role-specific targets and teamwork in the operating room].
Hoeper, K; Kriependorf, M; Felix, C; Nyhuis, P; Tecklenburg, A
2017-12-01
The primary goal of a surgical team is the successful performance of an operation on a patien; however, this primary goal can show discrepancies from the goals of individual team members. The main causes for differences of interests can be variations in subjective preferences and organizational differences. Subjective preferences are due to the values held by those involved. These values are of an intrinsic nature and therefore difficult to change. Another reason for individual goals is that hospitals and universities are professional bureaucracies. Experts working in professional bureaucracies are known to identify themselves to a greater extent with their respective profession than with their institution; however, teams in the operating room (OR) have to work together in multidisciplinary teams. The main goal of this analysis is to document role-specific targets and motivations within teams. This was a case study at a university hospital with 40 operating rooms. The data collection resulted from the three pillars of the goal documentation instrument, which includes expert interviews, a utility analysis and card placement as a basis for communicative validation. The results were analyzed with a systematic method as a qualitative content analysis. The four-pillar success model, which maps aspects of a successful hospital, was used as a deductive coding scheme. The four pillars represent the level of medical quality (process, structure and outcome quality), economy and efficiency, client satisfaction (patients and referring physicians) and employee satisfaction. At a university hospital an additional focus is on research and teaching. In addition to the four pillar success model as a deductive coding scheme, an inductive coding scheme was introduced. Approximately 10% of the employees from each professional group (surgeons, anesthesiologists, OR nurses, nurse anesthetists) were interviewed resulting in 65 interviews overall. The interviews were conducted within a time span of 4 months. Considering the main categories quality of medical care, economy and efficiency, patient satisfaction and employee satisfaction as well as research and teaching, surgeons thought the categories of economy and efficiency (37%) and quality of medical care (34%) to be the most important. For anesthesiologists, however, the category of employee satisfaction (38%) was most important, followed by the category of economy and efficiency (31%). For the OR nurses as well as for the nurse anesthetists the category of employee satisfaction was of highest priority (61% and 57%, respectively). The results show that considering the main categories no dimension is equally important for the participating professional groups. This can result in goal conflicts. Additionally, the ad hoc teams make it impossible for team building to occur, making it difficult for the professional groups to adapt to each other and the individual goals. This presents a high potential for conflict. The difference in the perception of the importance of employee satisfaction is a crucial factor for emerging conflicts in the OR, as employee satisfaction correlates with productivity and patient satisfaction. Knowing and communicating the different goals is a first step for optimizing the OR management system.
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.
Asselin, Jodie; Salami, Eniola; Osunlana, Adedayo M.; Ogunleye, Ayodele A.; Cave, Andrew; Johnson, Jeffrey A.; Sharma, Arya M.; Campbell-Scherer, Denise L.
2017-01-01
Background: The 5As [Ask, Assess, Advise, Agree, Assist] of Obesity Management Team study was a randomized controlled trial of an intervention that was implemented and evaluated to help primary care providers improve clinical practice for obesity management. This paper presents health care provider perspectives of the impacts of the intervention on individual provider and team practices. Methods: This study reports a thematic network analysis of qualitative data collected during the 5As Team study, which involved 24 chronic disease teams affiliated with family practices in a Primary Care Network in Alberta. Qualitative data from 28 primary care providers (registered nurses/nurse practitioners [n = 14], dietitians [n = 7] and mental health workers [n = 7]) in the intervention arm were collected through semistructured interviews, field notes, practice facilitator diaries and 2 evaluation workshop questionnaires. Results: Providers internalized 5As Team intervention concepts, deepening self-evaluation and changing clinical reasoning around obesity. Providers perceived that this internalization changed the provider-patient relationship positively. The intervention changed relations between providers, increasing interdisciplinary understanding, collaboration and discovery of areas for improvement. This personal and interpersonal evolution effected change to the entire Primary Care Network. Interpretation: The 5As Team intervention had multiple impacts on providers and teams to improve obesity management in primary care. Improved provider confidence and capability is a precondition of developing effective patient interventions. Trial registration: ClinicalTrials.gov, no.: NCT01967797. PMID:28450428
2013-01-01
Background At the time of this study (2009) the role of the nurse practitioner was new to the province of British Columbia. The provincial government gave the responsibility for implementing the role to health authorities. Managers of health authorities, many of whom were unfamiliar with the role, were responsible for identifying the need for the NP role, determining how the NP would function, and gaining team members’ acceptance for the new role. Method The purpose of the study was to explain the process of nurse practitioner role implementation as it was occurring and to identify factors that could enhance the implementation process. An explanatory, single case study with embedded units of analysis was used. The technique of explanation building was used in data analysis. Three primary health care settings in one health authority in British Columbia were purposively selected. Data sources included semi-structured interviews with participants (n=16) and key documents. Results The results demonstrate the complexity of implementing a new role in settings unfamiliar with it. The findings suggest that early in the implementation process and after the nurse practitioner was hired, team members needed to clarify intentions for the role and they looked to senior health authority managers for assistance. Acceptance of the nurse practitioner was facilitated by team members’ prior knowledge of either the role or the individual nurse practitioner. Community health care providers needed to be involved in the implementation process and their acceptance developed as they gained knowledge and understanding of the role. Conclusion The findings suggest that the interconnectedness of the concepts of intention, involvement and acceptance influences the implementation process and how the nurse practitioner is able to function in the setting. Without any one of the three concepts not only is implementation difficult, but it is also challenging for the nurse practitioner to fulfill role expectations. Implications for research, policy, practice and education are discussed. PMID:23343534
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bissani, M; Fischer, R; Kidd, S
2006-04-03
The primary goal of this visit was to perform a joint assessment of the Renewable Energy and Water Desalination Center's (REWDC) program in radioactive waste management. The visit represented the fourth technical and scientific interaction with Libya under the DOE/NNSA Sister Laboratory Arrangement. Specific topics addressed during the visit focused on Action Sheet P-05-5, ''Radioactive Waste Management''. The Team, comprised of Mo Bissani (Team Lead), Robert Fischer, Scott Kidd, and Jim Merrigan, consulted with REWDC management and staff. The team collected information, discussed particulars of the technical collaboration and toured the Tajura facility. The tour included the waste treatment facility,more » waste storage/disposal facility, research reactor facility, hot cells and analytical labs. The assessment team conducted the first phase of Task A for Action Sheet 5, which involved a joint assessment of the Radioactive Waste Management Program. The assessment included review of the facilities dedicated to the management of radioactive waste at the Tourja site, the waste management practices, proposed projects for the facility and potential impacts on waste generation and management.« less
2014 NASA Centennial Challenges Sample Return Robot Challenge
2014-06-14
The NASA Centennial Challenges prize, level one, is presented to team Mountaineers for successfully completing level one of the NASA 2014 Sample Return Robot Challenge, from left, Ken Stafford, WPI Challenge technical advisor; Colleen Shaver, WPI Challenge Manager; Ryan Watson, Team Mountaineers; Marvin Cheng, Team Mountaineers; Alexander Hypes, Team Mountaineers; Jarred Strader, Team Mountaineers; Lucas Behrens, Team Mountaineers; Yu Gu, Team Mountaineers; Nick Ohi, Team Mountaineers; Dorothy Rasco, NASA Deputy Associate Administrator for the Space Technology Mission Directorate; Scott Harper, Team Mountaineers; Tanmay Mandal, Team Mountaineers; David Miller, NASA Chief Technologist; Sam Ortega, NASA Program Manager for Centennial Challenges, Saturday, June 14, 2014, at Worcester Polytechnic Institute (WPI) in Worcester, Mass. Team Mountaineers was the only team to complete the level one challenge. During the competition, teams were required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge was to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)
Team Research at the Biology-Mathematics Interface: Project Management Perspectives
ERIC Educational Resources Information Center
Milton, John G.; Radunskaya, Ami E.; Lee, Arthur H.; de Pillis, Lisette G.; Bartlett, Diana F.
2010-01-01
The success of interdisciplinary research teams depends largely upon skills related to team performance. We evaluated student and team performance for undergraduate biology and mathematics students who participated in summer research projects conducted in off-campus laboratories. The student teams were composed of a student with a mathematics…
Making Choices: Self-Directed Teams or Total Quality Management?
ERIC Educational Resources Information Center
Holpp, Lawrence
1992-01-01
Describes differences between total quality management and self-directed teams in terms of job design, decision making, flexibility, supervision, labor relations, quality, customers, and training. Offers suggestions for which method to choose when. (SK)
75 FR 20985 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-22
.... SUMMARY: The North Pacific Fishery Management Council's Crab Plan Team (CPT) will meet in Alaska on May 10... Council; telephone: (907) 271-2809. SUPPLEMENTARY INFORMATION: The Plan Team will discuss recent Council...
Orach, Christopher Garimol; Mayega, Roy William; Woboya, Vincent; William, Bazeyo
2013-06-01
Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team's performance, roles and experiences following the training. The disasters most commonly experienced by the district teams were epidemics of diseases in humans (7 of 12), animals (epizoonotics) (3 of 12) and crops (3 of 12); hailstorms and floods (3 of 12). The capabilities viewed most useful for management of disasters were provision of health care services (9/12) and response management (8 of 12). The capability domains most often consulted during the disasters were general response management (31%), health services (29%) and water and sanitation (17%). The skills areas perceived to be vital following the training were response to epidemics 10/12, disaster management planning 8/12, hazards and vulnerability analysis 7/12 and principles of disaster planning 7/12 respectively. Main challenges mentioned by district teams were inadequacy of finance and logistics, lack of commitment by key partners towards disaster preparedness and response. The most common disaster experienced disasters related to outbreaks of diseases in man, animals and crops. The most frequently applied capabilities were response management and provision of emergency health services. The activities most frequently implemented following disaster management teams training were conducting planning meetings, refinement of plans and dissemination of skills gained. The main challenges were related to limited budget allocations and legal frameworks for disaster management that should be addressed by both central and local governments.
STS-121: Discovery Post Launch Press Briefing
NASA Technical Reports Server (NTRS)
2006-01-01
The briefing begins with Dean Acousta (NASA Press Secretary) introducing Michael Griffin (NASA Administrator), Bill Gerstenmaier (Associate Administrator for Space Operations) Wayne Hale (Space Shuttle Program Manager), John Shannon (Chairman, Mission Management Team, JSC), and Mike Leinbach (NASA Launch Director). The teams effort and dedication paid off in the form of a perfect launch and the weather cooperated. The Mission Management Team no problems during inspection. Debris assessment at 2 min. 47 sec. and 4 min. 50 sec. will be discussed when that information becomes available.The floor was then open for questions from the press.
Science operations management. [with Infrared Astronomy Satellite project
NASA Technical Reports Server (NTRS)
Squibb, G. F.
1984-01-01
The operation teams engaged in the IR Astronomical Satellite (IRAS) project included scientists from the IRAS International Science Team. The detailed involvement of these scientists in the design, testing, validation, and operations phases of the IRAS mission contributed to the success of this project. The Project Management Group spent a substantial amount of time discussing science-related issues, because science team coleaders were members from the outset. A single scientific point-of-contact for the Management Group enhanced the depth and continuity of agreement reached in decision-making.
Closing the Generational Gap in Surgery: Why So Angry?
2016-01-01
Summary: Significant and rapid changes in healthcare delivery are forcing surgeons into collaborative teams. Additionally, surgeons are faced with new bureaucratic requirements that do not directly impact patient care, but nevertheless require allocation of time and attention. Surgeons are required to communicate with an expanding group of individuals at various professional levels, adding further stress to daily tasks. Even the method of communication is undergoing rapid transformation. Some surgeons, especially those who are members of the Boomer or X Generation, find this revolution difficult to manage; whereas those who are members of the Y Generation may in fact be better equipped. Surgeons who either refuse to acknowledge these changes or simply lack emotional self-awareness run the risk of being labeled as disruptive. Behavioral techniques are explored which may help those surgeons who are having difficulty. PMID:27826481
Parkinson, Lynne; Richardson, Kristy; Sims, Jane; Wells, Yvonne; Naganathan, Vasi; Brooke, Elizabeth; Lindley, Richard
2013-10-01
The aim of this study was to identify seminal Australasian Journal on Ageing papers published over 30 years through a Delphi consensus process. The main data collection was a three-round Delphi consensus study with 38 past and current members of the Australasian Journal on Ageing Editorial Board, Editorial Team and Management Committee. Three papers were agreed as top-ranking. One of the top-ranking articles was also highly cited. One article was published in the 1990 s, two in 2001. While it is difficult to judge how well the top-ranking papers represent seminal papers arising over 30 years, these papers do represent three different research strengths in Australasia, they do span three different disciplines, and they do reflect some of the diversity that characterises ageing research in Australasia over 30 years. © 2013 ACOTA.
Test results management and distributed cognition in electronic health record-enabled primary care.
Smith, Michael W; Hughes, Ashley M; Brown, Charnetta; Russo And, Elise; Giardina, Traber D; Mehta, Praveen; Singh, Hardeep
2018-06-01
Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses. We performed content analysis using a distributed cognition approach, identifying patterns of information transmission across people and artifacts (e.g. electronic health records). Results illustrate challenges (e.g. information overload) as well as strategies used to overcome challenges. Various communication paths were used. Some team members served as intermediaries, processing information before relaying it. Artifacts were used as memory aids. Health information technology should address the risks of distributed work by supporting awareness of team and task status for reliable management of results.
Management Academy for Public Health: Creating Entrepreneurial Managers
Orton, Stephen; Umble, Karl; Zelt, Sue; Porter, Janet; Johnson, Jim
2007-01-01
The Management Academy for Public Health develops public health managers’ management skills. Ultimately, the program aims to develop civic entrepreneurs who can improve the efficiency and the effectiveness of their organizations. With help from a coach, teams write public health business plans to meet needs in their communities. An external evaluation found that 119 teams trained during the first 3 years of the program generated more than $6 million in enhanced revenue—including grants, contracts, and fees through their business plans—from $2 million in program funding. Approximately 38% of the teams expected to generate revenue from an academy business plan or a spin-off plan. Action-learning methods can help midcareer managers transfer their training to the workplace and build entrepreneurial skills. PMID:17329658
Improvement of Project Portfolio Management in an Information Technology Consulting Company
NASA Astrophysics Data System (ADS)
Kaewta, S.; Chutima, P.
2014-06-01
The scope of this research is to improve the efficiency of multiple project management in an information technology consulting company through the adaptation of the project portfolio management technique. The project management information system (PMIS) is implemented to establish effective communication channels so that internal and external teams as well as all relevant stakeholders can be employed to negotiate their work schedules. In addition, all activities created by multiple teams can be systematically reviewed and combined into a single checklist to be used as an agreed working plan for all team members. A general guideline for project portfolio management in information technology consulting companies is also proposed, which could results in a higher level of project on-time delivery.
Project Management, Critical Praxis, and Process-Oriented Approach to Teamwork
ERIC Educational Resources Information Center
Ding, Huiling; Ding, Xin
2008-01-01
To help alleviate issues of free-riding and conflicts in team projects, this study proposes the systematic incorporation of project management methods to introduce a process-oriented approach to and a critical praxis in team projects. We examined how the systematic use of project management methods influenced students' performance in team…
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...
Using a Multiperspective Design Team to Develop and Manage Multilayered Online Courses
ERIC Educational Resources Information Center
Anderson, Nella Bea; Poole, L. Lori; Quinn, Stephanie; Schlicht, Carrie L.
2014-01-01
The focus of this research-based review is how to best develop and manage online classes. After receiving faculty, student, and industry feedback, Colorado State University-Global Campus integrated multi-perspective design teams to develop and manage multilayered online courses. This article will reveal the instructional design, development…
The Academic Administrator Grid. A Guide to Developing Effective Management Teams.
ERIC Educational Resources Information Center
Blake, Robert R.; And Others
The use of the "management grid" method of organizational development in college and university administration is described in this adaptation of the 1964 book by the same authors, "The Management Grid." Five major administrative styles are identified: (1) caretaker, (2) comfortable and pleasant, (3) constituency-centered, (4) team, and (5)…
ERIC Educational Resources Information Center
Rogers, Camille, Ed.
The conference paper topics include: business and information technology (IT) education; knowledge management; teaching software applications; development of multimedia teaching materials; technology job skills in demand; IT management for executives; self-directed teams in information systems courses; a team building exercise to software…
Managing Complex Distance Education Projects in a Telework Environment
ERIC Educational Resources Information Center
Ally, Mohamed; Cleveland-Innes, Marti; Wiseman, Colin
2010-01-01
The advances of communication technologies have allowed professionals to work on distance education projects in a telework environment. Managers of these projects must have the skills to manage the projects from a distance. They must be able to select the appropriate team members to work on the project, orient team members, and monitor team…
Incident Management Organization succession planning stakeholder feedback
Anne E. Black
2013-01-01
This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...
Multidisciplinary management of hepatoblastoma in children: Experience from a developing country.
Shanmugam, Naresh; Scott, Julius Xavier; Kumar, Vimal; Vij, Mukul; Ramachandran, Priya; Narasimhan, Gomathy; Reddy, Mettu Srinivas; Kota, Venugopal; Munirathnam, Deenadayalan; Kelgeri, Chayarani; Sundaram, Karthick; Rela, Mohamed
2017-03-01
Advances in chemotherapy, liver resection techniques, and pediatric liver transplantation have vastly improved survival in children with hepatoblastoma (HB). These are best managed by a multidisciplinary team (MDT) in a setting where all treatment options are available. Until recently, this was difficult to achieve in India. All children (<16 years) with HB treated in a pediatric liver surgery and transplantation unit between January 2011 and July 2016 were reviewed. Data regarding the clinical presentation, preoperative management, surgical treatment, postoperative course, and outcomes were extracted from a prospectively managed database. Thirty children were treated for HB during the study period. Nine children were PRETEXT 4, 7 were PRETEXT 3, 13 were PRETEXT 2, and 1 was PRETEXT 1 (where PRETEXT is pretreatment extension). All children received a neoadjuvant chemotherapy before surgery followed by an adjuvant chemotherapy. Nineteen children had complete resection, while six underwent primary living donor liver transplantation. There were six mortalities including five children who poorly responded to chemotherapy with progressive tumor extension. At a median follow-up of 30 months, two children who underwent resection and one child who underwent liver transplant had disease recurrence. Improved outcomes can be achieved in children with HB even in countries with limited resources when they are managed by MDTs with expertise in pediatric oncology, liver resection, and liver transplantation. © 2016 Wiley Periodicals, Inc.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mauriello, P.J.; Ragbeer, D.
1997-12-01
In the wake of the U.S. Supreme Court decision in the Carbone vs. Clarkstown case striking down waste flow control as unconstitutional, Dade County, Florida, one of the most severely impacted communities in the nation, has managed to stabilize its waste stream and balance its solid waste department finances; although the road taken to restabilization has been a difficult one. At its peak in 1995, Dade County experienced an annual loss of solid waste in excess of 1,000,000 tons, or over 40 percent of the waste stream normally handled by the County. This diversion of waste was accompanied by amore » net revenue loss of $30 million per year. The County lost its ability to plan for future capacity needs, or to assure sufficient future waste flows to meet its put-or-pay obligation to the County`s Resources Recovery plant operator. The County`s solid waste management system bonds were downgraded by Moody`s Investors Service and Standard and Poors. With the help of a special solid waste management team, appointed by the County Manager, the department was able to rightsize its waste disposal operations to fit its reduced waste flows, stabilize its waste stream, and develop strategies to solve its long-term funding shortfall.« less
78 FR 69650 - North Pacific Fishery Management Council; Public Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-20
... the North Pacific Fishery Management Council's Scallop Plan Team. SUMMARY: The Scallop Plan Team (SPT... teleconference will be held at the Old Federal Building, 605 W 4th Avenue, Room 205, Anchorage, AK. Council...
Traffic management teams : a description and action plan for Virginia.
DOT National Transportation Integrated Search
1988-01-01
A traffic management team improves the overall traffic operations in an urban area, especially along urban corridors, through the communication, coordination, and cooperation of the transportation-related operational agencies in the area. Since vario...
Eggert, G M; Zimmer, J G; Hall, W J; Friedman, B
1991-10-01
This randomized controlled study compared two types of case management for skilled nursing level patients living at home: the centralized individual model and the neighborhood team model. The team model differed from the individual model in that team case managers performed client assessments, care planning, some direct services, and reassessments; they also had much smaller caseloads and were assigned a specific catchment area. While patients in both groups incurred very high estimated health services costs, the average annual cost during 1983-85 for team cases was 13.6 percent less than that of individual model cases. While the team cases were 18.3 percent less expensive among "old" patients (patients who entered the study from the existing ACCESS caseload), they were only 2.7 percent less costly among "new" cases. The lower costs were due to reductions in hospital days and home care. Team cases averaged 26 percent fewer hospital days per year and 17 percent fewer home health aide hours. Nursing home use was 48 percent higher for the team group than for the individual model group. Mortality was almost exactly the same for both groups during the first year (about 30 percent), but was lower for team patients during the second year (11 percent as compared to 16 percent). Probable mechanisms for the observed results are discussed.
ASC Distribution Management Center (DMC) Provides Materiel Management Capability
2008-09-01
Distribution Management Center (DMC) is the single interface for the synchronization and integration of logistical functions among active Army units in CONUS...with an integrated team of Soldiers, government service employees, and contractors assigned to Rock Island, as well as forward-positioned Distribution ... Management Teams (DMTs) at 15 major Army installations throughout CONUS, Alaska, and Hawaii. The current DMC structure provides the benefit of
A mixed methods evaluation of paediatric trainee preparedness to manage cardiopulmonary arrests.
Walsh, Órla; Lydon, Sinéad; O'Connor, Paul
2017-12-01
Paediatric cardiopulmonary arrest (CPA) survival rates are strongly linked to the training of the doctors responding to the event. This study sought to characterise the level of experience in managing CPAs among paediatric trainees and to investigate the nontechnical (NTS) required to effectively lead a paediatric CPA team. A mixed-methods research design was used. For the quantitative phase, a questionnaire was developed to assess training, confidence, and experiences related to CPA management. During the qualitative phase, 17 paediatric trainees participated in a series of critical incident technique (CIT) interviews to explore the NTS used during the management of paediatric CPAs. A total of 56 of 131 (37.1% response rate) trainees responded to the preparedness questionnaire. A total of 48.2% of respondents expressed low confidence in their skill as a team leader during the management of a CPA. The CIT interviews highlighted deficiencies in specific NTS (identifying options, prioritising, and identifying and utilising resources). Our results indicate that there is a desire for more training in CPA management among paediatric trainees, in particular as a team leader, which includes a focus on key NTS. What is Known • Levels of preparedness to be a paediatric cardiopulmonary arrests team member/leader are generally lower than desirable. • The importance of nontechnical skills to the effective performance of adult cardiopulmonary arrests teams has been identified. What is New • Levels of preparedness to be a cardiopulmonary arrests team member were higher than reported in US studies. • There is a need for greater training in cardiopulmonary arrest management which includes a focus on key nontechnical skills to include identifying options, prioritising, identifying and utilising resources.
ERIC Educational Resources Information Center
Edmondson, Amy; Bohmer, Richard; Pisano, Gary
2001-01-01
A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)
Teams in Education: Creating an Integrated Approach.
ERIC Educational Resources Information Center
Arcaro, Jerome S.
This handbook is designed to help educational professionals develop cross-functional or departmental quality teams. Nine chapters focus on: (1) the concept of Total Quality Management (TQM) and 14 points for quality in education; (2) team goals and formation; (3) stages of successful team building; (4) the development of quality task teams; (5)…
The Effect of Shared versus Individual Reflection on Team Outcomes
ERIC Educational Resources Information Center
Domke-Damonte, Darla J.; Keels, J. Kay
2015-01-01
In this study, teams in a strategic management classroom were given one of two versions of an assignment related to the development of a team contract: independent individual reflections on desired team behaviors versus team-level reflections on desired behavioral norms. Results of a multivariate analysis of covariance, controlling for gender and…
Two-year outcome of team-based intensive case management for patients with schizophrenia.
Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U
1995-12-01
Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.
Karim, Sherko Abdullah Molah; Abdulla, Karzan Seerwan; Abdulkarim, Qalandar Hussein; Rahim, Fattah Hama
2018-04-01
Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgery that carries a high rate of major complications, including delayed gastric emptying (DGE), pancreatic fistula, bleeding, intra-abdominal collection, and pulmonary complications. In this study, we have tried to demonstrate the outcomes, and rates of complications from patients who had undergone this procedure by our surgical team. This retrospective study has been constructed on 98 patients who underwent pancreaticoduodenectomy from May 2010 to November 2017 in three different hospitals of the Sulaimanyah governorate in the Kurdistan region of Iraq by the same surgical team. Data was collected from the medical records of patients. A preoperative work up had done for all patients, including those who are necessary for anesthesia fitness and those for staging assessment. None of the operated patients received any types of neoadjuvant therapy. Out of all 98 patients who underwent PD, the most common complication was wound infection (23.5%), followed by pancreatic leak (21.4%). The pulmonary complication rate was 17.3%, while the intra-abdominal collection rate was 12.2%. In 12.2% of our patients we faced postoperative bleeding, with five patients having to be reopened for this reason. About 77.3% of patients that underwent preoperative ERCP had difficult bile duct dissection. There was an association between preoperative ERCP and difficult bile duct dissection (P Value < 0.001). Outcomes of our surgical team compared to the published data of some other centers. Preoperative ERCP seems to make difficulty in bile duct dissection during PD. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Using Rituals to Strengthen Your Medical Practice Team.
Hills, Laura
2015-01-01
Rituals can cement the identity of and strengthen the bonds between any people, including the members of the medical practice team. This article presents the idea that the medical practice manager is in the ideal position to create and use rituals for team building. It defines the term ritual, and explores how rituals differ from customs or traditions. As well, it describes six benefits of rituals and the hallmarks of the most effective team rituals; describes seven creative and interesting corporate rituals that medical practice managers can study for inspiration; suggests 20 excellent opportunities within the medical practice calendar year for medical practice team rituals; and identifies six kinds of rituals that are used in organizations. Finally, this article provides a four-step action plan for ritualizing your medical practice team's morning huddles.
ERIC Educational Resources Information Center
Alotaibi, Norah Muhayya; Tayeb, Aziza
2016-01-01
Sound leadership has an important role in achieving the success of any institution; so the leader must possess some work team leadership skills such as decision-taking, communication, motivation, conflict management and meeting management. The current study is an attempt to identify the extent of practicing team work leadership skills among the…
Strength in Numbers: A Team-Based Approach to Managing Patients with Hyponatremia.
Adams, Kirkwood; Kearney, Michelle; Lee, Kiwon; Rhoney, Denise; Smith, K Melissa
2018-05-24
This virtual patient panel provides learners with real-world application of best practices among various members of the healthcare team in the management of patients with hyponatremia. A patient case is provided, followed by discussion among the team members to provide insight and context to why particular courses of action were chosen. (Online access: https://courses.elseviercme.com/hyponatremia17). Copyright © 2018. Published by Elsevier Inc.
Towards a Methodology for Managing Competencies in Virtual Teams - A Systemic Approach
NASA Astrophysics Data System (ADS)
Schumacher, Marinita; Stal-Le Cardinal, Julie; Bocquet, Jean-Claude
Virtual instruments and tools are future trends in Engineering which are a response to the growing complexity of engineering tasks, the facility of communication and strong collaborations on the international market. Outsourcing, off-shoring, and the globalization of organisations’ activities have resulted in the formation of virtual product development teams. Individuals who are working in virtual teams must be equipped with diversified competencies that provide a basis for virtual team building. Thanks to the systemic approach of the functional analysis our paper responds to the need of a methodology of competence management to build virtual teams that are active in virtual design projects in the area of New Product Development (NPD).
[The function of team-meetings for treatment teams on child and adolescent psychiatric wards].
Branik, Emil; Meng, Heiner
2006-01-01
In the daily work of multidisciplinary teams on child and adolescent psychiatric wards team-meetings play a central role to coordinate various treatment activities. In medical literature studies on the topic are lacking, and only few articles were found. The authors explore by a descriptive-hermeneutic analysis the numerous functions of meetings for the treatment team. To them belong catharsis, containment, reflection, regulation and integration. Psychodynamic, group dynamical and institutional factors will be described regarding their influence on the therapy management. Issues of power in institutions will be comprised in the discussion. The dialectical tension between professionalism and emotionality in the work with patients especially from the borderline-spectrum as well as between unity and diversity within the treatment team in regard to the different roles of each and everyone team member will be presented. Hints at how to manage these tensions will be given to preserve the therapeutical milieu on the ward.
A Project Team Analysis Using Tuckman's Model of Small-Group Development.
Natvig, Deborah; Stark, Nancy L
2016-12-01
Concerns about equitable workloads for nursing faculty have been well documented, yet a standardized system for workload management does not exist. A project team was challenged to establish an academic workload management system when two dissimilar universities were consolidated. Tuckman's model of small-group development was used as the framework for the analysis of processes and effectiveness of a workload project team. Agendas, notes, and meeting minutes were used as the primary sources of information. Analysis revealed the challenges the team encountered. Utilization of a team charter was an effective tool in guiding the team to become a highly productive group. Lessons learned from the analysis are discussed. Guiding a diverse group into a highly productive team is complex. The use of Tuckman's model of small-group development provided a systematic mechanism to review and understand group processes and tasks. [J Nurs Educ. 2016;55(12):675-681.]. Copyright 2016, SLACK Incorporated.
Brainstem dysgenesis during the neonatal period: diagnosis and management.
Castilla-Fernández, Yolanda; Boix, Héctor; Macaya, Alfons; Vázquez, Elida; Gratacòs, Margarida; Roig-Quilis, Manuel
2013-07-01
To report our neonatal management experience in patients who received a diagnosis of brainstem dysgenesis (BSD). This study retrospectively reviewed the medical records of 15 neonates with BSD diagnosed between 1984 and 2011. Data on the perinatal period, physical examination, laboratory findings, and management by systems were systematically analyzed. All cases were sporadic. Cocaine abuse and misoprostol use were recorded in two pregnancies. The reason for admission was prematurity (2 of 15), respiratory distress (8 of 15), gastroschisis (1 of 15), and abnormal neurological examination (4 of 15). Clinically, the most commonly affected cranial nerves were the 7th (13 of 15), 9th (11 of 15), 10th (8 of 15), 5th (7 of 15), 12th (7 of 15), 6th (3 of 15), 4th (1 of 15), and 3rd (1 of 15). Five patients required positive pressure ventilation during delivery room resuscitation, three had difficult airways, and two needed tracheostomy during admission. Most patients required nasogastric tube feeding shortly after birth, and four patients had a gastrostomy on discharge. Two patients died of respiratory and cardiac failure. Electromyography and nerve conduction velocity were used to exclude generalized neuromuscular disorders, and in conjunction with other neurophysiological and gastrointestinal tract studies, helped uncover the extent of brainstem involvement in most cases. Cranial magnetic resonance imaging supported the diagnosis in more than half of the patients. Early diagnosis of BSD is mainly clinical, difficult to establish unless suspected, and crucial to prevent complications. Neonatal care of patients with BSD requires a comprehensive approach that must take into consideration the etiological, anatomical, and pathogenic aspects contributing to the clinical manifestations of this disorder. Care should be provided by multidisciplinary teams, in which neonatologists, pediatric neurologists, nutritionists, physical therapists, and other professionals participate, depending on the associated morbidity in order to improve its management and prognosis.
[Developing team reflexivity as a learning and working tool for medical teams].
Riskin, Arieh; Bamberger, Peter
2014-01-01
Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.
Managing the culturally diverse medical practice team: twenty-five strategies.
Hills, Laura
2014-01-01
A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.
A powerful team: the family physician advocating for patients with a rare disease.
Dudding-Byth, Tracy
2015-09-01
Rare diseases are characteristically difficult to diagnose and for the majority, there are no effective treatments or evidence-based management guidelines. Although it is unrealistic to expect family physicians to recognise the wide clinical spectrum of rare diseases, their longitudinal and holistic approach to medicine place them in a unique position to consider the possibility of a rare disease. This article outlines the challenges faced by the rare disease community, and the role of the primary care physician to advocate for answers as their patients transition through the healthcare system. The road to the diagnosis of a rare disease can test the doctor-patient relationship. Patients often struggle for answers and family physicians are stymied by a lack of information. At the same time, the availability of cyber-based health information and online rare-disease patient groups has led to the emergence of the 'expert' patient, who seeks a collaborative and empowering relationship with their physician. Following diagnosis, the family physician plays a crucial part in providing continuity of care, advocating access to expert healthcare, coordinating complex management and becoming a source of psychological support.
Primary Immune Deficiencies – Principles of Care
Chapel, Helen; Prevot, Johan; Gaspar, Hubert Bobby; Español, Teresa; Bonilla, Francisco A.; Solis, Leire; Drabwell, Josina
2014-01-01
Primary immune deficiencies (PIDs) are a growing group of over 230 different disorders caused by ineffective, absent or an increasing number of gain of function mutations in immune components, mainly cells and proteins. Once recognized, these rare disorders are treatable and in some cases curable. Otherwise untreated PIDs are often chronic, serious, or even fatal. The diagnosis of PIDs can be difficult due to lack of awareness or facilities for diagnosis, and management of PIDs is complex. This document was prepared by a worldwide multi-disciplinary team of specialists; it aims to set out comprehensive principles of care for PIDs. These include the role of specialized centers, the importance of registries, the need for multinational research, the role of patient organizations, management and treatment options, the requirement for sustained access to all treatments including immunoglobulin therapies and hematopoietic stem cell transplantation, important considerations for developing countries and suggestions for implementation. A range of healthcare policies and services have to be put into place by government agencies and healthcare providers, to ensure that PID patients worldwide have access to appropriate and sustainable medical and support services. PMID:25566243
Towards ethical decision support and knowledge management in neonatal intensive care.
Yang, L; Frize, M; Eng, P; Walker, R; Catley, C
2004-01-01
Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.
Spanish consensus for the management of sinonasal tumors.
López, Fernando; Grau, Juan José; Medina, José Antonio; Alobid, Isam
Sinonasal tumors are rare neoplasms with distinctive clinical, aetiological and pathological features. The diagnosis and treatment of these tumours is challenging because of their low incidence, histological diversity and production of non-specific symptoms in the early stages. They have a variable prognosis depending on their histology, origin and staging. Their location, close to neurocritical structures, which are of special relevance to surgery and postoperative treatment, makes their treatment difficult and complex, leading to high morbidity and mortality. Surgery followed by radiotherapy is the mainstay of treatment. To provide the best possible care, patients with sinonasal cancer should be treated in clinical referral centres specializing in skull-base pathologies. Such centres should include a multidisciplinary team led by otolaryngologist surgeons. This article outlines a consensus protocol for the management of these tumours devised by the Spanish Society of Otolaryngology in collaboration with the Spanish Society of Medical Oncology and the Spanish Society for Radiation Oncology. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.
Conflict management styles of Asian and Asian American nurses: implications for the nurse manager.
Xu, Yu; Davidhizar, Ruth
2004-01-01
Foreign nurses and American nurses who are culturally diverse make up an increasing number of the US nursing workforce. Of foreign nurses, Asians constitute the largest number. Conflict is an inevitable aspect of human relations in health care settings. Nurses and other health team members with diverse cultural background bring to the workplace different conflict behaviors that directly impact the outcomes of conflicts. It is essential for health care team members and managers to be cognizant of different conflict behaviors as well as different conflict management styles so that strategies can be designed to build a culturally diverse health care team that is able to effectively achieve group and organizational objectives.
Kelm, Diana J; Ridgeway, Jennifer L; Gas, Becca L; Mohan, Monali; Cook, David A; Nelson, Darlene R; Benzo, Roberto P
2018-05-18
Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress. A better understanding of this process could lead to more effective training approaches, improved team performance, and better patient outcomes. All participants were instructed to use a mindfulness meditation device (Muse™ headband) at home for 7 min twice a day or 14 min daily over the 4-week training period. This device uses brainwave sensors to monitor active versus relaxing brain activity and provides real-time feedback. We conducted a single-group pretest-posttest convergent mixed-methods study. We enrolled 24 healthcare providers, comprising 4 interprofessional code teams, including physicians, nurses, respiratory therapists, and pharmacists. Each team participated in a simulation session immediately before and after the mindfulness training period. Each session consisted of two simulated cardiopulmonary arrest scenarios. Both quantitative and qualitative outcomes were assessed. The median proportion of participants who used the device as prescribed was 85%. Emotional balance, as measured by the critical positivity ratio, improved significantly from pretraining to posttraining (p = .02). Qualitative findings showed that mindfulness meditation changed how participants responded to work-related stress, including stress in real-code situations. Participants described the value of time for self-guided practice with feedback from the device, which then helped them develop individual approaches to meditation not reliant on the technology. Time measures during the simulated scenarios improved, specifically, time to epinephrine in Scenario 1 (p = .03) and time to defibrillation in Scenario 2 (p = .02), improved. In addition, team performance, such as teamwork (p = .04), task management (p = .01), and overall performance (p = .04), improved significantly after mindfulness meditation training. Physiologic stress (skin conductance) improved but did not reach statistical significance (p = .11). Mindfulness meditation practice may improve individual well-being and team function in high-stress clinical environments. Our results may represent a foundation to design larger confirmatory studies.
Tiger Team Assessment of the Fermi National Accelerator Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-06-01
This draft report documents the Tiger Team Assessment of the Fermi National Accelerator Laboratory (Fermilab) located in Batavia, Illinois. Fermilab is a program-dedicated national laboratory managed by the Universities Research Association, Inc. (URA) for the US Department of Energy (DOE). The Tiger Team Assessment was conducted from May 11 to June 8, 1992, under the auspices of DOE's Office of Special Projects (OSP) under the Office of the Assistant Secretary for Environment, Safety and Health (EH). The assessment was comprehensive, encompassing environmental, safety and health (ES H), and quality assurance (QA) disciplines; site remediation; facilities management; and waste management operations.more » Compliance with applicable Federal , State of Illinois, and local regulations; applicable DOE Orders; best management practices; and internal Fermilab requirements was addressed. In addition, an evaluation of the effectiveness of DOE and Fermilab management of the ES H/QA and self-assessment programs was conducted. The Fermilab Tiger Team Assessment is part a larger, comprehensive DOE Tiger Team Independent Assessment Program planned for DOE facilities. The objective of the initiative is to provide the Secretary of Energy with information on the compliance status of DOE facilities with regard to ES H requirements, root causes for noncompliance, adequacy of DOE and contractor ES H management programs, response actions to address the identified problem areas, and DOE-wide ES H compliance trends and root causes.« less
Tiger Team Assessment of the Fermi National Accelerator Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-06-01
This draft report documents the Tiger Team Assessment of the Fermi National Accelerator Laboratory (Fermilab) located in Batavia, Illinois. Fermilab is a program-dedicated national laboratory managed by the Universities Research Association, Inc. (URA) for the US Department of Energy (DOE). The Tiger Team Assessment was conducted from May 11 to June 8, 1992, under the auspices of DOE`s Office of Special Projects (OSP) under the Office of the Assistant Secretary for Environment, Safety and Health (EH). The assessment was comprehensive, encompassing environmental, safety and health (ES&H), and quality assurance (QA) disciplines; site remediation; facilities management; and waste management operations. Compliancemore » with applicable Federal , State of Illinois, and local regulations; applicable DOE Orders; best management practices; and internal Fermilab requirements was addressed. In addition, an evaluation of the effectiveness of DOE and Fermilab management of the ES&H/QA and self-assessment programs was conducted. The Fermilab Tiger Team Assessment is part a larger, comprehensive DOE Tiger Team Independent Assessment Program planned for DOE facilities. The objective of the initiative is to provide the Secretary of Energy with information on the compliance status of DOE facilities with regard to ES&H requirements, root causes for noncompliance, adequacy of DOE and contractor ES&H management programs, response actions to address the identified problem areas, and DOE-wide ES&H compliance trends and root causes.« less
Spits, Christine; Wallace, Luke; Reinke, Karin
2017-01-01
Visual assessment, following guides such as the Overall Fuel Hazard Assessment Guide (OFHAG), is a common approach for assessing the structure and hazard of varying bushfire fuel layers. Visual assessments can be vulnerable to imprecision due to subjectivity between assessors, while emerging techniques such as image-based point clouds can offer land managers potentially more repeatable descriptions of fuel structure. This study compared the variability of estimates of surface and near-surface fuel attributes generated by eight assessment teams using the OFHAG and Fuels3D, a smartphone method utilising image-based point clouds, within three assessment plots in an Australian lowland forest. Surface fuel hazard scores derived from underpinning attributes were also assessed. Overall, this study found considerable variability between teams on most visually assessed variables, resulting in inconsistent hazard scores. Variability was observed within point cloud estimates but was, however, on average two to eight times less than that seen in visual estimates, indicating greater consistency and repeatability of this method. It is proposed that while variability within the Fuels3D method may be overcome through improved methods and equipment, inconsistencies in the OFHAG are likely due to the inherent subjectivity between assessors, which may be more difficult to overcome. This study demonstrates the capability of the Fuels3D method to efficiently and consistently collect data on fuel hazard and structure, and, as such, this method shows potential for use in fire management practices where accurate and reliable data is essential. PMID:28425957
Cleanroom Software Engineering Reference Model. Version 1.0.
1996-11-01
teams. It also serves as a baseline for continued evolution of Cleanroom practice. The scope of the CRM is software management , specification...addition to project staff, participants include management , peer organization representatives, and customer representatives as appropriate for...2 Review the status of the process with management , the project team, peer groups, and the customer . These verification activities include
The influence of incident management teams on the deployment of wildfire suppression resources
Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson
2017-01-01
Despite large commitments of personnel and equipment to wildfire suppression, relatively little is known about the factors that affect how many resources are ordered and assigned to wildfire incidents and the variation in resources across incident management teams (IMTs). Using detailed data on suppression resource assignments for IMTs managing the highest complexity...
Structuring Effective Student Teams.
ERIC Educational Resources Information Center
Dickson, Ellen L.
1997-01-01
Experience with student teams working on policy analysis projects indicates the need for faculty supervision of teams in the process of addressing complex issues. The problem-solving approach adopted in one policy analysis course is described, including assignments and tasks, issues and sponsors, team dynamics, conflict management, and the…
Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A
2017-02-01
Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
... palliative care team works in conjunction with your oncology care team to manage your care and maintain ... among family member, caregivers, and members of the oncology care team. When is palliative care used in ...
Standardizing Management of Adults with Delirium Hospitalized on Medical-Surgical Units.
Angel, Clay; Brooks, Kristen; Fourie, Julie
2016-01-01
Delirium is common among inpatients aged 65 years and older and is associated with multiple adverse consequences, including increased length of stay (LOS). However, delirium is frequently unrecognized and poorly understood. At one hospital, baseline management of delirium on medical-surgical units varied greatly, and psychiatric consultations focused exclusively on crisis management. To implement a multidisciplinary program for rapid identification and proactive management of patients with delirium on medical-surgical units. A pilot from September 2010 to July 2012 included 920 unique patients, of whom 470 were seen by the delirium management team. A delirium management team included a redesigned role for consulting psychiatrists and a new clinical nurse specialist role; the team provided assistance with diagnosis and recommendations for nonpharmacologic and pharmacologic management of delirium. Multidisciplinary education focused on delirium identification and management and nurses' use of appropriate assessment tools. Electronic health record functions supported accurate problem list coding, referrals to the team, and standardized documentation. Length of stay. During the study period, average LOS in the target population decreased from 8.5 days to 6.5 days (p = 0.001); average LOS for the Medical Center remained stable. Compared with patients whose delirium was diagnosed during the baseline period, patients who received a delirium diagnosis during the pilot period had a higher illness burden and were likelier to have a history of delirium and diagnosed dementia. Program implementation was associated with reduced LOS among older inpatients with delirium. The delirium team is an effective model that can be quickly implemented with few additional resources.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sproles, A.
1993-03-01
During summer 1992, the World Association of Nuclear Operators (WANO) sponsored an exchange visit between Georgia Power Company's Edwin I. Hatch nuclear plant, a two-unit boiling water reactor site, and the Smolensk atomic energy station, a three-unit RBMK (graphite-moderated and light-water-cooled) plant located 350 km west of Moscow, in Desnogorsk, Russia. The Plant Hatch team included Glenn Goode, manager of engineering support; Curtis Coggin, manager of training and emergency preparedness; Wayne Kirkley, manager of health physics and chemistry; John Lewis, manager of operations; Ray Baker, coordinator of nuclear fuels and contracts; and Bruce McLeod, manager of nuclear maintenance support. Alsomore » traveling with the team was Jerald Towgood, of WANO's Atlanta Centre. The Hatch team visited the Smolensk plant during the week of July 27, 1992.« less
GREMEX - A management game for the new public administration.
NASA Technical Reports Server (NTRS)
Mcgregor, E. B.; Baker, R. F.
1972-01-01
This is a critique of a new management game being used in the federal government - Goddard Research Engineering Management Exercise (GREMEX). The exercise involves teams of players who act as managers of a research and development project - the orbiting optical observatory - of the National Aeronautics and Space Administration. During this exercise a computer and the referee-instructor together provide the realistic environment within which the team participants make their decisions affecting the course of the project. The article discusses the place of GREMEX in a tradition of games and simulations, and notes the similarities and differences between GREMEX and other management games currently in use for business training. Some of the actual decisions being made by the GREMEX teams are described to illustrate the nature of the exercise.
[Principles of management of high-energy injuries of the leg].
Jovanović, Mladen; Janjić, Zlata; Marić, Dusan
2002-01-01
High-energy traumas are open or closed injuries caused by force (missile, traffic injuries, crush or blust injuries, falling from heights), affecting the body surface and transferring high amount of kinetic energy inducing great damage to the tissue. Management of such lower extremity injuries has evolved over past several decades, but still remains a difficult task for every surgical team. Specific anatomic and functional characteristics combined with extensive injuries demands specific treatment protocols. In a multiple injured patient the first priority is management of life-threatening trauma. Despite other injuries, surgical treatment of limb-threatening injuries must start as soon as life-threatening condition has been managed. Algorithms are especially beneficial in management of severely injured, but salvageable extremities and in making decision on amputation. Insight into mechanisms of injury, as well as systematic examination of the affected limb, should help us understand the extensiveness of trauma and make an adequate management plan. Prevention of wound infection and surgical approach to high-energy limb trauma, which includes wound extension, wound excision, skeletal stabilization and if necessary muscle compartment release, should be done in the first 6 hours after injury. Commonly used methods for soft tissue defects must provide wound coverage in less than five days following injury. Early passive and active mobilization and verticalization of patients is very important for successful treatment. Good and timely evaluation of the injured and collaboration between plastic and orthopaedic surgeons from the beginning of treatment, are crucial for final outcome.
1994-02-28
improvements. Pare 10 ka•- V •DkI U Release Manager The Release Manager provides franchisees with media copies of existing libraries, as needed. Security...implementors, and potential library franchisees . Security Team The Security Team assists the Security Officer with security analysis. Team members are...and Franchisees . A Potential User is an individual who requests a Library Account. A User Recruit has been sent a CARDS Library Account Registration
A New Model for a Carpool Matching Service.
Xia, Jizhe; Curtin, Kevin M; Li, Weihong; Zhao, Yonglong
2015-01-01
Carpooling is an effective means of reducing traffic. A carpool team shares a vehicle for their commute, which reduces the number of vehicles on the road during rush hour periods. Carpooling is officially sanctioned by most governments, and is supported by the construction of high-occupancy vehicle lanes. A number of carpooling services have been designed in order to match commuters into carpool teams, but it known that the determination of optimal carpool teams is a combinatorially complex problem, and therefore technological solutions are difficult to achieve. In this paper, a model for carpool matching services is proposed, and both optimal and heuristic approaches are tested to find solutions for that model. The results show that different solution approaches are preferred over different ranges of problem instances. Most importantly, it is demonstrated that a new formulation and associated solution procedures can permit the determination of optimal carpool teams and routes. An instantiation of the model is presented (using the street network of Guangzhou city, China) to demonstrate how carpool teams can be determined.
A New Model for a Carpool Matching Service
Xia, Jizhe; Curtin, Kevin M.; Li, Weihong; Zhao, Yonglong
2015-01-01
Carpooling is an effective means of reducing traffic. A carpool team shares a vehicle for their commute, which reduces the number of vehicles on the road during rush hour periods. Carpooling is officially sanctioned by most governments, and is supported by the construction of high-occupancy vehicle lanes. A number of carpooling services have been designed in order to match commuters into carpool teams, but it known that the determination of optimal carpool teams is a combinatorially complex problem, and therefore technological solutions are difficult to achieve. In this paper, a model for carpool matching services is proposed, and both optimal and heuristic approaches are tested to find solutions for that model. The results show that different solution approaches are preferred over different ranges of problem instances. Most importantly, it is demonstrated that a new formulation and associated solution procedures can permit the determination of optimal carpool teams and routes. An instantiation of the model is presented (using the street network of Guangzhou city, China) to demonstrate how carpool teams can be determined. PMID:26125552
Members' sensemaking in a multi-professional team.
Rovio-Johansson, Airi; Liff, Roy
2012-01-01
The aim of this study is to investigate sensemaking as interaction among team members in a multi-professional team setting in a new public management context at a Swedish Child and Youth Psychiatric Unit. A discursive pragmatic approach grounded in ethonomethodology is taken in the analysis of a treatment conference (TC). In order to interpret and understand the multi-voiced complexity of discourse and of talk-in-interaction, the authors use dialogism in the analysis of the members' sensemaking processes. The analysis is based on the theoretical assumption that language and texts are the primary tools actors use to comprehend the social reality and to make sense of their multi-professional discussions. Health care managers are offered insights, derived from theory and empirical evidence, into how professionals' communications influence multi-professional cooperation. The team leader and members are interviewed before and after the observed TC. Team members create their identities and positions in the group by interpreting and "misinterpreting" talk-in-interaction. The analyses reveal the ways the team members relate to their treatment methods in the discussion of a patient; advocating a treatment method means that the team member and the method are intertwined. The findings may be valuable to health care professionals and managers working in teams by showing them how to achieve greater cooperation through the use of verbal abilities. The findings and methods contribute to the international research on cooperation problems in multi-professional teams and to the empirical research on institutional discourse through text and talk.
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.
Cramm, Jane M; Strating, Mathilde M H; Bal, Roland; Nieboer, Anna P
2013-04-01
Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2-3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2-3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings. Copyright © 2013 Elsevier Ltd. All rights reserved.
Multi-UAV Collaborative Sensor Management for UAV Team Survivability
2006-08-01
Multi-UAV Collaborative Sensor Management for UAV Team Survivability Craig Stoneking, Phil DiBona , and Adria Hughes Lockheed Martin Advanced...Command, Aviation Applied Technology Directorate. REFERENCES [1] DiBona , P., Belov, N., Pawlowski, A. (2006). “Plan-Driven Fusion: Shaping the
Mobil`s Energy Management Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schoeneborn, F.C.
1997-06-01
Mobil`s Facilities Management Network sponsored a cross-divisional team to reduce energy costs. This team developed an Energy Management Plan to reduce energy costs by $25 million annually throughout all Mobil divisions over the next five years (total of $125 million committed savings). The core of this plan is the belief that energy costs are controllable and should be managed with the expertise that Mobil manages other parts of the business. Areas of focus are economic procurement, efficient consumption, and expertise sharing.
Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A
2014-09-01
There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Social science informing forest management — bringing new knowledge to fuels managers
Pamela Jakes
2007-01-01
To improve access, interpretability, and use of the full body of research, a pilot project was initiated by the USDA Forest Service to synthesize relevant scientific information and develop publications and decision support tools that managers can use to inform fuels treatment plans. This article provides an overview of the work of the Social Science Core Team. Team...
A Research on the Construction of University R&D Management Team in China
ERIC Educational Resources Information Center
Jia, Ning
2007-01-01
The system of Chinese universities R&D as a branch of the system of the whole country R&D, has a great effect on the development and innovation of the country's science and technique. Consequently, it's important to construct an effective management team with high diathesis for University R&D management. Based on the statistics of the…
Coordinating a Team of Robots for Urban Reconnaisance
2010-11-01
Land Warfare Conference 2010 Brisbane November 2010 Coordinating a Team of Robots for Urban Reconnaisance Pradeep Ranganathan , Ryan...without inundating him with micro- management . Behavorial autonomy is also critical for the human operator to productively interact Figure 1: A...today’s systems, a human operator controls a single robot, micro- managing every action. This micro- management becomes impossible with more robots: in
Total Quality Management (TQM). Process Action Team Course
1990-05-30
SHET SC EXHAUSTE May 30,1990 DEPARTMENT OF DEFENSE Lfl N CI TOTAL QUALITY MANAGEMENT (TQM) Process Action Team Coursef ©990, Booz.Allen & Hamilton Inc...organization’s TQM infrastructure. If you need additional information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar that...Programs. These efforts were identified in Appendix A of Booz, Allen’s training manual Qtl Quality Management Awareness Seminar. Revision 5, November 15
A strategic value management approach for energy and maintenance management in a building
NASA Astrophysics Data System (ADS)
Nawi, Mohd Nasrun Mohd; Dahlan, Nofri Yenita; Nadarajan, Santhirasegaran
2015-05-01
Fragmentation process is always been highlighted by the stakeholders in the construction industry as one of the `critical' issue that diminishing the opportunity for stakeholders that involved during the operation and maintenance stage to influence design decisions. Failure of design professionals to consider how a maintenance contractor or facility manager will construct the design thus results in higher operating cost, wastage, defects during the maintenance and operation process. Moving towards team integration is considered a significant strategy for overcoming the issue. Value Management is a style of management dedicated to guiding people and promoting innovation with the aim to improve overall building performance through structured, team-oriented exercises which make explicit, and appraise subsequent decisions, by reference to the value requirements of the clients. Accordingly, this paper discusses the fragmentation issue in more detail including the definition, causes and effects to the maintenance and operation of building and at the same time will highlighted the potential of VM integrated team approach as a strategic management approach for overcoming that issue. It also explores that the team integration strategy alleviates scheduling problems, delays and disputes during the construction process, and, hence, prevent harming the overall building performance.
Aims and harvest of moral case deliberation.
Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M
2013-09-01
Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.
Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H
2015-12-01
Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. © The Author(s) 2015.
Watts, Brook; Lawrence, Renée H; Drawz, Paul; Carter, Cameron; Shumaker, Amy Hirsch; Kern, Elizabeth F
2016-08-01
Effective team-based models of care, such as the Patient-Centered Medical Home, require electronic tools to support proactive population management strategies that emphasize care coordination and quality improvement. Despite the spread of electronic health records (EHRs) and vendors marketing population health tools, clinical practices still may lack the ability to have: (1) local control over types of data collected/reports generated, (2) timely data (eg, up-to-date data, not several months old), and accordingly (3) the ability to efficiently monitor and improve patient outcomes. This article describes a quality improvement project at the hospital system level to develop and implement a flexible panel management (PM) tool to improve care of subpopulations of patients (eg, panels of patients with diabetes) by clinical teams. An in-depth case analysis approach is used to explore barriers and facilitators in building a PM registry tool for team-based management needs using standard data elements (eg, laboratory values, pharmacy records) found in EHRs. Also described are factors that may contribute to sustainability; to date the tool has been adapted to 6 disease-focused subpopulations encompassing more than 200,000 patients. Two key lessons emerged from this initiative: (1) though challenging, team-based clinical end users and information technology needed to work together consistently to refine the product, and (2) locally developed population management tools can provide efficient data tracking for frontline clinical teams and leadership. The preliminary work identified critical gaps that were successfully addressed by building local PM registry tools from EHR-derived data and offers lessons learned for others engaged in similar work. (Population Health Management 2016;19:232-239).
TeamSTEPPS for health care risk managers: Improving teamwork and communication.
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.
Team Learning in SMES: Learning the Lessons
ERIC Educational Resources Information Center
McKeown, Ian
2012-01-01
This research identifies and explores the factors that influence team learning in the context of an SME management team. It examines the difficulties the team members face in attempting to share and combine their experiences to co-construct knowledge and understanding of their environment and future opportunities. The paper reveals a connection…
Team Projects and Peer Evaluations
ERIC Educational Resources Information Center
Doyle, John Kevin; Meeker, Ralph D.
2008-01-01
The authors assign semester- or quarter-long team-based projects in several Computer Science and Finance courses. This paper reports on our experience in designing, managing, and evaluating such projects. In particular, we discuss the effects of team size and of various peer evaluation schemes on team performance and student learning. We report…
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.
Team working in intensive care: current evidence and future endeavors.
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.