Collaborative Practice Model Research Articles

Exploring the Impact of Digital Technologies on Team Collaborative Design

This paper presents the results of a protocol study exploring the impact of various digital technologies on team collaborative design processes. Previous studies have suggested that compared to traditional methods such as sketching, digital technologies can provide further benefits for collaborative processes. However, there persists a lack of understanding about the impacts of digital technologies on such processes, particularly in relation to emerging significant digital technologies such as immersive Virtual Reality (VR). Therefore, this study aims to fill that gap by exploring team collaboration behaviours of two groups of professionals working in two digital design environments—desktop 3D modelling with Revit and immersive VR using Hyve-3D—as well as their behaviours during traditional sketching sessions for benchmarking purposes. Utilising protocol analysis method, the think-aloud data of participants was recorded, transcribed and coded using an adapted collaborative practice model. Team collaboration activities are broadly categorised as ‘Content’ or ‘Process’: content referring to design task-based activities, while process refers to activities related to the organising of group processes. The results suggest that during the design collaboration process, designers allocated the majority of their efforts towards process-oriented design activities. Differences between design environments only had a minor impact on the amount of effort expended on process-oriented activities and content-oriented activities. Moreover, traditional sketching design environments were shown to be potentially beneficial for problem-solution and associated negotiation activities. Additionally, immersive environments were associated with a reduction in the designers’ cognitive effort that was expended on exploring the design environment.

Predicting collaborative practice between midwives and obstetricians: A regression analysis.

Effective collaborative practice between midwives and obstetricians improves patient safety and obstetrical outcomes, but its implementation remains challenging. Therefore, its determinants need to be better understood. This study examined factors impacting collaborative practice (CP) between these professional groups. This study was a cross-sectional survey that took place in Swiss hospital labor wards in 2021. Collaborative practice perceptions of 70 midwives (57.4% response rate) and 44 obstetricians (29.0% response rate) were assessed using the Interprofessional Collaboration Scale, with the score serving as the main outcome. A total of 13 individual, behavioral, and organizational predictors were analyzed by multiple linear regression. Participants rated collaborative practice with a median score of 3.1 (IQR: 2.8-3.4) out of a maximum score of 4.0. Results showed that five predictors significantly influenced collaborative practice: type of profession (β= -0.180; 95% CI: -0.296 - -0.040, p=0.011), trust/respect (β=0.343; 95% CI: 0.085-0.040, p=0.000), shared visions/goals (β=0.218; 95% CI: 0.030-0.204, p=0.009), workplace (β=0.253; 95% CI: 0.089-0.445, p=0.004) and shared power (β=0.163; 95% CI: 0.042-0.222, p=0.015). The model explained 66% of the variance (adjusted R2) in collaborative practice in labor wards. This study has identified key factors influencing CP in Swiss labor wards: workplace characteristics that require tailored CP models, and a power-sharing culture that fosters trust, respectful interactions and shared goals, requiring active exchange between midwives and obstetricians.

Nurse-Led Care Coordination in a Transitional Clinic for Uninsured Patients With Diabetes.

The purpose of this article is to inform the reader of the practice of the registered nurse care coordinator (RNCC) within an interprofessional, nurse-led clinic serving uninsured diabetic patients in a large urban city. This clinic serves as a transitional care clinic, providing integrated diabetes management and assisting patients to establish with other primary care doctors in the community once appropriate. The clinic uses an interprofessional collaborative practice (IPCP) model with the RNCC at the center of patient onboarding, integrated responsive care, and clinic transitioning. Interprofessional, nurse-led clinic for uninsured patients with diabetes. Interprofessional models of care are strengthened using a specialized care coordinator. Care coordination is a key component in case management of a population with chronic disease. The RNCC, having specialized clinical expertise, is an essential member of the interdisciplinary team, contributing a wide range of resources to assist patients in achieving successful outcomes managing diabetes. Transitional care coordination, moving from unmanaged to managed diabetes care, is part of a bundled health care process fundamental to this clinic's IPCP model. In a transitional clinic setting, frequent interaction with patients through onboarding, routine check-ins, and warm handoff helps support and empower the patient to be engaged in their personal health care journey.

Patients' experiences of and roles in interprofessional collaborative practice in primary care: a constructivist grounded theory study.

This constructivist grounded theory study aimed to (1) explore patients' experiences of and roles in interprofessional collaborative practice for chronic conditions in primary care and (2) consider the relevance and alignment of an existing theoretical framework on patients' roles and based on the experiences of patient advocates. High-quality management of chronic conditions requires an interprofessional collaborative practice model of care considering an individual's mental, physical, and social health situation. Patients' experiences of this model in the primary care setting are relatively unknown. A constructivist grounded theory approach was taken. Interview data were collected from primary care patients with chronic conditions across Australia in August 2020 - February 2022. Interviews were recorded, transcribed verbatim, and thematically analysed by (1) initial line-by-line coding, (2) focused coding, (3) memo writing, (4) categorisation, and (5) theme and sub-theme development. Themes and sub-themes were mapped against an existing theoretical framework to expand and confirm the results from a previous study with a similar research aim. Twenty adults with chronic conditions spanning physical disability, diabetes, heart disease, cancer, autoimmune, and mental health conditions participated. Two themes were developed: (1) Adapting to Change with two sub-themes describing how patients adapt to interprofessional team care and (2) Shifting across the spectrum of roles, with five sub-themes outlining the roles patients enact while receiving care. The findings suggest that patients' roles are highly variable and fluid in interprofessional collaborative practice, and further work is recommended to develop a resource to support greater patient engagement in interprofessional collaborative practice.

Filipino Nurses’ Experiences in a Collaborative Advanced Practice Model: A Critical Incidents Study

The advanced practice nursing role has been found to be a potential solution in low and middle-income countries where access to primary care physicians is limited. In the Philippines, this advanced role has yet to be enacted, hindering the full potential of nurses as primary care providers. Hence, this study aimed to provide an in-depth analysis of nurses’ experiences within a collaborative advanced practice model for hypertension care in the Philippines. This qualitative study utilized a modified version of the Critical Incident Technique. Three participating nurses were asked to self-report the behaviors, interactions, and emotions that positively or negatively impacted their clinic experiences. Similarities in the data were iteratively labeled and classified until major themes emerged. Findings indicate that the overarching theme underpinning the nurses’ experiences in a collaborative advanced practice model was the significant role transition they underwent. While undergoing this transition, three distinct sub-themes of critical incidents emerged: 1) acquiring and maintaining competence, 2) establishing and strengthening collaboration, and 3) gaining and maintaining trust or respect. These insights on the successful role transition of advanced practice nurses in a primary care setting should be used by low- and middle-income countries when establishing their advanced practice nursing frameworks. Furthermore, training programs that prepare advanced practice nurses should also tailor their curricula and strategies on the relevant competencies to include collaboration skills towards building trust with patients and other healthcare providers.

Abstract 090: Using Evidence-Based Resources And Unique Self-Measured Blood Pressure Program Designs To Improve Blood Pressure Control

Background: The AHA National Hypertension Control Initiative (NHCI) is a $32M, 3-year grant from the Health Resources and Services Administration (HRSA) and the Office of Minority Health (OMH) to provide training and technical assistance (T/TA) to 350 HRSA-funded community health centers (CHCs) with blood pressure (BP) control rates below 58.9% in 2019. Hypothesis: NHCI can improve BP control particularly among Black, Hispanic, American Indian/Alaskan Native (AI/AN) persons through systematic, culturally sensitive, and evidence-based interventions, including use of self-measured blood pressure (SMBP). Methods: AHA’s T/TA included a training curriculum, evidence-based tools from Target: BP™ and the AMA MAP™ framework, and new tools, including a BP Measurement Policy and a BP Treatment Algorithm. CHCs used these resources to change clinical care and to implement SMBP though multidisciplinary and culturally relevant approaches that reflect the organizational capacities and characteristics of their patients. For example, 3 CHCs successfully implemented SMBP programs using different designs and achieved notable improvements in BP control (defined by the performance measure <140/90 mm Hg). SWLA in Louisiana established a team-based care model that emphasizes standardized processes, including an SMBP onboarding protocol and a BP treatment algorithm. Canyonlands in Arizona coupled systematic in-clinic practices with AI/AN community health workers (CHW) to reach patients from the Navajo Nation in a culturally relevant manor. Via Care in California developed a collaborative practice model with their clinical pharmacists and clinicians for systematic medication management, SMBP and lifestyle education, and team-based visits. Results: SWLA increased BP control from 44% to 69% in 2022, Canyonlands from 53% in 2021 to 70% in 2023 in AI/AN patients that partnered with a CHW, and Via Care from 55% in 2021 to 74% in 2022. So far, the highest BP control rate percentage change was for CHCs that participated with NHCI and had a 5.1% year-over-year increase compared to 3.8% at all HRSA centers from 2020 to 2021. Conclusion: Various SMBP program designs with systematic processes, team-based care models and culturally sensitive approaches can improve BP control.

Stakeholders’ Perceptions of Digital Collaboration in Delivering a Mixed-Use Housing Development Project: A Case Study in Australia

The paper presents an analysis of collaborative processes in delivering mixed-use housing developments, with a focus on the adoption and roles of digital collaboration to address complex challenges. Extending the collaborative practice (CP) model, the research utilises a qualitative approach and an instrumental case study involving nine semi-structured interviews with key stakeholders from an award-winning mixed-use housing development in Australia. The study identifies key collaboration elements, such as early project establishment, a well-defined brief, and an adaptive integrated digital plan relevant to the interdisciplinary team. The scarcity of successful “extreme” mixed-use cases globally highlights the need for a core conceptual model for collaboration in complex housing developments, focused on digital collaboration, to support future projects in the sector. The research emphasises social innovation in mixed-use housing developments and highlights the importance of effective digital collaboration for addressing environmental, economic, and social sustainability needs. Contributions to the field extend both theoretical and empirical aspects of the CP model, critically exploring the potential of digital collaboration in mixed-use housing projects. The findings reveal critical elements for establishing a digital collaboration plan, leveraging technology to enhance stakeholder experiences and project delivery. The research is especially relevant in the post-COVID era, where digital collaboration gains significance for the industry.

Activities to Promote Interprofessional Practice at Primary Healthcare Level: A Systematic Review

Currently, there is a trend towards interprofessional practice. Consequently, healthcare professionals must devise strategies to deal with the challenges faced in the public health sector. Investigating the ways in which healthcare professionals promote interprofessional care principles to manage patient care outcomes is crucial. Primary healthcare is a significant level of health service delivery, therefore, the implementation of interprofessional practice at this level is especially important. In this review, we aim to explore and describe the activities outlined in the literature, which are used to promote interprofessional practice at primary healthcare level. A systematic search of seven databases was conducted for articles published between 2008 and 2021. All articles with a quantitative, qualitative or mixed methodology, a primary healthcare facility study setting, and full-text availability were included. A methodological appraisal tool was adapted from the RE-AIM framework. Twelve studies were included in the final review. Interprofessional clinics, interprofessional collaborative practices, collaborative care processes, and interprofessional team training were the primary activities identified in the review. These studies aimed to promote interprofessional practice in healthcare settings through various activities. There was limited information regarding the efficiency of the activities. According to the findings, undertaking interprofessional collaborative practice models appears to be the most practicable strategy for implementing interprofessional activities. It is crucial that facility management support this endeavour for its implementation to be successful.

Teaching Person-Centered Care and Interprofessional Collaboration through a Virtual Mental Health World Café: A Mixed Methods IPE Pilot Project

The purpose of this convergent mixed methods interprofessional education (IPE) pilot project was to help health profession students gain valuable insight about the experiences of people living with mental illness, to help them have a better understanding of person-centered care and have greater knowledge about the importance of interprofessional collaboration. A developmental workgroup which consisted of mental health consumers, four interdisciplinary students, and our team developed and implemented a virtual Mental Health World Café IPE event. Twelve other students attended the World Café event. A paired sample t-test was used to examine group differences between pre- and post-test scores for the Interprofessional Socialization and Valuing Scale and the Texas AHEC Survey measures among the four student leaders and the 12 student participants of the virtual Mental Health World Cafe. We conducted individual interviews with the four student leaders and collected reflective journals from the 12 students who attended the World Café event. We examined to what extent the statistically significant quantitative results supported the qualitative results separately for the student leaders and for the student participants of the virtual World Café. We also examined how both the quantitative and qualitative findings aligned with the key components of the Patient-Centered Care in Interprofessional Collaborative Practice Model. While the project allowed the students to reflect upon how they may apply the principles of person-centered care and interprofessional collaboration, the impact of the consumers on the student’s experiences was profound and resulted in widespread engagement of the students who attended the event.

An adversarial collaboration protocol for testing contrasting predictions of global neuronal workspace and integrated information theory.

The relationship between conscious experience and brain activity has intrigued scientists and philosophers for centuries. In the last decades, several theories have suggested different accounts for these relationships. These theories have developed in parallel, with little to no cross-talk among them. To advance research on consciousness, we established an adversarial collaboration between proponents of two of the major theories in the field, Global Neuronal Workspace and Integrated Information Theory. Together, we devised and preregistered two experiments that test contrasting predictions of these theories concerning the location and timing of correlates of visual consciousness, which have been endorsed by the theories' proponents. Predicted outcomes should either support, refute, or challenge these theories. Six theory-impartial laboratories will follow the study protocol specified here, using three complementary methods: Functional Magnetic Resonance Imaging (fMRI), Magneto-Electroencephalography (M-EEG), and intracranial electroencephalography (iEEG). The study protocol will include built-in replications, both between labs and within datasets. Through this ambitious undertaking, we hope to provide decisive evidence in favor or against the two theories and clarify the footprints of conscious visual perception in the human brain, while also providing an innovative model of large-scale, collaborative, and open science practice.

Attention Deficit Hyperactivity Disorder: What Are Pharmacists' Roles and Associated Outcomes?

Globally, the prevalence of attention deficit hyperactivity disorder (ADHD) is increasing. The treatment for ADHD is multifaceted and requires long-term care and support. Pharmacists are capable of assisting patients and their caretakers in achieving desired outcomes. This work discusses and summarizes pharmacists' roles in ADHD care and their associated outcomes. Overall, pharmacists are positioned to educate on ADHD, optimize medications in a collaborative practice model, manage and monitor side effects, and provide remote and virtual pharmaceutical care. Pharmacists could directly contribute to ensuring medication safety and increasing awareness regarding the optimal use of ADHD medications. Patients with ADHD can benefit from pharmacist involvement in a variety of ways, including, but not limited to, initial screening and referral, the provision of clinical consultation and feedback, and the improvement of self-management and self-awareness of the illness. Pharmacists also play a significant role in therapeutic decision making regarding the initiation, intensification, and monitoring of ADHD treatment to ensure its effectiveness and quality of life improvement. Lastly, pharmacists could help identify more cost-effective treatment approaches for ADHD patients based on the clinical scenario that is encountered.

Collaborative Practices Between Speech-Language Pathologists and Teachers: A Survey of Teachers in Two Australian States

ABSTRACT Purpose: We investigated the collaborative practice between speech-language pathologists (SLPs) and teachers in two Australian states with different policies and legislations affecting SLP services in schools. Methods: Teachers from New South Wales (NSW) and Queensland (QLD) completed an online survey (N = 117). A mixed-method approach was used to analyse teachers’ responses in the survey. Results: QLD teachers were significantly more likely to work with SLPs in multiple models of collaborative practice. NSW teachers were more than twice as likely to work with SLPs in the pull-out model as the single means of collaborative practice. While NSW and QLD teachers accessed SLP services differently, they perceived funding and lack of time to be influencing collaborative practices. A clear need was highlighted for SLPs and teachers to develop a greater depth of shared understanding for successful collaborative practices. Conclusion: This study provided preliminary insight into SLP-teacher collaborative practices in two Australian states with different policies and legislations affecting SLP services in schools. There is a need for evidence-based and student-centred guidelines to facilitate SLP-teacher collaborative practices in schools.

Real-World Safety and Health Care Resource Utilization Analysis of Venetoclax and Hypomethylating-Agent Treatment for AML in an Academic-Affiliated Urban Community Oncology Network

Introduction Acute Myeloid Leukemia (AML) is a disease that affects predominantly older patients with a median age at diagnosis of 68 years. Elderly patients often have medical comorbidities and are ineligible for intensive induction chemotherapy. Recently, the FDA approved the combination of HMA/venetoclax for patients with newly diagnosed AML who are 75 years or older, or who have comorbidities precluding intensive induction chemotherapy. Through this retrospective analysis of patients treated at a metropolitan academic leukemia center and academic-affiliated community oncology practice network, our goal was to evaluate the safety and health care resource utilization of HMA/venetoclax treatment in a real-world experience. Methods We performed a retrospective analysis of patients treated for AML with HMA/venetoclax as standard-of-care at UCLA from 2018 to 2021. Patients treated with first-line HMA/venetoclax at UCLA community clinics (CC) and at UCLA main campus (academic centers, AC) and had a treatment record available in the electronic medical system were included. We specifically sought to collect safety parameters. Short-term efficacy outcomes were secondary endpoints. Results Thirty-three patients were eligible for analysis: eleven patients who received care in CC and 22 patients who were treated at AC. Baseline characteristics and treatment information are presented in Table 1. The average age was 76 years old for CC and 71 years old for AC. The proportion of patients older than 60 years old is 100% in CC, and 82% at AC. ECOG performance status was predominantly 0 and 1, irrespective of treatment location. Both groups have predominantly a secondary AML diagnosis (CC 64%, AC 59%). According to ELN 2017 criteria, 36.4% of CC had adverse risk disease, compared to 72% of AC patients. CC patients had median of 30% bone marrow blasts at diagnosis and AC had 59% blasts. Forty percent of CC patients and 64% of AC patients had baseline platelet counts <50x103/uL. Regarding treatment, eight out of 11 CC patients had consultation with a physician from the academic leukemia group. Twenty-seven percent of CC patients and 82% of AC patients were treated inpatient for cycle 1. Eighteen percent of CC patients and 66.6% AC patients received venetoclax at a starting dose lower than 400mg daily. Eighty-six percent of the dose reductions were due to concurrent azoles use. Finally, prophylactic antibiotics were used in 45% of CC patients compared to 64% of AC patients, and antifungal prophylaxis was used in 27% of CC patients compared to 64% of AC patients. Safety data, health care resource utilization, and clinical outcome information are reported in Table 2. The percentage of patients with grade 4 neutropenia duration >30 days after cycle 1 was 50% in CC vs. 43% at AC. There were no deaths before 30 days at CC and there were 2 deaths (10%) in AC. Thirty- to sixty-day mortality was zero in both groups. Thirty-six percent of CC patients and 59% of AC required hospitalization (infectious related: 43% CC, 52% AC; cytopenia: 29% CC, 10% AC). The median number of hospital days was 3 (range, 0-17) in CC, and 27 (range, 6-81) in AC; and 0% of CC vs. 18% of AC patients required an ICU stay. Regarding clinical response, bone marrow biopsy was done after cycle 1 in 91% of CC vs. 41% of AC patients. Of these patients, CR/CRi rate was 80% in CC patients vs. 56% in AC patients. Discussion Our study suggests that AML treatment with HMA/venetoclax can be administered safely in real-world community setting. The high number of CC patients that had consultation with AC group reflects the integrative collaborative practice model at our urban academic affiliated oncology community practice. Patients treated in CC tend to be older, with more favorable AML, and better BM function reserve at baseline. The CR rate for patients treated in CC is comparable to previously published data. The high number of patients treated inpatient for cycle one at AC likely indicates AC carries a more acutely ill AML patient population compared to CC, which likely resulted in more health care resource utilization. It is interesting to observe that in the CC group, 29% of the complications leading to hospitalization are from cytopenia, suggesting that health care resource utilization could be further optimized with pre-emptive transfusion scheduling. Limitations of this analysis include that this is a small, single center, retrospective analysis. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Address by the Chair of the ADEA Board of Directors

Address by the Chair of the ADEA Board of Directors

Leading Multisector Partnerships to Address Social Determinants of Health and Advance Health Equity for an Underresourced Heart Failure Patient Population.

Addressing the social determinants of health (SDoH) to advance health equity for persons with heart failure is a complex endeavor. Best results are achieved in partnership with multiple sectors beyond just the health care industry. We describe the evolution of an academic-practice-community partnership addressing the SDoH to advance health equity for a population of underresourced heart failure patients. Using a bundled approach to care delivery within a nurse-led interprofessional collaborative practice model and cultivating multisector partnerships, we initiated a systematic approach to addressing the SDoH within a heart failure clinic in the southeastern United States. Through our SDoH program, our clinic has improved access to care, medications, and food for our patients, thus advancing health equity and reducing hospital readmissions. Our multisector partnerships to address SDoH and advance health equity provide a foundation to improve population health outcomes for underresourced persons with heart failure. An SDoH program such as ours would not have been possible without strong leadership and collaboration of colleagues from multiple disciplines and sectors. In keeping with the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity report, we showcase our actions consistent with the report's recommendations.

Research Ready Grant Program (RRGP) protocol: a model for collaborative multidisciplinary practice–research partnerships

BackgroundLittle attention has been given to the process of implementing or evaluating a structured academic–clinician (university–health service) research capacity-building (RCB) model within healthcare settings. We have developed a model for collaborative multidisciplinary practice–research partnerships called the Research Ready Grant Program (RRGP). The RRGP is informed by Cooke’s (BMC Fam Pract 6:44, 2005) RCB framework and principles. The aim of the study outlined in this protocol is to conduct a process and outcome evaluation of the programme. We will explore how the RRGP's structured mentor model contributes to RCB of clinician-led multidisciplinary research teams. We will identify key factors at the organization, team and individual levels that affect research capacity of health professionals working in one regional health service district. This protocol describes the RRGP design and outlines the methods we will employ to evaluate an RCB programme, the RRGP, delivered in a regional health service in Australia.MethodsThe study will adopt an exploratory concurrent mixed-methods approach designed to evaluate the process of implementing an RCB model across one regional hospital and health service. Both quantitative and qualitative data collection methods over a 12-month period will be implemented. Data triangulation will be applied to capture the complex issues associated with implementing collaborative multidisciplinary practice–research partnerships.DiscussionThe RRGP is an innovative RCB model for clinicians in their workplace. It is expected that the programme will facilitate a culture of collaborative multidisciplinary research and strengthen hospital–university partnerships.

Working with children with cortical visual impairment who use augmentative and alternative communication: implications for improving current practice

The aim of this study was to describe how professionals from multiple disciplines (e.g., speech-language pathologists, teachers, occupational therapists) in the United States reported challenges they face in delivering services to children with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC). Three surveys were utilized to identify barriers to and priorities for improving educational and clinical services and in-service and preservice education from the perspectives of professionals in school, community, and university settings. Results suggest that current service delivery models may not be meeting the needs of either children with CVI who use AAC or the professionals whose job it is to provide them with services. Professionals in community-based settings appeared to encounter more barriers. Findings help to support a discussion about approaching AAC interventions for children with CVI who use AAC by adopting interprofessional collaborative practice (IPCP) and interprofessional education (IPE) models, which reflect long-standing best practice guidelines for AAC service delivery and are encouraged by multiple professional organizations.

Multidisciplinary Management of Pancreatic Cancer.

At JADPRO Live Virtual 2021, presenters reviewed the epidemiology of pancreatic cancer, treatment options for patients with different stages of pancreatic cancer, and the most common symptoms and complications related to pancreatic cancer and their management in a collaborative practice model.

Teaching Strategies and Psychological Effects of Entrepreneurship Education for College Students Majoring in Social Security Law Based on Deep Learning and Artificial Intelligence.

This study aims to achieve the goal of cultivating and reserving emerging professional talents in social security law, improve the curriculum and mechanism of entrepreneurship education, and improve students’ entrepreneurial willingness and entrepreneurial ability. Deep learning technology is used to study the psychological effects of entrepreneurship education for college students majoring in social security law. Firstly, the concept of entrepreneurial psychology is elaborated and summarized. A related model is designed using the theory of proactive personality and planned behavior through questionnaire survey and regression analysis to explore the relationship between students’ entrepreneurial psychology and entrepreneurial intention. Secondly, an entrepreneurship education method based on deep learning is proposed, and a teaching model of multi-dimensional collaborative entrepreneurship education practice is constructed. On this basis, the deep learning algorithm combines the characteristics of the personalized recommendation algorithm to construct an efficient Problem-Based Learning (PBL) learning resource recommendation algorithm. Finally, the proposed method is tested. The results show that the Significant (Sig.) value of students who have participated in PBL deep learning courses is less than 0.05, indicating that PBL significantly improves students’ learning ability and the ability to deal with entrepreneurial environments. The results verify the impact of entrepreneurial learning on entrepreneurial intentions. The research on PBL online learning recommendation system shows that the proposed recommendation algorithm is superior to the traditional recommendation algorithm in both roots mean square error value and mean absolute error value on both datasets. The proposed method provides a new idea of reform and innovation to cultivate social security law professionals and the cultivation of the reserve model.

Taking an interprofessional collaborative practice to the next level: Strategies to promote high performing teams

Interprofessional collaborative practice is an effective model to deliver care to vulnerable populations. Nurse-led interprofessional clinics have shown improvements in patient outcomes including patients with heart failure. Yet, few studies report the sustainability of high performing interprofessional teams. The purpose of this paper is to describe the interventions and strategies implemented by the Heart Failure Transitional Care Services for Adults Clinic team over a 4-year time period to hardwire and promote high team performance and interprofessional collaboration as well as the ongoing evaluation of team function. This prospective study used an implementation science design so that important information learned could be easily translated into practice in a timely way. All domains of the SOAP-C questionnaire improved over time. Four of 7 domains in the CPAT questionnaire also improved over time. Team assessment revealed the team is in the performing stage of Tuckman's stages of team development. Working to build a high performing nurse-led interprofessional team that cares for underserved patients with heart failure is challenging, yet achievable. Our findings extend our previous work and support others who utilize the interprofessional collaborative practice model to improve health outcomes. • Successful integration of interprofessional collaborative practice competencies is achievable. • Consistent and focused attention on the entire team is essential for high performing teams. • Integration of interprofessional collaborative practice competencies can assist teams to become high performing teams.