Education Of Team Members Research Articles

Leveraging Consistent Communication Tools and Organizational Values to Promote Accountability Among Health Care Providers.

Teamwork and effective communication between all health care staff members are essential to providing safe, high-quality patient care. High-reliability organizations align behavioral expectations with organizational values and prioritize safety over other performance metrics and pressures. Communication breakdowns, such as inadequate or incomplete information shared between caregivers, continues to be an issue that is linked to errors and staff member dissatisfaction. Initiatives to improve health care communication and improve patient outcomes are well documented, yet communication issues in the health care setting continue. An organization's credo defines its values and behavioral expectations. Educating team members on an organization's credo creates accountability among those teams to align their behavior with the organization's values, policies, and professional commitment. A Coworker Observation Reporting System offers a communication method for providing meaningful feedback on behaviors inconsistent with an organization's credo.

The interpreter's role and deaf students' autonomy in mainstream classrooms.

This article explores the interpreter's role and approaches to working with deaf students as seen from deaf individuals' and interpreters' perspectives. A group of 41 formerly mainstreamed deaf individuals and interpreters offered insights into how the interpreter's role in mainstream classrooms influences deaf student autonomy and participation. This research illustrates the significance of autonomy for mainstreamed deaf students and suggests a correlation between the interpreter's role and deaf students' perceived autonomy in the classroom. In addition, the findings suggest that deaf students do not always know what an interpreter is supposed to do in K-12 classrooms. This study also finds that educational team members do not always explicitly communicate their roles and responsibilities to deaf students, leading to confusion that impacts their autonomy and overall experience. Finally, this research finds that deaf students are not trained with the ability to negotiate and renegotiate the interpreter's role. This article concludes with considerations and recommendations for deaf education and interpreter education communities.

Disrupting the System: How Social Systems Perpetuate Educational Segregation of Students with Extensive Support Needs

Education teams continue to place students with extensive support needs (ESN) in segregated settings despite nearly 50 years of research culminating in the conclusion that students with ESN have better outcomes when educated in general education contexts. This article uses Bronfenbrenner’s ecological systems theory to explain how social systems influence the beliefs, attitudes, and decisions made by education team members about the educational placement of students with ESN. This article describes: (a) Bronfenbrenner’s ecological systems theory to explain how each social system influences decisions made about the educational placement of students with ESN; (b) the history of educational segregation of students with disabilities; (c) macrosystems of education team members and how they perpetuate segregated placement decisions of students with ESN; and (d) actions to disrupt the education system and segregated placement decisions.

Functional Communication Training in Inclusive School Settings for Students With Intellectual and Developmental Disabilities: A Literature Review

Functional communication training (FCT) is a well-established, evidence-based practice used to address challenging behavior among individuals across settings, ages, and disability categories. However, the research is limited on the implementation of FCT in inclusive school settings for students with intellectual and developmental disabilities. The purpose of this review was to summarize FCT intervention studies implemented in inclusive K–12 school settings for students with intellectual and developmental disabilities. We synthesized studies to summarize study characteristics, quality, and intervention effectiveness. Our findings suggest that FCT was most often implemented as part of a multi-component intervention package and delivered by education team members. Furthermore, the quality of most studies was either acceptable or strong. The overall effect size estimate for primary dependent measures as measured by Tau-U suggested large to very large changes in student behavior. We present implications for practice specific to educational teams that support the behavioral needs of students with intellectual and developmental disabilities in inclusive settings and offer avenues for future research.

Securing Endotracheal Tubes During Prone Positioning.

Securing Endotracheal Tubes During Prone Positioning.

1015 Reducing Waiting Time to Surgery for Patients with Femoral Peri-Prosthetic Fractures (FPP#s): A Quality Improvement Project

Abstract Introduction Research has shown that early fixation and return to mobility in femoral fragility fractures improves post-operative outcomes. Based on this, in patients with neck of femur fractures (NOF#), NICE guidelines advise fixation ‘on the day of or the day after admission’. However, no guidelines exist in the case of femoral periprosthetic fractures (FPP#) despite emerging evidence showing improved outcomes in this cohort of patients also. Method We retrospectively analysed the waiting times from admission to surgery for NOF#s and FPP#s admitted between 1/9/20 to 1/4/21 at St. Richard's and Worthing Hospitals that required surgery. 30 FPP# and 503 NOF# patients were admitted during this period. Data was collected on all FPP# patients and a randomly selected cohort of 30 patients from the NOF# group. Results There was an average waiting time of 1.3 days for NOF#s and 3.7 days for FPP#s from admission to surgery. Conclusions This initial data demonstrates the longer waiting times for FPP# patients. We identified key areas where improvements could be sought decreasing time until CT scanning for evaluation of fracture pattern and decreasing time until a specialist opinion from a hip surgeon to decide between operative fixation or conservative management. By addressing these and educating team members about the positive outcomes by reducing delays to surgery in FPP# patients we hope to decrease their waiting times. We are currently re-auditing to identify any improvements and any further facets for advances in the future.

843 Improving Antibiotic Prophylaxis Prescribing in Arthroplasty Surgery Following Neck of Femur Fracture (NOF#): A Clinical Audit Revealing Multi-Factorial Influences on Prescribing Accuracy

Abstract Introduction Post-op infection is a serious complication in surgery, particularly in arthroplasty. NICE guidelines advise antibiotic prophylaxis for all arthroplasty procedures to avoid this. This audit aimed to assess our concordance with our local guidelines and achieve improvements where we were deficient. Method Electronic prescribing records were analysed for 60 patients who underwent arthroplasty following NOF# across St. Richard's and Worthing Hospitals between 4/3/19 – 17/6/19. We presented these initial findings at our local orthopaedic clinical governance meeting to educate team members. We then collected a second cycle of data between 1/11/20 – 16/12/20. Results Patients receiving some form of antibiotic prophylaxis improved from 90% to 100%. Patients receiving the appropriate prophylaxis as per local guidelines increased from 78% to 83%. However, more patients were given incomplete prophylaxis in the second cycle: 5% of patients were on concurrent antibiotics for chest infection and were not given full prophylaxis, 5% of patients were under-dosed on gentamicin and 3% of patients were not given the full 24 hours’ worth of flucloxacillin. No patients developed joint infections post-op after following up for 6 months. Conclusions Although all patients were given prophylaxis in the second cycle, patients not receiving the full recommended course of antibiotics represents an avoidable risk in developing post-op infection. We identified that communication between orthopaedic surgeons, anaesthetists and orthogeriatric ward team members and awareness of prescribing responsibility were implicated in accurate prescribing of prophylactic antibiotics. We aim to address these with further education and amendments to performas and then re-audit to look for further improvements.

Wearable Technologies: A New Way to Address Student Anxiety

This article provides an overview of wearable technology devices that measure physiological markers associated with stress and their use with children and youth. Tips for teachers and educational team members regarding their use are provided.

Candida Auris Outbreak Investigation

<h3>Background</h3> Candida auris (C. auris) is an emerging pathogen that can be multidrug resistant and has a high mortality rate. It is easily transmissible and extremely persistent in health care environments and has resulted in multiple outbreaks worldwide. Our hospital experienced a C. auris outbreak on an intensive care unit, which resulted in over 20 transmissions to patients. Here we describe our experience with this outbreak and steps implemented to control it. <h3>Methods</h3> An epidemiologic map was constructed to identify the source of the outbreak. The outbreak was traced back to a patient who was admitted a few months prior to the intensive care unit. The following measures were implemented: creation of an incident command structure, screening of all patients on the index unit and any unit with positive cases, screening of all patients transferred from active outbreak units, education for team members on horizontal measures, and implementation of standard work for cleaning measures. Cohort units were established for patients who were colonized with C. auris. <h3>Results</h3> Exposure screening on the index unit led to the identification of seven additional inpatient units as potential areas of risk. Weekly point prevalence screening of all patients on these units was initiated. During the time-period of August to November 2021, 440 screens were performed and 23 resulted positive (5.2% positivity rate). <h3>Conclusions</h3> Candida auris has the potential to persist in healthcare settings and can live in the environment for a long time. Prospective surveillance of at-risk patients is crucial to prevent the spread of this pathogen in our healthcare system. Rapid identification of cases and response to outbreaks requires a multidisciplinary effort and strict adherence to horizontal infection prevention methods to avoid resurgence of this pathogen in the environment.

Development, Implementation, and Assessment of a New Competency and Outcomes-Based Orientation in an Air Medical Transport Program

ObjectiveThe development and evaluation of new employees in air medical transport has historically lacked standardization and competency-based learning goals. Here we discuss the development, implementation, and assessment of a new competency-based education and evaluation method at Geisinger's Life Flight air medical transport service. MethodsUsing Bloom's taxonomy of learning, 14 competencies for flight employees were identified. An electronic database was created to track progress across competencies and serve as an information repository for the identification of goals and the development of individualized learning plans. Ten months after implementation of the new method, 11 preceptors and education team members were surveyed to understand their views on the new program. ResultsAt the time of survey administration, 20 orientees had completed orientation under the new education and evaluation program in an average of 6.45 weeks, with a range of 3 to 10 weeks. Of the 11 surveyed instructors, 81.1% definitely agree that the new method adequately assesses performance compared with 45.5% with the previous unstandardized method; 81.8% of the instructors rated the overall change as very helpful. ConclusionThe adoption of a competency-based learning model for air medical transport employee education and evaluation improves the assessment of performance and allows for the development of customized learning plans.

Entrepreneurial teams and early performance of new ventures: An analysis of Taiwanese tech-firms

In this paper, we investigate the effects of the relation between the human capital of the entrepreneurial team, R&D-manufacturing linkage and the performance of new technology-based firms in accordance with a resource-based view. We try to comprehend how entrepreneurial teams and R&D-manufacturing linkage shape firm’s ability to have a positive outcomes in terms of company sales revenue and international connection. We take advantage of a new data relating to a sample composed of 152 taiwanese young firms that operate in technology-based industries. We find that firms with higher proportionally advanced professional education entrepreneurs in the team have a positive effect on firms' performance. Furthermore, it is R&D-manufacturing linkage that determines technology-based firm’s growth. Individuals with entrepreneurial experiences exerts key influences on firm's international connection. Firms can also benefit from their team members' background affiliation and achieve better performance. Lastly, we provide evidence that there are gains from the complementary capabilities of entrepreneurial teams and firms relating to (i) advanced professional education , (ii)entrepreneurial or CEO experiences and team members' background affiliation and (iii) R&D-manufacturing linkage. We conclude that the human capital of entrepreneurial team and R&D-manufacturing linkage of new technology-based firms have a critical impact on the firm’s development. These findings are consistent with and complements the growing body of research that emphasizes the importance of entrepreneurial teams in developing knowledge about the strategies and allocation of the enterprises resources.

Impact of Oncology Pharmacists on the Knowledge, Attitude, and Practices of Clinicians to Enhance Patient Engagement of Self-Administered Oral Oncolytics.

Oncology clinical pharmacists are uniquely positioned to make interventions to impact the knowledge, attitudes, and practices of clinicians as well as patient activation and engagement. To accomplish this goal, pharmacists can target health system-related, provider-related, and patient-related factors to enhance patient-centered care and drive behavioral health changes. Interventions that pharmacists must tackle include educating team members and patients on the medication acquisition process, communicating urgency of treatment, optimizing workflows, facilitating guideline recommendations, preventing, and managing treatment toxicities, and promoting patient self-advocacy through education and shared decision-making. As crucial members of the healthcare team, oncology pharmacists can simplify highly complex treatment regimens to facilitate and optimize patients’ ownership of their care. This narrative review will focus on the example of venetoclax treatment in acute myeloid leukemia to demonstrate the impact that pharmacists provide that leads to behavioral change of patients and clinicians.

Honoring Team Decision-Making During Manifestation Determination Meetings Through Collaborative and Proactive Solutions

The Individuals With Disabilities Education Act requires schools to conduct a manifestation determination (MD) meeting when suspending students with disabilities for more than 10 days. The MD procedure is intended to safeguard educational access by providing a process to determine if a student’s disability is related to the suspending behavior. An accurate decision requires educational team members to effectively collaborate to review relevant data and the student’s Individualized Education Program. Collaborative and proactive solutions (CPS) offer a framework for collaboration that may ensure that all team members meaningfully participate during the MD meeting while encouraging a rigorous analysis of student-specific data. The use of CPS is proposed as a framework to generate meaningful collaboration in MD meetings, which may result in positive student outcomes that reach beyond merely addressing a behavioral violation.

Applying behavioral analytic consultation to schools to assess and treat a student's elopement

AbstractA team of behavioral consultants applied the Behavioral Analytic Consultation to Schools model while working with educators in a public school setting to evaluate and treat elopement behavior of an 11‐year‐old student with autism spectrum disorder. Assessment conducted by the consultants included interviews, descriptive analysis, preference assessment, trial‐based functional analysis of elopement, and a reinforcer analysis conducted using an alternating treatment design. An acceptable behavior intervention was developed in consultation with educational staff and family. Consultants trained educational staff on procedures to implement the intervention and data collection. When intervention components were implemented as designed, the student's elopement in the classroom and out of the school building decreased. This study is an example of a successful application of the Behavioral Analytic Consultation to Schools model where consultants take primary responsibility for the evaluation, and collaborate with educational team members and family members to apply what was learned from the assessment to a successful intervention. The results of this application of the model provide continued support for evaluating the use of the model to improve outcomes for students engaging in severe behavior in public school settings.

Building Consensus about the Functional Vision Assessment Process: A Delphi Study

Introduction: Within the field of visual impairment, there is no set of standards that guide teachers of students with visual impairments as they conduct, report, and share functional vision assessment (FVA) results with other educational team members, and university instructors vary in how they teach the assessment process to preservice teachers. Methods: In parallel, a group of teachers of students with visual impairments and a group of university instructors completed three rounds of a Delphi study. After providing background information in Round 1, they rated 84 statements about the FVA process. The level for consensus was set at 80%. Results: Of the 84 statements, consensus was reached for 45 statements regarding the level of importance by both groups. Participants rated 11 of 22 visual skills (e.g., near acuity, distance acuity) as extremely important to include in the FVA process. Discussion: There continues to be a need to build consensus on when FVAs should be conducted, what visual skills should be included when conducting them, what should be included in reports, and with whom assessment information should be shared. The importance of conducting such assessments for all students, including students under the age of 5 years and those with additional disabilities, needs to be recognized by the field of visual impairment. Implications for practitioners: University personnel need to work together to develop consistent curricula that focuses on the FVA process. Future studies that examine the FVA practices of individual teachers are necessary.

Cardiac Surgery-Enhanced Recovery Programs Modified for COVID-19: Key Steps to Preserve Resources, Manage Caseload Backlog, and Improve Patient Outcomes

Abstract The COVID-19 pandemic has magnified the importance of delivering high-quality healthcare while preserving limited or depleted resources. This is particularly true in cardiac surgery, which depends on the same equipment, hospital capacity, and personnel that have been re-directed to COVID-19 care. Enhanced recovery programs promote standardized, consistent perioperative care, with an emphasis on incorporating evidence-based measures to optimize the patient experience, improve outcomes and utilize resources efficiently. Developing and implementing a program in the current COVID-19 environment is a daunting task. The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac), representing an international, multi-disciplinary group of experts, provides the rationale, supportive evidence, and a proposed outline for a sustainable modified program within the constraints of the COVID-19 pandemic. It is feasible to launch in the current healthcare climate and is designed to preserve resources, reduce case backlog, and protect patient and provider safety while improving patient care and preserving institutional quality metrics. The program can also create the foundation for future growth.

A Collaborative Learning Assessment of Developmental Care Practices for Infants in the Cardiac Intensive Care Unit

Assess differences in approaches to and provision of developmental care for infants undergoing surgery for congenital heart disease. A collaborative learning approach was used to stratify, assess, and compare individualized developmental care practices among multidisciplinary teams at 6 pediatric heart centers. Round robin site visits were completed with structured site visit goals and postvisit reporting. Practices of the hosting site were assessed by the visiting team and reviewed along with center self-assessments across specific domains including pain management, environment, cue-based care, and family based care coordination. Developmental care for infants in the cardiac intensive care unit (CICU) varies at both a center and individual level. Differences in care are primarily driven by variations in infrastructure and resources, composition of multidisciplinary teams, education of team members, and use of developmental care champions. Management of pain follows a protocol in most cardiac intensive care units, but the environment varies across centers, and the provision of cue-based infant care and family-based care coordination varies widely both within and across centers. The project led to proposed changes in clinical care and center infrastructure at each participating site. A collaborative learning design fostered rapid dissemination, comparison, and sharing of strategies to approach a complex multidisciplinary care paradigm. Our assessment of experiences revealed marked variability across and within centers. The collaborative findings were a first step toward strategies to quantify and measure developmental care practices in the cardiac intensive care unit to assess the association of complex inpatient practices with long-term neurodevelopmental outcomes.

Enjeux et défis de l'accompagnement des adultes présentant une déficience intellectuelle

Communication is a fundamental right recognized in the Convention on the Rights of Persons with Disabilities. People with intelle ctual disability who have little or no language rarely have opportunities to communicate. The difficulties they encounter, as well as certain characteristics of the environments in which they live, are major obstacles to the development of their communicative skills. The paper documents the methodology used to support the members of educational teams in developing interventions aimed at enabling the persons concerned to improve their communicative skills. A case study details and illustrates all the steps followe d in the study. The results highlight the importance of introducing both physical and social facilitators to promote the development of these skills.

Maximizing Expertise and Collaboration to Support Students With Brain Injury: A Case Study in Speech-Language Pathology

Purpose Through a hypothetical case study, this article aimed to describe an evidence-based approach for speech-language pathologists in managing students with moderate-to-severe traumatic brain injury (TBI), particularly within a formal statewide-supported school-based brain injury team model, such as the BrainSTEPS Brain Injury School Consulting Program operating in Pennsylvania and Colorado. Conclusion Upon transitioning from the medical setting back to school, children with TBI present with unique educational needs. Children with moderate-to-severe TBIs can demonstrate a range of strengths and deficits in speech, language, cognition, and feeding and swallowing, impacting their participation in various school activities. The specialized education, training, and insight of speech-language pathologists, in collaboration with multidisciplinary medical and educational team members, can enable the success of students with TBI when transitioning back to school postinjury ( DePompei &amp; Blosser, 2019 ; DePompei &amp; Tyler, 2018 ). This transition should focus on educational planning, implementation of strategies and supports, and postsecondary planning for vocations or higher education.

Exploring the applicability of occupational therapy transition assessments for students with disabilities

ABSTRACTYoung adults with disabilities often require extensive support and planning to ensure that they have a successful transition from the secondary education setting to the postsecondary work, education/training, and living environment. The purpose of this study was to improve occupational therapy support to transition teams by evaluating feedback from transition team members (teachers, therapists, psychologists, and administrators) about occupational therapist conducted postsecondary transition assessments. These occupational therapist transition assessments were conducted for individuals with developmental disabilities who were preparing to transition from high school to the postsecondary community setting. The occupational therapist conducted 18 transition assessments and collected 71 feedback surveys from the interdisciplinary special education team members during the district’s special education transition programme planning and evaluation process. This study examines the feedback from these special educators about those evaluations. The study results yielded useful information regarding the agreed value that occupational therapy conducted transition assessments bring to the transition team for transition planning. This study also identified four foundational assessment areas that occupational therapists should always consider when conducting a transition assessment. These areas include the student’s sensory processing, occupational performance, vocational interests, and self-determined postsecondary goals.