Interdisciplinary Health Care Research Articles

Patients' experiences with a welfare technology application for remote home care: A longitudinal study.

To explore the longitudinal experiences using an application named remote home care for remote palliative care among patients with cancer living at home. Introducing welfare technology in home-based care for patients with cancer in the palliative phase is internationally suggested as a measure to remotely support palliative care needs. However, little is known about the experiences of patients utilising welfare technology applications to receive home-based care from healthcare professionals in a community care context. Although living with cancer in the palliative phase often presents rapidly changing ailments, emotions and challenges with patients' needs changing accordingly, no studies exploring the longitudinal experiences of patients were found. A qualitative study with a longitudinal, exploratory design. Data were collected through individual interviews with 11 patients over 16 weeks. The data were analysed using qualitative content analysis. The COREQ checklist guided the reporting of the study. Three themes were identified: (1) potential to facilitate self-governance of life-limiting illness in daily life, (2) need for interpersonal relationships and connections, and (3) experiences of increased responsibility and unclear utility of the Remote Home Care. The results showed that remote home care facilitated patients' daily routines, symptom control and improved illness-management at home. Interpersonal relationships with healthcare professionals were considered pivotal for satisfactory follow-up. Infrastructural glitches regarding data access, information sharing and lack of continuous adjustments of the application represented major challenges, with the potential to impose a burden on patients with cancer in the palliative phase. By exploring the experiences of patients in palliative care over time as the disease progresses, this study provides constructive insights for the design and development of welfare technology applications and optimal care strategies. The remote home care was developed by interdisciplinary healthcare professionals.

Oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life in pregnant women

ObjectivesThis questionnaire-based cross-sectional study aimed in the evaluation of oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life (OHRQoL) in pregnant women in southwest-Saxony, Germany.Materials and methodsConsecutive patients attending the clinics for Obstetrics and Gynecology, Heinrich-Braun-Klinikum Zwickau, Germany, were recruited in the years 2020 and 2021. The evaluation consisted of three parts: (I) dental and oral hygiene behavior, (II) periodontal complaints and (III) German short form of oral health impact profile (OHIP G14) to assess OHRQoL.Results853 out of 1056 participants were included in the study. The pregnant women reported that they have received information on oral health during pregnancy more often from gynecologists than from dentists. Slightly more than half of the participants (51.5%) rated to regularly undergo a professional tooth cleaning. Similarly, nearly half of the women stated to perform interdental cleaning (55.8%). The most common periodontal complaint was bleeding of the gums (45.4%). The OHIP G14 findings of all questions as well as sum scores showed a median of 0. Regression analysis revealed that regular professional tooth cleaning was a predictor of better OHRQoL (β – 0.698, CI95 0.049–1.299; p < 0.04).ConclusionOral hygiene and oral health behavior of pregnant women in southwest-Saxony requires improvement. While the overall OHRQoL of the cohort was not reduced, professional tooth cleaning and thus professional preventive measures can support OHRQoL during pregnancy. Improved interdisciplinary oral health care concepts for pregnant women should be fostered. These concepts can also positively influence OHRQoL issues.

Abstract 11679: Simple Text-Messaging and Social Support to Increase Hypertension Medication Adherence in Non-Hispanic Black Adults in New Orleans, LA

Introduction: Non-Hispanic Black adults (NHB) have the highest US CVD risk, the leading cause of mortality. Medication nonadherence predicts suboptimal HTN control. Self-measured blood pressure (SMBP) effectively tracks BP changes and medication response. Purpose: This New Orleans, LA predominantly NHB single cohort pilot study examined uncontrolled HTN utilizing bidirectional electronic messaging (BEM) with an interdisciplinary healthcare team assessing medication adherence, quality of life (QOL), and BP, without pharmacotherapeutic change. Methods: Participants were screened from Tulane Cardiology Clinic and community sources. Eligibility criteria included: uncontrolled HTN (BP &gt;130/80 mmHg), low Krousel-Wood (KW) adherence score, and smartphone access. Participants (n=36) were provided validated bluetooth-enabled BP devices synced to smartphones via a cloud-based BP recording app. Demographic information included: age, self-identified race (91.7% NHB), and sex. Pre- and post-study KW adherence scores, CDC Health Related QOL surveys, BMI and BP were obtained. Participants were followed with BEM for 8 weeks with SMBP and daily text reminders. Results: Mean age was 58.7±12.8 years; mean BMI was 34.8±7.8; 63.9% were female; 25.7 % with previous diabetes diagnosis; 72% with obesity. Nonadherence significantly improved with mean KW adherence composite score change from 2.19 to 1.58 (p = 0.0001). Mean baseline SBP/DBP was 142.19/81.19; SBP decreased significantly by mean 10.5±20.0 mmHg (p = 0.0027) with no significant change in DBP. There was a non-significant decline in the average summary index of unhealthy days during the previous 30 days from 9.1 days to 6.8 days, change -2.3 ± 10.7 (p = 0.21). Conclusions: A novel approach combining cloud-based bluetooth SMBP transmission with BEM health communication significantly improved medication adherence and systolic BP in a predominantly NHB urban cohort without modifying existing pharmacotherapy. “Supported in part by U54 GM104940 from the National Institute of General Medical Sciences of NIH, which funds the LA Clinical and Translational Science Center. Content is solely the responsibility of the authors and does not necessarily represent official views of the NIH.”

Change in end-of-life care and staff thinking at a geriatric health services facility after the introduction of the "My Wishes" notebook

A geriatric health services facility had been working to improve end-of-life care since 2014. In 2017, the facility introduced the My Wishes notebook, which confirms individual's medical choices and distributed the Explaining Practices and Intentions of End-of-life Care book in 2018, in order to help their staff improve care for older adults. Care staff used their learning in caregiving for older adults. This study aimed to clarify the change in end-of-life care and staff thinking at a geriatric health services facility after the introduction of the My Wishes notebook. We requested cooperation from all care staff at a geriatric health services facility, and focus group interviews were conducted with 13 staff members over two days in June 2019. The responses in relation to two parameters, the staff members' thoughts and the change in end-of-life care, following the introduction of My Wishes were recorded and qualitatively analyzed. Six categories of responses were extracted from the qualitative analysis: "Difficulty in using My Wishes", "Effects of the use of My Wishes ", "The practice of sought care", "Intentional involvement with patients' families", "Self-confidence in end-of-life care", and "End-of-life care becoming common practice". After the introduction of My Wishes, the care staff found that there were difficulties in using My Wishes, such as writing on paper and difficulties in them hearing. On the other hand, they felt the effects of using My Wishes, such as knowing a new side, feeling further possibilities of care, and activating communication among interdisciplinary healthcare providers. Then, while intentionally engaging with patients' families, they will seek and practice the care that the older adults want. Furthermore, while repeatedly searching for and practicing the care that older adults want, they will gain confidence in providing care and change to normalize these care practices.

Evaluating a Pharmacist-Initiated Care Bundle for Patients with Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is a cause of significant morbidity and mortality, and management of patients with this complex disease remains a challenge. Pharmacists work within an interdisciplinary health care team to coordinate services and ensure that standards of care are met. A pharmacist-initiated care bundle provided in the outpatient setting has shown promising results in improving COPD management. To evaluate, in the acute care setting, the effectiveness of a pharmacist-initiated COPD care bundle in improving compliance with health care measures known to improve outcomes in patients with COPD. This retrospective chart review included patients with acute exacerbation of COPD admitted from May 14, 2019, to February 29, 2020. Completion rates for the 6 individual components of the COPD care bundle were compared between patients who did and did not receive the pharmacist-initiated intervention. A subgroup of 22 patients received the following additional interventions: documentation of the modified Medical Research Council score, assessment of COPD medications, and vaccination review and administration. A total of 106 patients were included in the analysis, 53 patients in each of the control and intervention groups. The pharmacist-initiated intervention increased completion rates for the overall COPD care bundle from 2% to 17% (p = 0.003), for provision of the COPD flare-up action plan from 4% to 79% (p < 0.001), and for provision of smoking cessation education from 0% to 36% (p = 0.04); however, there was no significant difference in assessment by a respiratory therapist. For the subgroup that received additional interventions, vaccination reviews were conducted for 21 (96%) of the 22 patients, which led to 9 (41%) receiving a guideline-recommended vaccine. Pharmacist involvement in initiation of the care bundle significantly increased completion rates for the activities included in the care bundle.

Men’s perception of information and psychological distress in the diagnostic phase of prostate cancer: a comparative mixed methods study

BackgroundPrevious studies indicate that men experience frustration and uncertainty when confronted with an elevated prostate specific antigen (PSA) test and during further diagnostics for prostate cancer. The novel Stockholm3 test is an algorithm-based test that combines plasma protein biomarkers, genetic markers and clinical variables in predicting the risk of PCa. The test was introduced in a western part of Norway as a new tool for detecting prostate cancer. This study aimed to explore and compare men’s perception of information and possible experience of distress between a PSA group and a Stockholm3 group during the diagnostic phase of prostate cancer.MethodsThis study is a part of the trailing research evaluating the impact of the change from PSA to Stockholm3. It is a multicenter study using a comparative mixed method design. Data were collected in a PSA group (n = 130) and a Stockholm3 group (n = 120) between 2017 and 2019. Quantitative data were collected using questionnaires and qualitative data were collected using semi-structured interviews (n = 20). The quantitative and qualitative data were analysed and compared separately and then merged in a side-by-side discussion. The study adheres to the GRAMMS guidelines for reporting mixed-methods research.ResultsCompared with the PSA group, men in the Stockholm3 group reported that the information from the general practitioners was better. Similarly, men in the Stockholm3 group were more likely to indicate that they had received sufficient information regarding how examinations would be conducted. No differences were found between the groups regarding waiting time and distress. Three themes emerged from the qualitative analysis of the two groups: “Information affects the experience of comprehension”, “Stepping into the world of the healthcare system”, and “Periodically feelings of distress”.ConclusionThe Stockholm3 test may facilitate the provision of information to patients. However, some patients in both groups experienced distress and would benefit from more information and additional support from healthcare professionals. Routines that ensure sufficient information from the interdisciplinary healthcare team should be of priority during the diagnostic phase of prostate cancer in order to provide patients with predictability and to avoid unnecessary distress.

The biopsychosocial model in paediatric clinical practice-An interdisciplinary approach to somatic symptom disorders.

The paper aims to show how the biopsychosocial (BPS) model can be applied as a clinical method and guide the assessment and treatment of children and adolescents with somatic symptom disorders (SSD). Based on relevant literature and our clinical work with children and adolescents with SSD, we have developed a method to ensure a structured, interdisciplinary examination of biological, psychological and social factors, operationalising the BPS model into a clinical method. The BPS model renders assessment and treatment of complex conditions as a basis for evaluating phenomena not confined by diagnostic tools, but still includes all information from these tools. It requires an interdisciplinary approach, giving individual patient and caregivers a central position. A thorough medical examination is required as a starting point for assessments. Good results rest upon a shared understanding between patient, caregivers and professionals. 'Biopsychosocial' is often claimed as a basis for clinical work with complex cases, medical, functional and psychiatric, but scarcely with a corresponding BPS method or practice. The BPS method should guide further development of holistic, interdisciplinary health care on all levels, to assess and help children and adolescents with SSD.

The Attitudes Toward Interdisciplinary Health Care Teams Scale: Factor Analysis in Registered Dietitians

The Attitudes Toward Interdisciplinary Health Care Teams Scale: Factor Analysis in Registered Dietitians

Knowledge, perspectives and health outcome expectations of antibiotic therapy in hospitalized patients

SummaryBackgroundThe World Health Organization (WHO) has recognized antimicrobial resistance (AMR) as a top threat to global health. However, the public has an incomplete understanding of AMR and its consequences.AimThe aim of this study was to explore patients’ understanding, perspective and health outcome expectations for antibiotic therapy within an inpatient internal medicine population.MethodsA mixed methods study, combining a cross-sectional survey with qualitative methods. Fourteen questions (10 paper survey and four open ended interview questions) were used, and were completed by the participant in one sitting. Participants were recruited from General Internal Medicine units at two academic hospitals in Canada (convenience sample).FindingsThirty participants were included. Out of a scale of 1–100%, participants indicated moderate concern (mean of 40%) about getting an infection that could not be cured by antibiotics. The majority agreed that they trusted their healthcare team to decide on appropriate antibiotic therapy (mean of 81%). The participants strongly agreed (mean of 90%) that it was important to understand the rationale for their antibiotic therapy. Three themes emerged from the qualitative analysis: 1) varying levels of knowledge; 2) viewing antibiotics as beneficial while emphasizing effectiveness; and 3) trusting the healthcare team with expectations for inclusion in decision making.ConclusionThe study results showed varying levels of patients’ antibiotic knowledge and large gaps in awareness related to AMR. Exploring the role and workflow of interdisciplinary healthcare professionals may be a potential strategy to minimize patients’ knowledge gap related to antimicrobial therapy and AMR.

Psychological safety between pediatric residents and nurses and the impact of an interdisciplinary simulation curriculum

BackgroundEffective teamwork in interdisciplinary healthcare teams is necessary for patient safety. Psychological safety is a key component of effective teamwork. The baseline psychological safety on pediatric inpatient healthcare teams is unknown. The purpose of this study is to determine the baseline psychological safety between pediatric nurses and residents and examine the impact of an interdisciplinary nighttime simulation curriculum.MethodsA convergent, multistage mixed methods approach was used. An interprofessional simulation curriculum was implemented fall 2020 to spring 2021. Qualitative focus group data and quantitative survey data on team psychological safety were collected and compared, both pre- and post-intervention and across nurses and residents. Thematic analysis of the qualitative data was conducted, and themes integrated with survey findings.ResultsData were collected from 30 nurses and 37 residents pre-intervention and 32 and 38 post-intervention, respectively. Residents and nurses negatively rated psychological safety (pre-intervention mean = 3.40 [SD = 0.72]; post-intervention mean = 3.35 [SD = 0.81]). At both times psychological safety was rated significantly lower for residents (pre-intervention mean = 3.11 [SD = 0.76], post-intervention mean = 2.98 [SD = 0.84]) than nurses (pre-intervention mean = 3.76 [SD = 0.45], post-intervention mean = 3.79 [SD = 0.50]), all P < .001. Qualitative analysis identified six integrated themes: (1) influence of existing relationships on future interactions, (2) unsatisfactory manner and frequency of communication, (3) unsatisfactory resolution of disagreements (4) overwhelming resident workload impairs collaboration, (5) interpersonal disrespect disrupts teamwork, and (6) interprofessional simulation was useful but not sufficient for culture improvement.ConclusionResident-nurse team psychological safety ratings were not positive. While interprofessional simulation curriculum shows promise, additional efforts are needed to improve psychological safety among residents and nurses.

Development and Modification of a Culturally Tailored Education Program to Prevent Breast Cancer in Korean Immigrant Women in New York City.

Breast cancer (BC) is the most common cancer in Korean American (KA) women. In view of its high prevalence in these women, their low screening rates, and the cultural influence of BC risk factors in their lifestyles, we developed a community-based culturally tailored BC prevention program, the Korean Breast Cancer Risk Reduction Program (KBCRRP). Guided by the PRECEDE-PROCEDE and health belief models, the KBCRRP was developed to achieve four goals: (1) healthy weight, (2) physically active lifestyle, (3) healthy diet, and (4) BC screening and adherence. KBCRRP combines effective multicomponent strategies for BC screening and a group-based lifestyle intervention incorporating traditional Korean health beliefs and is tailored for BC risk reduction. In this paper, we provide an overview of the program, the process of program development, implementation, and evaluation, and modification during the COVID-19 pandemic. The initial program involved 8 weeks of in-person group education sessions led by interdisciplinary healthcare professionals and 16 weeks of follow-up involving smartphone applications, phone calls, and text messaging from trained lifestyle coaches. Participants received opportunities to obtain free mammography during the program. After feasibility testing, the program was modified by incorporating participants’ feedback. During the COVID-19 pandemic, we provided the program using the Zoom video platform. Participants’ recruitment and retention during the pandemic was successful, reflecting the fact that virtual delivery of group-based education was a feasible and acceptable alternative to in-person sessions. Collaboration with community organizations serving the target population is the key to developing and sustaining a successful community-based educational program.

Maintenance of Effects and Correlates of Changes Following Mindfulness for Interdisciplinary Health Care Professional Students.

Objectives:To evaluate long-term outcomes after an 8-week mindfulness intervention, Mindfulness for Interdisciplinary Health Care Professionals (MIHP), and investigate relationships between outcomes overtime.Design/Methods:In this single-arm study, 35 participants received MIHP and completed measures of burnout, perceived stress, activity impairment, and dispositional mindfulness at baseline, post-MIHP, and a 3-month follow-up. Changes over time were evaluated using repeated-measures analysis of variance (ANOVA) and reliable change indices (RCIs). Then, correlations between dispositional mindfulness and distress/impairment outcomes were evaluated.Results:At follow-up, aspects of burnout and several mindfulness skills demonstrated maintained improvements. RCIs showed that a higher percentage of participants improved on all outcomes at each time period than declined—all outcomes showed little to no deterioration. However, most participants did not reliably change, and this was more pronounced at the follow-up. Changes in two mindfulness skills (acting with awareness and nonjudging of inner experience) were consistently negatively correlated with distress and impairment outcomes.Conclusions:Acquired mindfulness skills during MIHP were maintained at the follow-up. RCI analyses demonstrated that MIHP may protect against worsening stress and burnout during training. Two mindfulness skills, acting with awareness and nonjudging of inner experience, showed potential mechanistic effects on work-relevant outcomes. Booster sessions to encourage maintained mindfulness practices and skills should be investigated in future trials. This study was registered on clinicaltrials.gov (#NCT03403335) on January 11, 2018.

Telemedicine, safe medication stewardship, and COVID-19: Digital transformation during a global pandemic.

Telemedicine may provide equitable, accessible, and affordable healthcare to individuals globally. Recently tele-medicine has emerged as a vital resource for interdisciplinary healthcare professionals to provide critical medical care on the frontlines during the combined COVID-19 pandemic and the drug and opioid crisis. With the recent 2020 expansion of insurance coverage of telemedicine services by the United States Centers for Medicare & Medicaid Services, there has been an uptick in the need to understand how to comprehensively train physicians and health care professionals on telemedicine during a public health crisis. This study gathered 98 survey responses from interdisciplinary healthcare professionals regarding their telemedicine experience, focusing on trends of use with the drug and opioid crisis during the COVID-19 pandemic. The results demonstrate that during the COVID-19 pandemic, telemedicine provided a novel, innovative way to address an unmet need in healthcare and may aid to improve safe medication stewardship (SaMS) practice guidelines. Further expanded population-based research and randomized clinical trials are necessary to confirm these preliminary recommendations and form best practices for use in digital health and telemedicine. In addition, further studies will confirm the benefits of interdisciplinary healthcare professionals’ engagement in harm reduction strategies via telemedicine to address improving safe medication use.

Consensus on scales for an interdisciplinary health assessment tool for the elderly population

Objective: to describe the consensus of the content of an instrument for assessing interdisciplinary health care of the elderly population. Methods: consensus study conducted among physicians, nurses, and social workers, contemplating the construction of instrument and the pre-test for selection of scales for use in practice. Questionnaire consisting of questions that identified representative scales in the assessment of the elderly. The scales that obtained consensus criterion of equal to or greater than 75% were considered selected by the experts. Sample was composed through snowball sampling, resulting in 101 participants. Results: of the 13 scales submitted,the professionals indicated that eight were suitable for use and two were already applied within their practice. The excluded became part of the recommendations for good practices in elderly care. A discrepancy was identified between what they consider to be useful and of interest versus what is applied in practice. Conclusion: consensus among experts allowed us to identify and select interdisciplinary assessment data for a proposed instrument to support the care process. Contributions to practice: this contributes to awareness about the use of recommended scales for the elderly and to avoid the overlapping of the same interventions by several professionals, with significant gains for this population.

Perspectives on physician leadership: The role of character-based leadership in medicine.

Physician leadership is multifaceted, but leadership training in medicine often is not. Leadership education and training for physicians are rarely grounded in conceptual leadership frameworks and suffer from a primary focus on cognitive leadership domains. Character-based leadership is a conceptual leadership framework that moves beyond cognitive competencies and articulates dimensions of character that promote effective leadership. The purpose of this study was to explore the relevance of character-based leadership in the medical context. This qualitative descriptive study used semi-structured interviews to explore health care professionals' perceptions of character in relation to effective leadership in medicine. All interviews were audiorecorded and transcribed. Consistent with descriptive qualitative inquiry, a qualitative latent content analysis was used. Simultaneous data collection and analysis incorporating character-based leadership as a theoretical framework was used to help organise the analysis of the data. The researchers met regularly to clarify coding structures and categorise codes until sufficiency was reached. Twenty-six individuals (12 doctors, 5 nurses, 2 social workers, 2 directors and a pharmacist, dietician, coordinator, administrator and unit clerk) participated. Character-based leadership resonated with participants; they deemed character essential for effective physician leadership. Participants reflected on different character dimensions they attributed to an effective physician leader, in particular, collaboration, humility and humanity. They shared examples of working in interdisciplinary health care teams to illustrate these in practice. Moreover, participants believed that effective physician leaders need not be in a positional leadership role and asserted that physicians who demonstrate character stand out as leaders regardless of their career stage. Our findings suggest a role for a character-based leadership framework in medical education. Participants recognised the execution of character in everyday practice, associated character with effective leadership and understood leadership in dispositional rather than positional terms. These findings provide important insights for expanding and enhancing existing leadership training interventions.

Sexual and Reproductive Health Care Experiences and Perceptions of Women with Congenital Heart Disease.

Due to medical advances, women with congenital heart disease (CHD) are living longer, healthier lives and many are considering pregnancy. The hemodynamic changes of pregnancy present high risks of morbidity and mortality for many women with CHD. As little is known about these women's reproductive health experiences, this study explores their perceptions of pregnancy and family planning care as related to CHD. Women ages 18-45 years with a diagnosis of CHD associated with a World Health Organization (WHO) classification II-IV for pregnancy morbidity and mortality participated in individual, semi-structured interviews exploring their experiences, attitudes, and preferences toward parenthood, pregnancy, contraception and family planning care provision. Interviews were audio-recorded, transcribed verbatim. Two independent coders performed analysis using deductive and inductive coding approaches. Twenty women with CHD participated in interviews (average age 30.1 years, SD 5.85). Nine women had a prior pregnancy and 14 considered becoming a parent in the future. We identified 5 key themes among the women: (1) CHD impacted their reproductive health goals and decisions; (2) Women with CHD perceived a lack of safe contraceptive methods for their condition; (3) Women desired tailored, disease-specific sexual and reproductive health (SRH) information; (4) Women viewed their cardiologist as the primary source for SRH information and prefer provider-initiated discussions starting in adolescence; and (5) Women desire coordinated pre-pregnancy and intrapartum care between their cardiologists and women's health providers. These results provide a foundation for interventions to improve patient-centered interdisciplinary reproductive healthcare for this population.

Interdisciplinary Approach to Reducing Healthcare Associated Infections Amid COVID-19 Pandemic

BackgroundThe COVID-19 pandemic has challenged acute-care hospitals (ACH) in numerous ways including increases in healthcare associated infections (HAI). The Centers for Disease Control and Prevention (CDC) 2020 Annual National and State HAI Progress Report denotes a 24% increase in central line associated bloodstream infections (CLABSI) between 2019 and 2020 with a 50% increase in the intensive care units (ICU) and minimal change in catheter associated urinary tract infections (CAUTI).MethodsAn interdisciplinary Healthcare Acquired Conditions (IHAC) team was implemented in a mid-size community hospital in Wisconsin to focus on the increase of HAI's during the pandemic. The IHAC team began meeting in November 2020 to discuss HAI events in real time and identify opportunities for improvement. The IHAC team was co-led by Nursing and Quality with standing membership including Infection Prevention, Risk, Safety, and Site Leadership. After HAI identification, IP communicates HAI event to the attribution unit. The unit reviews the medical record to complete a standardized tool and shares findings at the IHAC meeting. During the IHAC review, the team identifies improvement opportunities and assigns accountability with site leadership support.ResultsSince the IHAC team was established, there was an ongoing decline in HAIs. The following events were reported from January to December 2020: five (5) ICU CLABSI with a standardized infection ratio (SIR) 2.770 and two (2) non-ICU CLABSI SIR 0.667; two (2) ICU CAUTI SIR 1.002 and eight (8) non-ICU CAUTI SIR 1.864. After implementation of the IHAC team, there was a decrease in CAUTI and CLABSI events in January to September 2021: one (1) ICU CLABSI SIR 0.609 and one (1) non-ICU CLABSI SIR 0.318; one (1) ICU CAUTI SIR 0.573 and two (2) non-ICU CAUTI SIR 0.455.ConclusionsHAI reduction is achievable with an interdisciplinary approach discussing and identifying opportunities for improvement with the support of senior leadership.

Social Work Leadership Competencies for Practice amid Crisis: A Scoping Review.

Leadership skills are a critical component of effective social work practice in interdisciplinary healthcare and mental healthcare settings. Over the last two decades there has been increased attention to the importance of social work leadership skills for clinical practice. Moreover, social workers display essential leadership skills when supporting individuals and communities amid large-scale crises such as pandemics, natural disasters, wars, and other sociopolitical crises. Currently, there is an absence of literature on social work leadership skills for effective practice in healthcare and mental healthcare settings during times of crisis. To bridge this knowledge gap, this scoping review aimed to synthesize and map the current literature on social work leadership competencies in healthcare and mental healthcare amid crises. Arksey and O'Malley's five-stage framework for scoping reviews guided this project. Six academic databases were searched, and a total of nine articles met inclusion criteria. A thematic analysis was conducted to identify recurrent themes among these articles. Results highlight that leadership was defined as both a role and a skill set, and identified collaboration, connection, and shared learning as key leadership competencies for social workers. Implications for social work practice, education, and research are discussed.

Post-COVIDLMU: implementation and evaluation of an interdisciplinary and cross-sectoral healthcare and research network for evidence-based treatment of patients with severe post-COVID syndrome

Post-COVIDLMU ist ein interdisziplinäres und sektorenübergreifendes Versorgungs- und Forschungsnetzwerk des LMU(Ludwig-Maximilians-Universität)-Klinikums. Der Schwerpunkt liegt auf der Behandlung und Erforschung komplexer und schwerer Post-COVID(„coronavirus disease“)-Syndrom-Fälle bei Erwachsenen. Die Behandlung dieser Patientengruppe erfolgt interdisziplinär unter Einbezug zahlreicher Fachkliniken des LMU-Klinikums. Ergänzt wird das universitäre Behandlungsangebot durch moderne telemedizinische Sprechstunden, interdisziplinäre Fallkonferenzen unter Beteiligungsmöglichkeit der zuweisenden Kollegen*innen sowie der Möglichkeit für Patient*innen, an Studien der medizinischen Forschung zum Post-COVID-Syndrom teilzunehmen. Das LMU-Klinikum kooperiert eng mit niedergelassenen Ärzten*innen sowie verschiedenen Rehaeinrichtungen in Deutschland.

Addressing Shortages of Mental Health Professionals in U.S. Jails and Prisons.

Many jails and prisons in the United States do not have enough mental health professionals (MHPs) to meet the mental health needs of the people incarcerated in these facilities. This article examines strategies used to address MHP shortages in U.S. jails and prisons, including compensation incentives, telemental health services, interdisciplinary health care, flexible work schedules, and training rotations in correctional settings. These measures may help alleviate some of the shortages of MHPs in correctional facilities; however, these shortages will likely persist without broader policy reforms that decrease the size of U.S. correctional populations or increase the number of MHPs across the country.