Interdisciplinary Meetings Research Articles

Implementing Screening for Neonatal Delirium in the Neonatal Intensive Care Unit: A Quality Improvement Initiative.

Delirium is not commonly diagnosed in neonatal intensive care units and can adversely impact patient outcomes in the ICU setting. Recognition of delirium in the NICU is a necessary first step to address the potential impact on neonatal outcomes. We conducted a quality improvement initiative implementing screening for neonatal delirium. We aimed to increase screening in NICU patients from 0% to 85% by March 2022. Interdisciplinary meetings were held with key stakeholders to develop a clinical algorithm. We used standardized tools for delirium screening. Our process measures included weekly nursing compliance with Richmond Agitation Sedation Scale/Cornell Assessment of Pediatric Delirium/ scoring documentation (Fig. 1) and patients referred to psychiatry. Outcome measures included the percentage of patients screened for delirium before discharge. We conducted Plan-Do-Study Act cycles to optimize the screening process in the electronic medical record (EMR). This included creating an order set, documentation flowsheets, and prompts in the EMR for patients. After initial implementation, we achieved an average weekly screening compliance of 76% (Fig. 1). Inclusion criteria expansion resulted in a downward compliance shift to 59%. Subsequently, the addition of the EMR checklist resulted in a center-line shift to a sustained average weekly screening compliance of 77%. An average of 82% of all eligible NICU patients received delirium screening before discharge (Fig. 2). Using quality improvement methodology, there was increased screening and recognition of delirium in our NICU. Future research efforts could focus on assessing preventive measures and the impact of neonatal delirium on patient outcomes.

Hospital Unit Type and Professional Roles as a Predictor of Relational Coordination in an Army Medical Center.

High-quality communication and relationships are associated with quality of care. Workflow differences across hospital units can impede communication and relationships among health care professionals. Relational coordination (RC) is a process of communication supported by shared goals, shared knowledge, and mutual respect and is associated with quality of care and better performance outcomes in civilian hospitals. However, RC has not been explored in military hospitals. The objective of our study was to determine whether RC differs between hospital units and professional roles. Specifically, we examined RC differences by unit type for nurses, resident physicians, and physicians working in an Army Medical Center. We conducted an exploratory analysis of a secondary question from a cross-sectional study using a convenience sample of active-duty and civilian licensed practical nurses (LPNs), registered nurses (RNs), physician residents, and physicians (n = 289). We received institutional review board approval from the study site. Data were collected from January 2020 to March 2020, and participants completed a 47-item survey regarding their experiences of RC in various hospital units. We used t tests and one-way analyses of variance to explore bivariate relationships between RC and other study variables, as well as multiple regression to explore whether RC varied by unit type. We controlled for education and experience by including them in the model because these variables may influence perceptions of nurse-physician RC and their interactions with each other. Seventy percent of participants were civilian (n = 203), 75% RNs (n = 217), and 78% female (n = 216). The mean age of respondents was 40 years (SD = 11.7), and the mean experience level was 11.9 years (SD = 9.5). RC was not associated with unit type. Total RC and between-role RC were associated with professional role. Physicians reported higher RC (β = .45, P = .01), and LPNs reported lower RC (β = -.06, P = .01). Education and experience were associated with RC. Participants with less experience reported higher RC (β = -.01, P = .00), and participants with graduate degrees reported lower RC (β = -.62, P = .00). We recommend hospital leaders consider interventions to build interprofessional relationships, including interdisciplinary meetings, huddles, and structured communication tools. Improving RC among health care professionals is a cost-effective and unique way to enhance communication and collaboration among health care professionals across hospital units.

Impact of an interdisciplinary process to increase utilization of neuraxial anesthesia for cesarean delivery: A retrospective database analysis

BackgroundNeuraxial anesthesia is the preferred anesthesia mode for cesarean delivery (CD). The primary study aim was to study the rate of neuraxial anesthesia for cesarean delivery before and after educational strategies were implemented, focusing on neuraxial anesthesia use for CD. MethodsWe performed a retrospective analysis of the mode of anesthesia for CD. Educational strategies to inform about neuraxial anesthesia for CD included interdisciplinary daily handovers and ward rounds, and interdisciplinary academic meetings and simulation sessions. We retrieved data from the hospital electronic record for mode of anesthesia for CD, intravenous supplementation, to assess the impact of our strategies on neuraxial anesthesia use for CD (2014–2023). ResultsThe rate of neuraxial anesthesia increased from 89.8% in 2014 to 96.3% in 2023, with corresponding decrease in general anesthesia from 10.2% to 4.5% for all CD. The use of labor epidural augmentation for unplanned CD increased from 31.9% to 55.1%. Intravenous supplementation with spinal anesthesia for unplanned CD increased from 18.1% to 32.1%. ConclusionsThis study demonstrates the utility of educational strategies to increase neuraxial anesthesia use and highlights the importance of proactive interdisciplinary labor management.

Unveiling missed nursing care: a comprehensive examination of neglected responsibilities and practice environment challenges

BackgroundThe global variable of missed nursing care and practice environment are widely recognized as two crucial contextual factors that significantly impact the quality of nursing care. This study assessed the current status of missed nursing care and the characteristics of the nursing practice environment in Iran. Additionally, this study aimed to explore the relationship between these two variables.MethodsWe conducted an across-sectional study from May 2021 to January 2022 in which we investigated 255 nurses. We utilized the Missed Nursing Care Survey, the Nursing Work Index-Practice Environment Scale, and a demographic questionnaire to gather the necessary information. We used the Shapiro‒Wilk test, Pearson correlation coefficient test, and multiple linear regression test in SPSS version 20 for the data analyses.ResultsAccording to the present study, 41% of nurses regularly or often overlooked certain aspects of care, resulting in an average score of 32.34 ± 7.43 for missed nursing care. It is worth noting that attending patient care conferences, providing patient bathing and skin care, and assisting with toileting needs were all significant factors contributing to the score. The overall practice environment was unfavorable, with a mean score of 2.25 ± 0.51. Interestingly, ‘nursing foundations for quality of care’ was identified as the sole predictor of missed nursing care, with a β value of -0.22 and a p-value of 0.036.ConclusionsThis study identified attending patient care interdisciplinary team meetings and delivering basic care promptly as the most prevalent instances of missed nursing care. Unfortunately, the surveyed hospitals exhibited an undesirable practice environment, which correlated with a higher incidence of missed nursing care. These findings highlight the crucial impact of nurses’ practice environment on care delivery. Addressing the challenges in the practice environment is essential for reducing instances of missed care, improving patient outcomes, and enhancing overall healthcare quality.

Towards an Interoperability Landscape for a National Research Data Infrastructure for Personal Health Data

The German initiative “National Research Data Infrastructure for Personal Health Data” (NFDI4Health) focuses on research data management in health research. It aims to foster and develop harmonized informatics standards for public health, epidemiological studies, and clinical trials, facilitating access to relevant data and metadata standards. This publication lists syntactic and semantic data standards of potential use for NFDI4Health and beyond, based on interdisciplinary meetings and workshops, mappings of study questionnaires and the NFDI4Health metadata schema, and literature search. Included are 7 syntactic, 32 semantic and 9 combined syntactic and semantic standards. In addition, 101 ISO Standards from ISO/TC 215 Health Informatics and ISO/TC 276 Biotechnology could be identified as being potentially relevant. The work emphasizes the utilization of standards for epidemiological and health research data ensuring interoperability as well as the compatibility to NFDI4Health, its use cases, and to (inter-)national efforts within these sectors. The goal is to foster collaborative and inter-sectoral work in health research and initiate a debate around the potential of using common standards.

An open door to the job market? Music therapy students’ reflections on practice placement in Norway

This study explores the transition between learning at university and learning in a work context through practice placement. It was conducted at the University of Bergen (UiB), which offers a five-year programme in music therapy. Practice placement is integrated at all levels of the programme, starting with observation of music therapy, to a placement where students work more autonomously. The aim of this study was to learn from the experiences of students participating in the programme, as their insights are crucial for informing the programme’s content. Our question was: How do students from the UiB five-year integrated music therapy programme reflect on their internship experiences, and how can we understand their reflections from a work-based learning perspective? To investigate this, we conducted two focus groups, each with five students. Following a thematic analysis of the data, three main themes and six sub-themes were developed: 1. Developing an identity as a music therapist (1.1. Gaining a professional identity, 1.2. Finding a voice in interdisciplinary meetings); 2. An open door to the job market (2.1. Learning from experience, 2.2. Developing new networks); and 3. Challenges with the music therapy practice placement (3.1. Feeling side-lined, 3.2. Lack of a broader teaching model). The themes, grounded in the empirical findings, are discussed from a sociocultural perspective, drawing on concepts such as apprenticeship learning, community of practice, and weak ties. This article concludes with implications for practice and suggestions for further research.

Videoconferencing in mental health services for children and adolescents receiving child welfare services: a scoping review

BackgroundVideoconferencing is considered an alternative to face-to-face consultations and a possibility to help overcome access-to-care barriers in mental health care services. Barriers to child and adolescent mental health services are particularly apparent in the case of children and adolescents receiving child welfare services. This scoping review aims to provide an overview of research on videoconferencing in the mental health treatment of children and adolescents receiving support from child welfare services.MethodsThis scoping review follows the review framework outlined by the Joanna Briggs Institute. The following databases were searched from January 2012 to April 2024: Scopus, Web of Science, PubMed, PsycINFO (Ovid), CINAHL Plus, Social Services s (ProQuest), Sociological s (ProQuest), and Google Scholar.ResultsThe search yielded 4322 unique records and resulted in the inclusion of 22 articles that met the inclusion criteria. The studies originated from Denmark, England, Australia, Norway, Canada, Chile, and the USA, and were grouped into four areas: (1) videoconferencing to increase access to mental health treatment for vulnerable groups (2) young people’s perspectives (3) videoconferencing in interdisciplinary collaborative meetings, and (4) use, awareness, and acceptance of videoconferencing among health and social care providers.ConclusionsThis scoping review shows that if videoconferencing in mental health care is to become an established and trusted method aimed at children and adolescents receiving child welfare services, several unresolved and potentially negative issues need attention and more research. This particularly applies to whether videoconferencing decreases or exacerbates inequalities in access to mental health services. A further question is whether new barriers are raised by screen-based treatment to threaten good therapeutic relationships, and by extension treatment quality and clinical outcomes.

Nursing Experience of A Young Girl with IgA Nephropathy who Received Initial Hemodialysis

<p>本文為一位青少女因IgA腎病初次接受血液透析治療，疾病進展快速，使個案及案父母產生焦慮及照護認知不足之護理經驗。護理期間自2020年06月15日至07月10日，運用Gordon十一項健康功能型態評估，以直接照護、會談、身體評估及跨科部會議等方式收集資料，確立個案健康問題有:營養不均衡、焦慮、照顧者角色緊張。照護過程中，透過陪伴、傾聽與案家建立信任之護病關係，藉由飲食日誌設計個別性菜單、透過跨科部會議調整飲食攝取模式，以改善營養不均衡；利用漫畫繪本、健康管理工具，提升自我照護技能，減輕其焦慮；同理父母心理壓力，討論照護工作之分配、喘息減壓方式，降低照顧負荷，使個案學會自主健康管理，進而達到親子共責之健康管理模式。因應蔬食飲食人口的增加，建議偕同營養師設計「透析素食菜單」，讓病人保有自己喜好的飲食模式，以增加疾病的適應性，藉此護理經驗作為日後照護此類病人之參考。</p> <p> </p><p>We reported a young girl who began to receive hemodialysis due to IgA nephropathy. Our nursing experience focus on her and her parents’ anxiety and lack of caring cognition due to rapidly progressive disease. During our nursing period from June 15th to July 10th, 2020, we used the “Gordon 11 Function Health Patterns” to collect data by direct care, interviews, physical examination and multi-disciplinary discussion. We found that our case had health problems including nutritional imbalance, anxiety and caregiver role strain. Furthermore, we established a trusting relationship by accompany, listening and building trust with her family. We used diet diaries to create individualized menu, used interdisciplinary team meetings to improve nutritional imbalances, and used comic books and health management tools to improve self-care skills and reduce anxiety. We empathized with parents’ psychological pressure, discussed the distribution of care work, provided respite care, reduced care load, taught her self-health management and then achieved the health management model of parent-child shared responsibility. In response to the increase in the population of vegetarian, we designed a "vegetarian menu for dialysis" with our dietitian. Therefore, the patients could maintain their own dietary preference to increase the adaptability to diseases. We took this nursing experience as a reference for the care of such patients in the future.</p> <p> </p>

The LIVER CARE trial - screening for liver disease in individuals attending treatment for alcohol use disorder: a randomized controlled feasibility trial.

Alcohol-related liver disease is a preventable disease with high mortality. If individuals with alcohol-related liver disease were to be diagnosed earlier by screening and they reduced their alcohol consumption, lives lost to alcohol-related liver disease might be saved. A liver stiffness measurement (FibroScan©) is a key tool to screen for alcohol-related liver disease in asymptomatic individuals. No randomized controlled trials have been conducted to test if screening for liver disease reduces alcohol consumption in individuals with alcohol use disorders, in addition to what can be obtained by motivational interventions. We aimed to assess the feasibility of a randomized controlled trial of a screening for liver disease on the prevalence of alcohol abstinence or light consumption after 6months in individuals attending outpatient treatment for alcohol use disorder. We used an interdisciplinary approach to develop the format of the randomized controlled trial. Individuals were recruited from one outpatient treatment facility for alcohol use disorders. Study participants were randomized 1:1 to receive a) a liver stiffness measurement in addition to usual care (intervention) or b) usual care (control). Follow-up on alcohol consumption was assessed by telephone interview after 6months and corroborated by data from records from public hospitals and the alcohol treatment facility. Feasibility was assessed by probabilities of recruitment, retention, and completion and estimated by the exact binominal test, with success defined as > 50% participation for each endpoint. The study design was evaluated at interdisciplinary meetings with staff and researchers from the outpatient alcohol treatment facility and the hospital clinic. Forty of 57 invited individuals agreed to participate in the study (recruitment = 70% (95% CI: 57-82)); 19 of 20 participants randomized to the intervention showed up for the screening (retention = 95% (95% CI: 75-100)). Follow-up telephone interviews succeeded for 33 of 39 reachable participants (completion = 85% (95% CI: 69-94)). Treatment records indicated that the 6 participants who were lost to follow-up for the telephone interview had not achieved alcohol abstinence or light consumption. There was no evidence that the intervention increased abstinence or light alcohol consumption at follow-up: 45% (95% CI: 23-68) in the intervention group and 65% (95% CI: 41-85) in the control grouphad aalcohol consumption below10 standard drinks/weekat 6months. The main obstacle regarding study feasibility was to avoid disappointment in individuals randomized as controls. This feasibility study developed a study design to test the influence of screening for liver disease on abstinence or light alcohol consumption in individuals attending treatment for alcohol use disorder. ClinicalTrials.gov identifier: NCT05244720; registered on February 17, 2022.

FOSTERING CROSS-DISCIPLINARY COLLABORATION IN OFFSHORE PROJECTS: STRATEGIES AND BEST PRACTICES

In the realm of offshore engineering projects, the integration of diverse professional expertise is essential for successful planning and execution. This paper explores strategies and best practices for fostering cross-disciplinary collaboration in offshore projects, aiming to enhance project outcomes and mitigate risks. The abstract begins by highlighting the significance of cross-disciplinary collaboration in addressing the complex challenges inherent in offshore endeavors. It delineates the various strategies proposed for effective collaboration, including establishing clear project objectives, creating a collaborative culture, implementing robust communication channels, promoting mutual understanding, and encouraging interdisciplinary training. Furthermore, it outlines best practices such as forming cross-functional teams, utilizing integrated project management tools, holding regular interdisciplinary meetings, and embracing diversity. Through the analysis of case studies and examples, this paper illustrates the application of these strategies and best practices in real-world offshore projects, emphasizing successful outcomes and key lessons learned. The abstract concludes by emphasizing the importance of fostering cross-disciplinary collaboration in offshore engineering projects and suggests avenues for future research to further enhance collaboration methods and outcomes in this critical field.
 Keywords: Cross-Disciplinary Collaboration, Offshore Projects, Integrating Diverse Professional Expertise, Planning, Execution, Offshore Engineering Projects.

Principles and Equations of Physics: a multidisciplinary laboratory

In the last two academical years, as part of the Italian Ministry plan PLS – “Piano Lauree Scientifiche” (Scientific Degree Plan), two courses for high school students and teachers consisting in some interdisciplinary and transversal online meetings have been proposed. They regarded the three principles of dynamics, the law of universal gravitation and Maxwell’s equations. “Variations” around these topics were also presented – of historical, philosophical and also of musical nature – to make the cultural setting of what has been discussed deeper and make it meaningful in the present. At the end of each course, students produced a video of few minutes with a personal reworking and rethinking of the meaning of one of the topics discussed.

Meeting Report for the Phenoscape TraitFest 2023 with Comments on Organising Interdisciplinary Meetings

The Phenoscape project has developed ontology-based tools and a knowledge base that enables the integration and discovery of phenotypes across species from the scientific literature. The Phenoscape TraitFest 2023 event aimed to promote innovative applications that adopt the capabilities supported by the data in the Phenoscape Knowledgebase and its corresponding semantics-enabled tools, algorithms and infrastructure. The event brought together 26 participants, including domain experts in biodiversity informatics, taxonomy and phylogenetics and software developers from various life-sciences programming toolkits and phylogenetic software projects, for an intense four-day collaborative software coding event. The event was designed as a hands-on workshop, based on the Open Space Technology methodology, in which participants self-organise into subgroups to collaboratively plan and work on their shared research interests. We describe how the workshop was organised, the projects developed and outcomes resulting from the workshop, as well as the challenges in bringing together a diverse group of participants to engage productively in a collaborative environment.

Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach.

Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

The use of information technology to improve interdisciplinary communication during infectious diseases ward rounds on the paediatric intensive care unit

Prospective audit with feedback during infectious diseases ward rounds (IDWR) is a common antimicrobial stewardship (AMS) practice on the Paediatric Intensive Care Unit (PICU). These interdisciplinary meetings rely on the quality of handover, with high risk of omission of information. We developed an electronic platform integrating infection-related patient data (COSARAPed). In the mixed PICU of a Belgian tertiary hospital we conducted an observational prospective cohort study comparing patient handovers during IDWRs using the COSARAPed-platform to those with access only to conventional resources. The quality of handover was investigated directly by assessment if the narrative was in accordance with Situation-Background-Assessment-Recommendation principles and if adequate demonstration of diagnostic information occurred, and also indirectly by registration if this was only achieved after intervention by the non-presenting AMS team members. We also recorded all AMS-recommendations. During a 6-month study period, 24 IDWRs and 82 patient presentations were assessed. We could only find a statistically significant advantage in favor of COSARAPed by indirect evaluation. We registered 92 AMS-recommendations, mainly resulting in reduced antibiotic pressure. We concluded that the IDWR is an appropriate platform for AMS on the PICU and that the utilisation of COSARAPed may enhance the quality of patient handover.

Interdisciplinary cooperation in the outpatient practice: results from a focus group interview with occupational therapists, speech and language therapists and physiotherapists / Gestaltung der interdisziplinären Zusammenarbeit in der ambulanten Therapie: Resultate eines Fokusgruppeninterviews mit Ergotherapeut*innen, Logopäd*innen und Physiotherapeut*innen

Abstract The complexity and diversity of healthcare conditions, as well as the financial and personnel challenges requires effective interdisciplinary collaboration (IDC) among various healthcare professionals (Robert-Bosch-Stiftung, 2011; Robert Koch Institute, 2015). In contrast to the inpatient practice, IDC has not established yet in primary care settings. There is a lack of concrete solutions that illustrate how IDC can be implemented in outpatient practice (Schmitz, Atzeni & Berchtold, 2020). The study aims to present realization possibilities of the IDC among occupational therapists, speech and language therapists and physiotherapists based on case examples from outpatient neurorehabilitation practices. Necessary framework conditions and support factors should be identified from successful applications. In an online focus group, five therapists from three outpatient therapy centers were interviewed about the interdisciplinary measures taking place at their workplace. The therapy centers implemented interdisciplinary team meetings, collaborative target setting and therapy planning as well as co-therapies in their everyday primary care practice. Digital communication channels and the use of digital practice software represent support measures that enable communication independent of location and time. Educational policy changes are needed to impart the corresponding attitudes, knowledge and skills to the healthcare professionals during the vocational training/study. The results of the study show that IDC can be implemented in the outpatient setting under appropriate conditions. Legal requirements are needed to enable the application of interdisciplinary measures through adequate remuneration systems and available time slots. Further calls address content in vocational trainings/studies to provide a basis for readiness and competencies for IDC.

Effectiveness of Police Intra-Departmental Collaboration in Combating Human Trafficking in Nairobi City County, Kenya

The primary aim of this study was to investigate the effectiveness of police intra-departmental collaboration in combating human trafficking in Nairobi County, Kenya. Human trafficking remains a critical issue requiring effective intra-departmental collaboration among police units. This study investigates how various strategies and practices impact the efficiency of police efforts in combating human trafficking; with a focus on Nairobi County. The study employs Network Theory which emphasizes the importance of communication networks in coordinating and enhancing collaborative efforts across different units within an organization. Data was collected through structured interviews and focus groups discussions with key stakeholders, including police officers, community leaders, and National Government Officers. The study utilized a purposive sampling method to ensure diverse perspectives on the effectiveness of intra-departmental collaboration. The research engaged 20 respondents, including local community leaders, senior police officers, and national-level officials. Data was analyzed using thematic analysis for qualitative responses and descriptive statistics for quantitative data. This approach facilitated a comprehensive understanding of the communication practices, command structure, resource allocation, and community involvement in combating human trafficking. The study found that centralized communication systems and routine interdepartmental meetings significantly enhance cooperation and efficiency in responding to human trafficking. Decentralization of command authority improves local responsiveness, while fair resource distribution fosters collaboration. Community leaders and organizations provide crucial intelligence and support, emphasizing the need for strengthened partnerships between police and community stakeholders. Effective anti-trafficking efforts depend on integrated communication systems, improved command structures, equitable resource allocation, and strong community partnerships. While centralized systems and strategic planning enhance inter-departmental collaboration, issues such as inadequate command guidance and resource imbalances hinder cooperation. To improve intra-departmental collaboration, it is recommended to decentralize decision-making authority, implement a unified communication platform, conduct regular interdisciplinary meetings, and ensure equitable distribution of resources. Additionally, fostering stronger relationships with local community leaders and organizations will enhance information sharing and overall effectiveness in combating human trafficking.

Medication optimization in nursing homes: the impact of education and interdisciplinary case conferencing

Introduction: Potentially inappropriate prescribing has shown to be highly prevalent in older adults, especially in nursing home residents. Previous research, such as the Come-On study, proved that a complex intervention, containing an educational component and interdisciplinary case conferencing, is effective in reducing this phenomenon. 
 Policy context and objective: Awaiting the structural implementation supported by the government, an initiative was set up in West-Flanders to locally implement such an intervention and explore its impact.
 Target population: This study targeted nursing home residents and nursing home staff.
 Innovation, impact, outcomes: The intervention included three components: 1) education of nursing home staff by the pharmacist with regard to medication use in nursing home residents, 2) interdisciplinary case conferencing during which medication plans of residents were discussed (i.e. medication review) by the resident’s general practitioner (or the nursing home’s coordinating physician), a nurse, and the pharmacist, and 3) intervision across nursing homes to discuss experiences. Nursing homes were encouraged to involve residents and family members as much as possible (e.g. to invite them to the interdisciplinary case conference). For each case conference, nursing homes were instructed to report the duration, the identified (potential) drug-related problems, and the proposed medication changes. Throughout the study, financial incentives were provided for pharmacists and nursing homes.
 Quantitative data were analyzed descriptively, while qualitative data were analyzed inductively. Furthermore, an economic evaluation was performed.
 Eight nursing homes participated in the study. Nursing home staff indicated to have better medication-related knowledge and to be more aware of potential drug-related problems thanks to their participation in the project. They also experienced better communication between all involved healthcare professionals and with residents and their families.
 So far, data with regard to the interdisciplinary case conferences has been collected from five nursing homes, encompassing 266 nursing home residents. An interdisciplinary case conference lasted on average about 30 minutes per resident. For 60% of these nursing home residents, at least one medication change was implemented (e.g. stopping of a drug, change of administration time or route, change of dosage form). The five most frequently stopped drugs included 1) vitamins and supplements, 2) psychotropic drugs, 3) pain killers, 4) PPIs, and 5) antihypertensive drugs. On average, this resulted in a saving of €105 per year per resident.
 It was noted that general practitioners only participated in the case conferences in one nursing home. Likewise, residents nor family members were present during the interdisciplinary meetings. Nevertheless, residents (and families) were interviewed regarding their medication use in preparation of the conference and were informed about medication changes afterwards. 
 Transferability and conclusion: The intervention was shown to be effective in optimizing the medication use of nursing home residents. Following steps will focus on the implementation of the intervention in a higher number of nursing homes, as well as in other home replacing settings. Additionally, opportunities for involvement of residents and their families, as well the participation of general practitioners will be further investigated.
 Key words: Residential care, interdisciplinary case conferences, inappropriate prescribing, medication review

The ADEM project: implementation of ‘Good medicines use conversation’ for COPD-patients, embedded in multidisciplinary context.

COPD is a chronic, progressive disease, for which a multidisciplinary approach is crucial. Appropriate follow-up is crucial to improve the quality of life of COPD-patients and reduce associated healthcare costs. 
 A ‘Good medicines use conversation’ COPD is a pharmaceutical care intervention, conducted by the community pharmacist, consisting of a tailored-made education of the COPD-patient on the disease and its treatment. Scientific research (PHARMACOP-trial) has shown that this intervention significantly improves therapy adherence and inhalation technique and reduces exacerbation rates and associated hospitalizations. 
 The aim of the ADEM implementation project was to investigate the needs for a sustainable implementation of this intervention.
 The ADEM project was conducted in Flemish-Brabant (Belgium), with the integrated care region ‘Leuven Cares’ as a separate entity. 
 All participating pharmacies (9 in region Flemish-Brabant and 8 in region ‘Leuven Cares’) received a support package consisting of: 1) a three-part online training about COPD and a visual COPD-atlas; 2) a population management-tool (a query to identify COPD-patients in the pharmacy, resulting in a list of COPD-patients with a ‘score’ per patient as an initial proxy for patient prioritization); and 3) local interdisciplinary meetings (LIM) to discuss and promote the intervention. Pharmacist of the region Caring Leuven additionally received individual care plans, providing an overview of the healthcare status of each COPD-patient, and an individual coaching session.
 Semi-structured interviews were conducted with 8 participating pharmacists (4 region Flemish-Brabant, 4 region ‘Leuven Cares’). Thematic analysis was performed.
 
 All elements of the support package were positively evaluated by the participating pharmacists. The population management tool seemed to support pharmacists in planning, interpreting and prioritizing care for COPD-patients. A follow-up study is needed to further investigate the tool and to what extent population management contributes to a more qualitative and effective pharmaceutical care. 
 COVID-19, lack of personnel, lack of reimbursement and lack of time were identified as limiting factors for the implementation of the protocol-based COPD-intervention. Cooperation with the GP was indicated by the majority as minimal and insufficient. Therefore, LIM’s were evaluated as very important to inform GP’s about the pharmaceutical intervention and make local agreements about the multidisciplinary approach of COPD.
 The findings of this study are in line with the available evidence on the implementation of new services in pharmacies. Many pharmacists have the intrinsic motivation to offer extended pharmaceutical care, but current practices often do not allow this. Population management appeared to be a major factor that can be used to facilitate the implementation. By considering the needs of the local population, pharmacists can work in a more targeted way and prioritize the pharmaceutical services they offer. Given the group of chronically ill people in Belgium is expected to grow in the coming years due to the increasing ageing of the population, there will be an increasing demand for specialized interventions and advice from the pharmacist. It is therefore necessary to provide a sufficient framework for these services, bearing in mind the needs of the local population and the requirement for a pragmatic approach in the pharmacy. 

Level of Interprofessional Collaboration in Hospital Intensive Care Unit (ICU)

Interprofessional collaboration plays a crucial role in the intensive care unit (ICU) setting. It involves healthcare professionals from different disciplines working together to provide holistic care to critically ill patients. In past decades research about effective collaboration has shown that it requires a combination of individual attitudes, team dynamics, and institutional factors. Individual attitudes encompass respect, trust, and open communication among team members. It is essential for professionals to value each other's expertise and contribute their unique perspectives to optimize patient outcomes. Team dynamics involve effective leadership, clear roles and responsibilities, and shared decision-making. When teams function cohesively, they can efficiently address complex ICU challenges. Institutional factors, such as organizational culture, policies, and resources, significantly influence interprofessional collaboration. Supportive environments that encourage collaboration through education, training, and interdisciplinary meetings foster a culture of teamwork. Ultimately, successful interprofessional collaboration in the ICU leads to improved patient safety, enhanced clinical outcomes, and better overall healthcare delivery. By leveraging the diverse skills and knowledge of healthcare professionals, ICU teams can provide comprehensive care that meets the complex needs of critically ill patients.

6 Feasibility and Perceived Benefit of an Interdisciplinary Rehabilitation Approach within a Tertiary Pediatric Hematology/Oncology Setting

Objective:Medulloblastoma is the most common pediatric malignant brain tumor. Approximately 29% of medulloblastoma patients experience postoperative posterior fossa syndrome (PFS) characterized by impairments in speech, motor, and mood. An interdisciplinary rehabilitation approach is associated with greater rehabilitation gains than a single discipline approach for brain injury patients with significant rehabilitation needs. However, literature regarding the feasibility and utility of this approach within a tertiary care pediatric hematology/oncology setting is lacking. The Acute Neurological Injury (ANI) service was developed to coordinate care for neurologically complex hematology/oncology patients receiving active cancer treatment, including those with PFS. ANI care coordination includes bimonthly interdisciplinary team meetings, interdisciplinary goal implementation for each patient, parent psychoeducation about applicable brain-behavior relationships (including PFS) at treatment initiation, neuropsychological assessment at transition times throughout treatment, cognitive remediation, and coordinated end of treatment transition planning. We gathered caregiver perspective on this approach within a tertiary care pediatric hematology/oncology setting.Participants and Methods:Parents of children and young adults (ages 4-20) with PFS after medulloblastoma resection who received coordinated care as part of the ANI program (n=20) were interviewed at least 4 months following completion of cancer treatment. 75% experienced postoperative mutism while the remainder experienced significantly decreased speech without mutism. All received cranial-spinal irradiation and focal boosts to tumor sites followed by chemotherapy per multi-institutional treatment protocol. Caregivers were interviewed regarding perceived feasibility and utility of ANI program components including parent psychoeducation, neuropsychological assessment, cognitive remediation, and interdisciplinary team coordination/goal setting, as well as parental supports. Yes/no responses were gathered as well as responses regarding the perceived utility of aspects of the interdisciplinary ANI program approach via a five-point Likert scale.Results:Surveys were completed by 66% of families contacted. Mean age at first contact with neuropsychology as part of the ANI program was 9.45 years (SD=4.4 years). Mean time between end of treatment and parent interview was 3.20 years (SD=2.01 years). Most parents reported that initial psychoeducation about PFS helped to decrease their concerns (81%) and increased their understanding of their child’s functioning in the context of PFS (88%). They reported benefit from neuropsychological assessment reports prior to initiating adjuvant treatment (92%), at end of treatment (90%), and one year following initiation of cancer treatment (100%), though they perceived less benefit from assessments intended to inform provider interventions during treatment (81% and 66%). Reports were shared most often with schools (75%), behavioral therapists (50%), physicians (50%), and rehabilitation specialists (25%). Parents indicated that the interdisciplinary ANI program approach was helpful (94%) and the coordinated interdisciplinary goal was beneficial (92%). Most parents favored the weekly frequency of cognitive remediation sessions (83%). Much interest was voiced in establishing a formal mentoring program to offer peer support by parents whose children have previously experienced PFS to those acutely managing a new PFS diagnosis (95%). Of note, all participants indicated that they would be willing to serve in a peer mentor role (100%).Conclusions:The interdisciplinary ANI program approach is feasible with perceived benefits to families managing new PFS and medulloblastoma diagnoses and receiving active cancer treatment.