Interdisciplinary Participants Research Articles

Designathons in health research: a global systematic review

IntroductionA designathon is a three-stage participatory activity informed by design thinking. There is a growing literature on designathons in health. This study synthesised designathons’ effectiveness and implementation-related factors to address...

Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process

BackgroundMany exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology.MethodsTwo hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1–10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%).ResultsIn round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate.Discussion and implicationsThe results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article.

Practice Improvement Projects in an Interdisciplinary Palliative Care Training Program.

Demand for palliative care (PC) continues to increase with an insufficient number of specialists to meet the need. This requires implementation of training curricula to expand the workforce of interdisciplinary clinicians who care for persons with serious illness. To evaluate the impact of utilizing individual practice improvement projects (PIP) as part of a longitudinal PC curriculum, the Coleman Palliative Medicine Training Program (CPMTP-2). Participants developed their PIPs based on their institutional needs and through a mentor, and participated in monthly meetings and bi-annual conferences, thereby allowing for continued process improvement and feedback. Thirty-seven interdisciplinary participants implemented 30 PIPs encompassing 7 themes: (1) staff education; (2) care quality and processes; (3) access to care; (4) documentation of care delivered; (5) new program development; (6) assessing gaps in care/patient needs; and (7) patient/family education. The majority of projects did achieve completion, with 16 of 30 projects reportedly being sustained several months after conclusion of the required training period. Qualitative feedback regarding mentors' expertise and availability was uniformly positive. The CPMTP-2 demonstrates the positive impact of PIPs in the development of skills for interdisciplinary learners as part of a longitudinal training program in primary PC. Participation in a PIP with administrative support may lead to operational improvement within PC teams.

The Futures Program: A Solution to the Physician Shortage in Geriatrics and Long-Term Care

Today’s digital and print geriatrics news are citing, almost daily, the overall workforce shortage being experienced in the United States. When we look specifically at health care, it reflects what is occurring in the general workforce. Within health care, I want to focus specifically on physicians. There are limited studies on the physician workforce; however, there are many projections of physician shortages, based on forecasting models, by 2030. In terms of geriatrics physicians, the numbers are staggeringly high. In 2006 the baby boomer generation started turning 60, and by 2030 this population will have grown from 36.8 million to 70 million when all boomers will have reached the age of 65. The American Geriatrics Society anticipates that 36,000 geriatricians will be needed by 2030. Currently, there are approximately 7,600 practicing in the United States. We are a short nine years from experiencing a geriatric “perfect storm.” As the physician shortage continues, the data reflect the ongoing trend to fill the gap with advanced practice practitioners. An article published by the American Association of Nurse Practitioners in 2019 (https://bit.ly/2UH0rW2) found that “by 2026, the Bureau of Labor Statistics projects that the NP role will have grown by 36 percent compared to 13 percent for physicians excluding anesthesiologists and surgeons.” Although there is a lack of nursing-home–specific data, Medicare billing data demonstrate the continued growth of the number of advanced practitioners in nursing home settings. The physician shortage is something that the Society, in partnership with its Foundation, has been focused on since 2001. Fortunately, this shortage is something that AMDA – The Society for Post-Acute and Long-Term Care Medicine, in partnership with the Society’s Foundation, has been focused on since 2001, when the Futures Program was created. One of the program’s primary goals is to introduce residents and geriatrics fellows to long-term care settings and inform them about the many practice opportunities in these settings, including the role of the medical director. This year the Futures Program is celebrating its 20th anniversary, and the Foundation is proud to report that:•Approximately 1,250 people have participated in the Futures Program.•20% of the participants have received their Certified Medical Director (CMD) designation.•25% of the participants have taken the Core Curriculum. Many Futures participants have served as committee chairs, board members, and national leaders in PALTC. When you consider the future in senior care, I think of the words of Bill Gates in his book The Road Ahead (Viking Penguin, 1995): “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten.” The next 10 years in health care will be pivotal as the older population expands and the labor force shrinks. Those of us serving on the Foundation board view this as an opportunity. The vision of the Foundation board is to expand the Futures Program and ensure that all interested physicians and advanced practitioners have expertise in caring for older adults in the PALTC environment. Further, especially considering the physician shortage, we plan to continue expanding and tailoring the program to include more interdisciplinary participants such as nurse practitioners, physician assistants, social workers, and PharmD graduates. Curriculum enhancements are also being considered to reflect many of the changes experienced in long-term care due to the COVID-19 pandemic. The Foundation’s goal is to support the education, through funding, of practitioners interested in long-term care so that they better understand the uniqueness and opportunities available within the PALTC spectrum. In preparation for the changes occurring during the next 10 years, please consider joining the Foundation’s work and helping to support the enhancement of the Futures Program. Visit https://www.paltcfoundation.org/ if you are interested in contributing to the Futures Program. Ms. Wassenaar is the owner of Wassenaar Consulting, LLC, and a member of the Foundation’s Board of Directors.

Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review.

Despite considerable research efforts, pancreatic cancer is associated with a dire prognosis and a 5-year survival rate of only 10%. Early symptoms of the disease are mostly nonspecific. The premise of improved survival through early detection is that more individuals will benefit from potentially curative treatment. Artificial intelligence (AI) methodology has emerged as a successful tool for risk stratification and identification in general health care. In response to the maturity of AI, Kenner Family Research Fund conducted the 2020 AI and Early Detection of Pancreatic Cancer Virtual Summit (www.pdac-virtualsummit.org) in conjunction with the American Pancreatic Association, with a focus on the potential of AI to advance early detection efforts in this disease. This comprehensive presummit article was prepared based on information provided by each of the interdisciplinary participants on one of the 5 following topics: Progress, Problems, and Prospects for Early Detection; AI and Machine Learning; AI and Pancreatic Cancer—Current Efforts; Collaborative Opportunities; and Moving Forward—Reflections from Government, Industry, and Advocacy. The outcome from the robust Summit conversations, to be presented in a future white paper, indicate that significant progress must be the result of strategic collaboration among investigators and institutions from multidisciplinary backgrounds, supported by committed funders.

Twelve Years of the Italian Program to Enhance Relational and Communication Skills (PERCS).

To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.

Caregiver-Centered Care Health Workforce Competencies: Developing Consistent Support for Family Caregivers

Family caregivers [FCGs] are the backbone of the health system. They provide over 80% of the care for people with dementia, chronic illnesses and impairments. Despite evidence of their contributions and consequences of caregiving, support for FCGs has not been a health system priority. Education to prepare health providers to effectively identify, engage, assess, and support FCGs throughout the care trajectory is an innovative approach in addressing inconsistent system of supports for FCGs. We report on development and validation of the Caregiver-Centered Care Competency Framework to help with curricular design and subsequent evaluation of effectiveness of care providers working within healthcare settings to engage and support FCGs. We used a three round modified Delphi approach. An expert panel of 42 international, national, and provincial stakeholders agreed to participate. In the first 2 rounds, multi-level, interdisciplinary participants, rated the indicators in terms of importance and relevance. In the 3rd round consensus meeting, participants validated the six competency domains, including indicators in small group sessions. Thirty-four experts (81%) participated in the round 1, 36 (85.7%) in round 2, and 42 people (100%) in round 3. There was stable consensus across all three rounds, 96.07% of participants rated the indicators as essential or important (Round 1, 95.81%; Round 2, 94.15; Round 3, 98.23%). FCG research has been primarily focussed on educating FCGs to provide care. These competencies will shape the design of educational curricula and interdisciplinary training programs aimed at supporting the health and social care workforce to provide caregiver-centered care.

Caregiver‐centered care health workforce competencies: Taking steps to support family caregivers of people living with dementia throughout the care trajectory

AbstractBackgroundFamily caregivers [FCGs] are the backbone of the health system [1‐3]. They provide over 80% of the care for people with dementia, chronic illnesses and impairments [4 5]. Despite evidence of their contributions and consequences of caregiving, support for FCGs has not been a health system priority[6‐8]. Multi‐level interdisciplinary Alberta stakeholders recommended developing Caregiver‐Centered Care Education for the health workforce to fill this gap [9‐14]. Education to prepare health providers to effectively identify, engage, assess, and support FCGs throughout the care trajectory is an innovative approach in addressing inconsistent system of supports for FCGs [5 6 15‐17]. Objective: We report on development and validation of the Caregiver‐Centered Care Competency Framework to help with curricular design and subsequent evaluation of effectiveness of care providers working within healthcare settings to engage and support FCGs. Project description: We used a modified Delphi approach. In the first 2 rounds, multi‐level, interdisciplinary participants, rated the indicators in terms of importance and relevance. In the 3rd round consensus meeting, participants validated the final competency indicators in small group sessions. Participants: Expert panel of international, national, and provincial stakeholders were invited to a 2‐day symposium March 14‐15, 2019 and participate in the Modified Delphi Process.ResultsAn expert panel of 42 international, national, and provincial stakeholders participated. Thirty‐four experts (81%) participated in the round 1, 36 (85.7%) in round 2, and 42 people (100%) in round 3. There was stable consensus across all three rounds, 96.07% of participants rated the indicators as essential or important (Round 1, 95.81%; Round 2, 94.15; Round 3, 98.23%). Six competency domains, including indicators, were validated. Discussion: FCG research has been primarily focused on educating FCGs to provide care [18‐20]. Our stakeholder engagement processes [9‐14] is critical to intervention research and practice that supports FCGs. The direct inclusion of multilevel stakeholders, particularly the FCGs, provided a robust forum for discussion and increased consensus around the value of a healthcare workforce trained to support FCGs.ConclusionsThese competencies will shape the design of educational curricula and interdisciplinary training programs aimed at supporting the health and social care workforce to provide caregiver‐centred care.

41 Fostering Hope: The Comprehensive Accessible care for Infants with Neonatal abstinence (CAIN) Study

Abstract Introduction/Background Neonatal Abstinence Syndrome (NAS) occurs in newborns exposed to drugs in-utero. In Canada, maternal opiate use in pregnancy has been steadily rising resulting in as many as 1850 babies born with NAS per year. Management of babies born with NAS requires supportive, interdisciplinary care. Depending on the severity of NAS, babies may be cared for with non-pharmacological interventions or some may need to be admitted to the Neonatal Intensive Care Unit for extended hospital stays to receive medication and management of ongoing complex health care needs. Hospital and community health care providers have expressed concerns around the continuity of care for these babies in their stay in hospital and their transition to home. Objectives This study examined the experiences of hospital and community-based health care providers and families regarding the management of babies with NAS. The driving force behind our inquiry related to our interest in streamlining care for these babies in highly complex health and social systems. Design/Methods In total, 47 interdisciplinary participants were interviewed over a four-month period with individuals from Women’s and Child Health, Community, and family members. Interviewed transcripts were reviewed over several months and were completed in December 2019 using an inductive thematic analysis which culminated in the identification of an overarching theme linked with primary themes. ​ Results The study identified existing gaps in the management of these patients, determined how to improve communication between hospital and community networks, and provided a better understanding of the attitudes, perceptions and experiences of hospital and community personnel. The overarching theme identified was hope, with the primary themes being: system, mental health, mother/baby, judgement, and knowledge (see Figure 1). Several gaps identified in the system included fear, stigma, and language. Certain solutions proposed for improvement included focused care in a rooming in model for the mother and baby dyad, supporting mothers’ well-being, involving mothers and families, and supporting care providers in a family centered care model. In Figure 1, green lines indicate themes that are linked with and support hope, and red lines indicate themes that are barriers to hope. Conclusion This research demonstrates that programs and interventions implemented when working with mothers and babies with NAS must foster hope in mothers, families, and in the extended care provider team.

The experience of the Program to Enhance Relational and Communication Skills 10 years after its inception in Italy.

Communicating unexpected and bad news is a stressful yet unavoidable aspect of clinical practice. However, there is a lack of educational models to train clinicians for difficult conversations. This study aims to: describe the main characteristics of the Program to Enhance Relational and Communication Skills (PERCS); present PERCS efficacy at 10 years since its inception in Italy; and illustrate a specific PERCS on organ donation as an example. PERCS is an educational model based on principles of experiential learning, developed at Children's Hospital Boston. PERCS has been offered as a continuing medical education program in an academic hospital in Milan. PERCS workshops last 5 hours and enroll a maximum of 13-15 interdisciplinary participants across levels of experience. The workshops are geared around the simulation and debriefing of difficult conversations. Before and after the workshops, participants rated their perceived preparation, communication and relational skills, confidence, and anxiety on 5-point Likert scales. Pre-post data were analyzed with paired sample t-tests. Between 2008 and 2018, 52 workshops have been offered, involving a total of 602 participants. Participants reported better preparation, confidence, communication and relational skills, and lower anxiety (for all dimensions, p<0.001) after the workshops. The strengths of the PERCS model includes: the integration between teaching specific skills and promoting relational attitudes, the learner-centered method, and its efficacy. Major challenges relate to the assessment of actual behavioral change of participants and long-lasting effect of the program at follow-ups.

Health Care Professionals' Reflections on Their Learning as Spiritual Generalists and Integration Into Practice.

Meeting spiritual needs of patients is an important aspect of quality health care, but continuing professional development and training to provide spiritual care remains inadequate. The purpose was to identify participants' learning from simulation-based spiritual generalist workshops and application to practice. Interdisciplinary participants completed self-report demographic questionnaires before the workshops and questionnaires after workshops that listed open-ended take-home learning. Responses were analyzed using qualitative content analysis. A subgroup was surveyed 3 to 9 months after training to examine whether and how participants had incorporated workshop learning into clinical work. Workshop participants 181/211 (85.8%) reported learning in four categories: core values and skills of spiritual generalists, understanding spirituality/religion and its role in health care, interfacing with chaplaincy, and interprofessional teamwork. Of the subsample, 73.5% (25/34) completed surveys 3 to 9 months after training. Of those, 25/25 (100%) reported drawing on what they learned in workshops, and 24/25 (96%) reported making clinical practice changes. One-day spiritual generalist simulation-based workshops can improve continuing professional development learning experiences to provide generalist level of spiritual care. Workshops offered valuable learning and resulted in applicable clinical skills across professional roles. At 3 to 9 months after training, participants reported improved spiritual screening, recognition of spiritual distress, and referral to chaplaincy.

Abstract 450: Rapid Cycle Deliberate Practice Improves Critical Item Retrieval From Crash Cart

Introduction: Unfamiliarity with crash cart contents contributes to decreased patient safety. There is no standardization of crash carts organization or contents. Initial moments of an emergency are critical and especially stressful. Responders familiar with the available equipment may be more efficient in retrieval and utilization of supplies. Methods: This study investigated the effects of Rapid Cycle Deliberate Practice (RCDP) as a training tool to increase familiarity with crash carts and contents, through a challenge of timed retrieval and assembly of critical items needed in response to in-hospital cardiac arrest (IHCA). Individuals were randomly assigned to one of four experimental groups to further identify efficient education methods. Hypothesis: RCDP predicted to improve retrieval performance and participant group assigned to hands-on discovery of the crash cart would show most improvement. Results: 75 interdisciplinary participants averaged total time for retrieval of 12 critical care items with completion of 4 corresponding tasks of 327 seconds decreased to 104 seconds from round 1 to 2. Secondly, average number of drawer pulls to retrieve items went from 14.8 to 10.5. The item most infrequently found in the 60 seconds allotted in round 1 was the intraosseous access kit (14/75, 18.67%). Connection of the defibrillator electrodes to the defibrillator device failed completion by 23 participants (30.67%) in the 60-second round 1. Retrieval of intraosseous access kit and connection of defibrillator electrodes was successful by all participants in round 2. Conclusions: Findings highlight the importance of training staff on available emergency equipment, with the expectation that increased familiarity and decreased response times will correlate to improved patient IHCA outcomes. Furthermore, findings indicate a need for standardization of crash cart organization across units and facilities.

Stakeholder perceptions of smart infusion pumps and drug library updates: A multisite, interdisciplinary study.

Results of a questionnaire-based study to evaluate smart infusion pump end users' perceptions and understanding of the drug library update process are reported. The Indianapolis Coalition for Patient Safety, Inc., in partnership with the Regenstrief Center for Healthcare Engineering, conducted a 33-item electronic, cross-sectional survey across 5 Indiana health systems from May through November 2017. Interdisciplinary participants identified for survey distribution included nurses, pharmacists, biomedical engineers, administrators, and medication safety officers. The survey assessed the following domains: patient safety, the drug library update process, knowledge of drug libraries and the update process, and end-user perceptions. A total of 778 submitted surveys were included in the data analysis, with a large majority of responses (90.2%) provided by nurses. The use of drug libraries for ensuring patient safety was deemed extremely important or important by 88% of respondents, but 36% indicated that they were unsure of whether drug libraries are updated on a routine basis in their health system. Approximately two-thirds agreed that the current update process improves quality of care (65.0%) and patient safety (68.1%). Moreover, 53.3% agreed that the current drug library update process was effective. However, less than 10% responded correctly when asked about the steps required to update the drug library. Furthermore, only 18% correctly indicated that when a pump is on it may not necessarily contain the most up-to-date version of the drug library. A survey of 5 health systems in Indianapolis identified several end-user knowledge gaps related to smart pump drug library updates. The results suggest that these gaps were most likely due to a combination of the 2-step update process and the fact that the current drug library version is not easy to find and/or user-friendly and it is unclear when an update is pending.

Design skills for environmental risk communication. Design in and design of an interdisciplinary workshop

Effective environmental risk management and risk reduction requires an inherently interdisciplinary and cross-sector approach to communication design. The challenging global impact of this area can only be addressed by increasing skills capacity in communication design across disciplines, a challenge which itself requires the design and delivery of new expert training. This paper reports on the design of and findings from an interdisciplinary, problem-based workshop to build risk communication skills, held at the World Bank’s Understanding Risk 2018 conference, Mexico City. The workshop combined high competence interdisciplinary participants (including designers) with detailed real-world scenarios in a 24-hour ‘pressure cooker’ working environment, designed by a team of interdisciplinary young professionals. The results show engagement from participants across the disciplines involved, who produced outcomes with a community education and user-centred focus. The workshop highlighted that more direct, critical, engagement from the design community is needed in educating about, and delivering, environmental risk communication.

Development of the Care Environment Scale-Long-Term Care.

A critical dimension of Quality Assurance and Performance Improvement (QAPI) activity in long-term care is an analysis of the care environment, that is, the way care and services are organized. The purpose of this study was to develop and pilot test a psychometrically sound tool that long-term care staff could use to assess the care environment and guide performance improvement activity. Focus groups with 57 interdisciplinary participants in five nursing homes developed initial items, with excellent content validity (item content validity index = 1.0) evaluated by an expert panel. Pilot testing of internal consistency of the Care Environment Scale-Long-Term Care (CES-LTC) was conducted in a web-based administration of the items by 425 interdisciplinary staff members in 30 nursing homes and four assisted living facilities. The CES-LTC is internally consistent (Cronbach's alpha = .90) and accounts for approximately 71.6% of the total variance. The three factors extracted from the exploratory factor analysis are Institutional Values (k = 6), Access to Resources (k = 10), and Person-Centered Approaches (k = 12). Intrarater reliability in a subsample of 66 registered nurses revealed good test-retest results (overall intraclass correlation coefficients [ICC] = 0.78). The CES-LTC appears to be a valid and reliable measure of staff perceptions of the care environment and may be used to actively engage staff in QAPI endeavors including root cause analyses and improvement activity.

Vulnerability Assessment of Climate Change Impact on Critical Oil/Gas Infrastructure: A Decision-Maker’s Perception in the Niger Delta

The impacts of climate change arising from flooding, the intrusion of high saline tidewater, rising temperature, wind storms, and rising Atlantic level are exacerbating significant threats to oil and gas critical installations in the Niger Delta. Understanding the hierarchies of vulnerable critical infrastructure could help assets managers in the industry to adopt sustainable adaptation measures against the looming impacts of climate change–induced stress on systems. In this article, the analytic hierarchy process (AHP) is implemented in prioritising vulnerable critical oil and gas infrastructure in the Niger Delta for effective and sustainable adaptation planning and response. A mix of an exploratory investigation involving interdisciplinary participants' engagement in focus groups were conducted in four multinational oil companies in the Niger Delta to elicit data for analysis. Participants in the study compared seven selected critical installations using an AHP questionnaire. A Mi-AHP spreadsheet analysis of stakeholders' perceptions revealed infrastructure vulnerability in hierarchical form: pipelines, terminals, roads/bridges, flow stations, loading bays, transformers/high voltage cables, and wellheads. The study shows that the vulnerability in the region is influenced by exposure, the presence of climate burdens, and proximity to inundated coastal areas below 4.5 meters above sea level. It also shows that critical systems are vulnerable due to interdependence and level of linkages that exist between directly vulnerable and non-directly vulnerable assets. Results also show that vulnerability in the region is due to critical perception, age and obsolescence, and weak adaptive capacity. This study furnished decision-makers in the oil and gas sector with information on which infrastructure is to be protected in terms of adaptation planning, investment, and implementation with particular attention on climate change.

Understanding Synthesis Across Disciplines to Improve Nursing Education.

Nursing students must learn higher-order thinking skills of analysis and synthesis to manage complex data for decision making in healthcare. Teaching synthesis, however, is challenging and elusive due to lack of understanding of the concept and an explicit pedagogy for teaching it. A qualitative, multi-phased research project was designed to gain understanding of what synthesis is, how professionals acquire synthesis skills, and how to best teach synthesis. The first phase explored interdisciplinary descriptions of synthesis. Three focus groups were conducted, and interdisciplinary participants responded to several questions. Several themes emerged suggesting that synthesis depends on cognitive skills and competencies, situational and contextual factors, preparation and knowledge acquisition skills, interpersonal and interaction skills, and personal qualities. Participants also supported use of multi-modal teaching strategies to reinforce students' use of synthesis in learning. This project provided a beginning understanding of the synthesis process, revealing striking similarities in synthesis across professional disciplines.

Agile Values and Their Implementation in Practice

Today agile approaches are often used for the development of digital products. Since their development in the 90s, Agile Methodologies, such as Scrum and Extreme Programming, have evolved. Team collaboration is strongly influenced by the values and principles of the Agile Manifesto. The values and principles described in the Agile Manifesto support the optimization of the development process. In this article, the current operation is analyzed in Agile Product Development Processes. Both, the cooperation in the project team and the understanding of the roles and tasks will be analyzed. The results are set in relation to the best practices of Agile Methodologies. A quantitative questionnaire related to best practices in Agile Product Development was developed. The study was carried out with 175 interdisciplinary participants from the IT industry. For the evaluation of the results, 93 participants were included who have expertise in the subject area Agile Methodologies. On one hand, it is shown that the collaborative development of product-related ideas brings benefits. On the other hand, it is investigated which effect a good understanding of the product has on decisions made during the implementation. Furthermore, the skillset of product managers, the use of pair programming, and the advantages of cross-functional teams are analyzed.

Using Simulated Transport Calls to Identify Diversity of Knowledge and Care Plans among the Multidisciplinary Team

Research has shown that patient safety and quality of care provided is affected by the knowledge, technical ability, and behavioral skills of each member of the multidisciplinary care team. All NICU patients at Boston Children's Hospital (BCH) are born at outside facilities. Thus, transport call preparedness is fundamental to providing exceptional care for NICU patients. Our study aims to answer the question: Does significant variance exist among the multidisciplinary team members in the interpretation of transport call data and the subsequent preparation that occurs when caring for critically ill neonates? The 2011 NICU Crisis Resource Management (CRM) course reflects results from a multidisciplinary needs assessment. Three transport calls for neonate with persistent pulmonary hypertension of the newborn (PPHN) were received by a multidisciplinary team. Each member completed a survey following each call. After the final transport call, the patient arrived in the simulator suite and the course progressed. One hundred forty interdisciplinary participants completed the course. After listening to the transport calls, 85.5% of participants categorized the patient as category, RED (Emergent/Urgent resuscitation-high acute status), while 14.5% of participants selected category, YELLOW (Patient in clinical transition or requiring time sensitive procedures). Of the healthcare providers, the highest percentage group selecting category YELLOW was the fellow group (18%), while 0% of the NNP group selected YELLOW. Blood pressure mean goal recommendations were more varied among the groups. Eighty-five per cent of attendings, 75% of neonatal nurse practitioners (NNPs), 75% of fellows, and 55% of RNs selected 40-50 mmHg; while 15% of attendings, 25% of NNPs, 12.5% of fellows, and 33% of RNs selected 50 mmHg or more. Importantly, 100% of participants, including attendings, NNPs, respiratory therapists (RTs), fellows, and RNs, said they would have a team huddle prior to the arrival of this infant. Within the variance that exists in regard to knowledge, experience, and practice among the multidisciplinary groups, attendings and NNPs tended to be more aligned with their assessment and approach. Simulated transport calls provide a safe environment to uncover these differences and to allow for future study to improve teamwork and to provide the best care for the critically ill neonate. Categories: Pediatrics, Medical Simulation

Demenz in Deutschland – Ergebnisse eines interdisziplinären Expertenworkshops

In the aging population of Germany the consequences of Dementia for the society and the health care sector are complex and solutions require a multidisciplinary approach. The aim of the two-day interdisciplinary expert conference was to consider dementia from different perspectives, to identify dementia-related problems and to discuss integrative solutions under consideration of complementary therapies. In different working groups the experts developed solutions and recommendations with regards to political need, health care and future research priorities. The present recommendations profited very much from the interdisciplinary participants of the conference and brought together the expertise of different fields resulting in a comprehensive picture about dementia in Germany.