Interprofessional Team Members Research Articles

Using an Educational Intervention to Map our Surgical Teams’ Function, Emotional Intelligence, Communication and Conflict Styles

The leadership team invited surgical team members to participate in educational sessions that created self and other awareness as well as gathered baseline information about these topics: communication, conflict management, emotional intelligence, and teamwork. Each educational session included an inventory that was completed to help participants understand their own characteristics and the characteristics of their team members. The results from these inventories were aggregated, relationships were identified, and the intervention was evaluated. A level 1 trauma center, Baylor Scott and White Health, in central Texas; a 636-bed tertiary care main hospital and an affiliated children's hospital. An open invitation for all surgical team members yielded 551 interprofessional OR team members including anesthesia, attending physicians, nursing, physician assistants, residents, and administration. Surgeons' communication styles were individual focused, while other team members were group focused. The most common conflict management mode for surgical team members on average was avoiding, and the least common was collaborating. Surgeons primarily used competing mode for conflict management, with avoiding coming in a close second. Finally, the 5 dysfunctions of a team inventory revealed low accountability scores, meaning the participants struggled with holding team members accountable. Helping team members understand their own and others' strengths and blind spots will help create opportunity for more purposeful and clear communication. Additionally, this knowledge should improve efficiency and safety in the high-stakes environment of the operating room.

Psychologists' Role in Addressing Healthcare Provider Burnout and Well-Being.

Burnout in health care has received considerable attention; widespread efforts to implement burnout reduction initiatives are underway. Healthcare providers with marginalized identities may be especially at risk. Health service psychologists are often key members of interprofessional teams and may be asked to intervene with colleagues exhibiting signs of burnout. Consequently, psychologists in these settings can then find themselves in professional quandaries. In the absence of clear guidelines, psychologists are learning to enhance their scope of practice and navigate ethical guidelines while supporting colleagues and simultaneously satisfying organizational priorities. In this paper we (a) provide an overview of burnout and its scope, (b) discuss ethical challenges health service psychologists face in addressing provider burnout, and (c) present three models to employ in healthcare provider burnout and well-being.

Barriers and Facilitators to Telehealth Timed Up and Go (TUG) Assessment in an Underserved Urban Stroke Population (P6-5.013)

<h3>Objective:</h3> To eliminate barriers and facilitate remote assessment of a standardized mobility outcome measure for stroke patients in a telehealth-based study to facilitate physical activity and rehabilitation at home through fitness monitoring and feedback. <h3>Background:</h3> Telehealth for assessment &amp; intervention for individuals with neurological conditions has grown since the CoVid-19 pandemic. Our stroke patients are from an underserved urban community with social, personal, and environmental barriers that would impact success of a telehealth program. <h3>Design/Methods:</h3> Patients (n= 6 to date) with minor stroke discharged home from acute hospitalization were recruited. Evaluation by the interdisciplinary team determined patient safety for discharge home (6Clicks Mobility Score=46.15(9.12)). A neurologist evaluated the patient through telehealth and information from 1 month monitoring period was reviewed with an infographic guided discussion to enhance self-efficacy. Physical therapy team members executed two TUG trials and determined real-time reliability. The assessors followed a standardized script including a flowsheet with video demonstrations of camera set-up, testing materials and TUG demonstration. Patients provided feedback regarding instruction mode and suggested improvements. The Theoretical Domains Framework (TDF) mapped identified barriers/facilitators, analyzed, and interpreted the results. Intertester reliability for TUG and TUG/physical mobility measure correlation were performed. <h3>Results:</h3> The flowsheet, video demonstration, and client feedback eliminated patient barriers in knowledge, environmental context and resources domains. Memory, attention, and decision process barriers were facilitated by flexible patient scheduling and phone call reminders. Professional role/identity barriers were eliminated by optimizing each interprofessional team member’s skill set. Patient selection criteria during hospitalization eliminated the barrier to beliefs about consequences. Beliefs about capability barriers were mitigated by intertester reliability (r²=0.98) during telehealth TUG assessment and correlation with remote monitored average daily step counts (r²=−0.52). <h3>Conclusions:</h3> TDF identified facilitators to telehealth TUG assessment in an urban underserved stroke community with resource and environmental constraints and should be utilized to promote equity in health care. <b>Disclosure:</b> Clare Bassile has nothing to disclose. Ms. McIntyre has nothing to disclose. Miss Powell has nothing to disclose. Ms. Sareen has nothing to disclose. Ms. Karsos has nothing to disclose. Dr. Naqvi has nothing to disclose.

Exploring Interprofessional Development of Entrustable Professional Activities For Pediatric Intensive Care Fellows: A Proof-of-Concept Study

Phenomenon : Entrustable professional activities (EPAs) delineate major professional activities that an individual in a given specialty must be “entrusted” to perform, ultimately without supervision, to provide quality patient care. Until now, most EPA frameworks have been developed by professionals within the same specialty. As safe, effective, and sustainable health care ultimately depends on interprofessional collaboration, we hypothesized that members of interprofessional teams might have clear and possibly additional insight into which activities are essential to the professional work of a medical specialist. Approach : We recently employed a national modified Delphi study to develop and validate a set of EPAs for Dutch pediatric intensive care fellows. In this proof-of-concept study, we explored what pediatric intensive care physicians’ non-physician team members (physician assistants, nurse practitioners, and nurses) constitute as essential professional activities for PICU physicians and how they regarded the newly developed set of nine EPAs. We compared their judgments with the PICU physicians’ opinions. Findings : This study shows that non-physician team members share a mental model with physicians about which EPAs are indispensable for pediatric intensive care physicians. Despite this agreement however, descriptions of EPAs are not always clear for non-physician team members who have to work with them on a daily basis. Insights : Ambiguity as to what an EPA entails when qualifying a trainee can have implications for patient safety and trainees themselves. Input from non-physician team members may add to the clarity of EPA descriptions. This finding supports the involvement of non-physician team members in the developmental process of EPAs for (sub)specialty training programs.

Importance of interprofessional collaboration in teaching diabetic foot self-management: Perceptions of health care professionals

BackgroundDiabetes and associated diabetic foot ulcers require coordinated management, including several health care professional (HCPs). Therefore, an interprofessional (IP) team-based approach is essential for effectively managing and educating the population on diabetic foot self-management strategies. However, the perceptions of the HCPs related to the importance of IP teamwork in diabetic foot care and their readiness to work in an IP team are less explored. MethodsThis qualitative study aimed to investigate the HCPs' perception on the importance of IP collaboration in diabetic foot care and their readiness to work as part of an IP team in teaching patients’ effective diabetic foot self-management techniques. The study includes seven HCPs involved in diabetic foot management patient education and treatment. In-depth interviews using an interview guide and a thematic analysis of the interview transcripts were undertaken. ResultsEvery participant was strongly motivated to be an IP team member. The following themes were identified that supported IP team-based approach in diabetic foot care: ‘patient-centric practices,’ ‘comprehensive care,’ ‘teamwork and coordination for improved patient outcome,’ ‘integrated approach,’ ‘professional knowledge amalgamation,’ ‘time-management,’ ‘education in a favorable environment,’ ‘constant motivation and support through educational modules,’ and ‘commitment and policy reforms.’ ConclusionsThe HCPs' were aware about the benefits of IP team-based approach in diabetic foot care. They further expressed their willingness to work as part of an IP team and suggested appropriate teaching methods for diabetic foot self-management. This manuscript thus attempts to create an awareness about the importance of IP approach in teaching the proper practices of diabetic foot care. The problems faced in implementing an IP approach in diabetic foot care and the possible solutions are also discussed.

The ACGME Framework for Medically Underserved Areas and Populations and Graduate Medical Education

The ACGME Framework for Medically Underserved Areas and Populations and Graduate Medical Education

Advancing Pharmacogenomics-Based Care Through Interprofessional Education

As genomic medicine becomes increasingly complex, pharmacists need to work collaboratively with other healthcare professionals to provide genomics-based care. The core pharmacist competencies in genomics were recently updated and mapped to the entrustable professional activities (EPAs). The new competency that is mapped to the “Interprofessional Team Member” EPA domain emphasizes the role of pharmacists as the pharmacogenomics experts in an interprofessional healthcare team. Interprofessional education (IPE) activities involving student pharmacists and students from other healthcare disciplines are crucial to prepare student pharmacists for a team-based approach to patient-centered care. This commentary discusses the pharmacogenomics-focused IPE activities implemented by 3 programs, the challenges faced, and the lessons learned. It also discusses strategies to develop pharmacogenomics-focused IPE activities based on existing resources. Developing pharmacogenomics-focused IPE activities will help prepare pharmacy graduates with the knowledge, skills, and attitudes to lead collaborative, interprofessional teams in the provision of pharmacogenomics-based care, consistent with the standards described in the genomics competencies for pharmacists.

The paradoxical effects of professional stereotypes on the quality of care by interprofessional teams: The contingent effects of team faultlines, team stereotypes, and championship behaviors.

Despite calls for interprofessional teamwork to ensure quality care in healthcare settings, interprofessional teams do not always perform effectively. There is evidence that professional stereotypes inhibit effective interprofessional teamwork, but they haven't been explored as a phenomenon that impacts team's performance and quality of care. To focus on professional stereotypes emerging in interprofessional teams and examine the contingency effects of interprofessional team's faultlines, professional stereotypes, and leader's championship behaviors on team's quality of care. A cross-sectional nested sample of 59 interprofessional teams and 284 professionals, working in geriatric long-term-care facilities in Israel. Additionally, five to seven of the residents of each facility were randomly sampled to obtain the outcome variable. Data collection employed a multisource (interprofessional team members), multimethod (validated questionnaires and data from residents' health records) strategy. The results indicated that faultlines are not directly harmful to team's quality of care; instead, they are likely to impact quality of care only when team stereotypes emerge. Furthermore, whereas teams typified by high professional stereotypes require person-oriented championship leadership, for teams typified by low team stereotypes, championship leadership harms the quality of care they provide. These findings have implications for handling interprofessional teams. Practically, leaders must be well-educated to better analyze team members' needs and maintain the appropriate leadership style.

In-Person or Online? Exploring Student Pharmacists’ Perceived Change in Interprofessional Skills between Two Delivery Formats

The COVID-19 pandemic drastically changed how education is delivered. Many academic programs quickly transformed their curriculum to online distance learning. This rapid transition may have compromised the rigor and fidelity of these activities. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity (IPE) involving a team of students from six different healthcare professions that switched to an online delivery format. This manuscript compares pharmacy students' perceived change in interprofessional skills between the two formats. Following the ISPE, second-year pharmacy students completed the revised Interprofessional Collaborative Competencies Attainment Survey (ICCAS-R). The ICCAS-R assesses the change in interprofessional collaboration-related competencies in healthcare students before and after IPE training using a retrospective pre-post approach. For each ICCAS-R item and each delivery format (44 in-person and 51 online), paired Student's t-test on pre- and post-ISPE scores, and Cohen's d were calculated. Every item of the ICCAS-R was significant (p < 0.001), regardless of delivery format. Nearly all ICCAS-R items had a large effect size, and the remaining items had a medium effect size. The amount of change pre- and post-ISPE for each ICCAS-R item was calculated. Student's t-test was used to compare the magnitude of change in interprofessional skills between the two delivery formats. Only one difference was noted between the two delivery formats-ICCAS-R item 16, which measured actively listening to interprofessional team members (p = 0.0321). When switching to an online format, the high-fidelity dimension of the ISPE was retained. The ISPE is an effective IPE activity at increasing pharmacy students' self-perceived interprofessional collaboration skills regardless of delivery format. Even though students reported the ISPE increased their ability to actively listen to the perspectives of interprofessional team members in both formats, the magnitude of the benefit was more profound in the in-person group.

Evaluating a virtual and in-person nutrition interprofessional educational experience for first-year medical students

Nutrition plays a critical role in preventing, managing, and treating noncommunicable diseases; thus it is essential physicians be able to appropriately refer to and collaborate with interprofessional (IP) care team members, like registered dietitian nutritionists (RDNs). This study evaluated the effectiveness of the Nutrition Clinical Experience (NCE) to increase first-year medical students' (M1s′) understanding of RDNs’ roles on the IP healthcare team, common reasons to consult a RDN, and interventions RDNs implement.M1s participated in a 1.5 or 2-h IP clinical observation experience with an outpatient or inpatient RDN. Due to the COVID-19 pandemic, virtual, in-person, and hybrid experiences were offered. Before the experience, students were provided a handout with an overview of a RDN's role, description of medical nutrition therapy, and example cases. During the NCE students shadowed a RDN as they conducted outpatient encounters or inpatient rounds, and were encouraged to discuss real or sample patient cases. Students and RDNs answered post-experience 5-point Likert surveys and free-response questions to evaluate experience effectiveness. Of responding students, 96% agreed or strongly agreed the experience helped them learn about RDNs' roles and 99% agreed or strongly agreed they were more likely to involve a RDN in patient care following the experience. Additionally, after the experience, 78% of participating students identified at least one common reason to consult a RDN and 70% described at least three interventions that RDNs implement. All responding RDNs agreed or strongly agreed the experience is valuable to students and 85% agreed or strongly agreed the NCE allowed them to communicate their roles to students. The ability to deliver the experience virtually makes it a useful curricular program for schools without on-site RDNs to engage preclinical students in IP experiences. This report includes materials required for the experience.

Many Hands Working Together: Adapting Hospital Care to Support Autistic Children's Mental Health.

Hospitals pose a threat to autistic children's mental health. Adapting hospitals to meet children's needs can address this issue. To determine the impact of an interprofessional program (Adaptive Care) to support autistic children's mental health on nursing staff's knowledge, efficacy, and confidence. Pretest-posttest, quasi-experimental design. Large pediatric hospital. Nursing staff were the first participants in the program implementation. Approximately 300 nursing staff received training through the program, and 107 completed program evaluation surveys. Of these, 18 nursing staff completed both the pretest and posttest surveys approximately 1 yr apart. Occupational therapy practitioners and other professionals developed and implemented the program, which consists of staff training and resources to adapt hospital physical and social environments and to ultimately improve patients' hospital experiences. Researcher-developed, pilot-tested, online survey to assess knowledge, perceived effectiveness, confidence, and strategies that staff used while caring for autistic children in the hospital. Respondents had increased effectiveness and confidence working with autistic children in the hospital after program implementation. Respondents reported significantly more strategies to care for autistic children. Interprofessional collaboration and programming can positively affect social environments in the hospital by enhancing nursing staff's self-efficacy, confidence, and strategies to support mental health and to enhance health care for autistic children. What This Article Adds: The Adaptive Care program is an example of occupational therapy practitioners and other interprofessional team members adapting physical and social health care environments to support autistic children's mental health. This program was effective at increasing nursing staff's self-efficacy, confidence, and strategies while caring for autistic children in the hospital. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel etal., 2021; Kenny etal., 2016).

Everybody Copes: An Interprofessional Workshop on Stress, Coping, and Helping Primary Care Patients Manage Medical Stressors.

The value of psychological principles has become apparent in medical settings, especially with the rise of patient-centered care. We aimed to provide a curriculum informing medical providers about the theoretical basis and clinical utility of the social-cognitive model of stress and coping. This workshop was delivered to an interprofessional team of faculty and trainees. Our initial pedagogical approach was to relate the concepts of cognitive appraisals and coping strategies to participants' own stress responses. We then used didactic presentation and small-group activities to explore ways to promote adaptive coping with patients to improve health outcomes. Learners participated in a mindfulness exercise, conceptualized coping strategies given a hypothetical case scenario, and, in small groups, role-played a patient encounter to construct an effective coping repertoire for the patient. Participants completed a prework self-assessment and workshop evaluation form. The 2.5-hour workshop had 48 participants from five professions (medicine, education, physician assistant, pharmacology, psychology). We received 35 evaluations (73% response rate). Learners reported increased real-world skills (M = 8.0 out of 10) and feeling better prepared for working in interprofessional settings (M = 7.6 out of 10). Qualitative feedback suggested that participants recognized the importance of individual differences in coping with stress and felt they could categorize strategies into emotion- or problem-focused coping. This workshop provided participants with basic knowledge about the social-cognitive model of stress and coping and allowed them to practice newly learned skills in a role-play as an interprofessional medical care team.

Interprofessional simulation of acute care for nursing and medical students: interprofessional competencies and transfer to the workplace

BackgroundTeamwork and communication are essential tools for doctors, nurses and other team members in the management of critically ill patients. Early interprofessional education during study, using acute care simulation, may improve teamwork and communication between interprofessional team members on the long run.MethodsA comparative sequential quantitative–qualitative study was used to understand interprofessional learning outcomes in nursing and medical students after simulation of acute care. Students were assigned to a uni- or interprofessional training. Questionnaires were used to measure short and long term differences in interprofessional collaboration and communication between the intervention and control group for nursing and medical students respectively. Semi-structured focus groups were conducted to gain a better understanding of IPE in acute simulation.ResultsOne hundred and ninety-one students participated in this study (131 medical, 60 nursing students). No differences were found between the intervention and control group in overall ICCAS scores for both medical and nursing students (p = 0.181 and p = 0.441). There were no differences in ICS scores between the intervention and control group. Focus groups revealed growing competence in interprofessional communication and collaboration for both medical and nursing students.ConclusionsInterprofessional simulation training did show measurable growth of interprofessional competencies, but so did uniprofessional training. Both medical and nursing students reported increased awareness of perspective and expertise of own and other profession. Furthermore, they reported growing competence in interprofessional communication and collaboration in transfer to their workplace.

Introducing Nursing Students to Pastoral Care Providers Via Simulation.

During a mock code simulation scenario in a medical-surgical undergraduate nursing course, two priests as pastoral care providers were included as interprofessional team members. Perceptions of the inclusion of pastoral care in an end-of-life simulation were assessed as part of a mixed-method study that included a qualitative analysis of debriefing sessions. Students reported an increase in awareness of the role of pastoral care in healthcare and learned to consider the spiritual aspects of end-of-life care. Participation of priests in an end-of-life simulation enhanced students' learning of spirituality as an aspect of nursing care.

Adaptation of Interdisciplinary Clinical Practice Guidelines to Palliative Care for Patients with Heart Failure in Iran: Application of Adapte Method.

Clinical Practice Guidelines (CPGs) have been recommended to manage palliative care and take the best treatment measures and decisions. This study aimed to adapt the interdisciplinary CPG to provide palliative care for patients with Heart Failure (HF) in Iran based on the ADAPTE method. Guideline databases and websites were systematically searched up to April 2021 to determine appropriate publications related to the study topic. Followed by assessing the quality of the selected guidelines via the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II), those with appropriate standard scores were selected to be used in designing the initial draft of the adapted guideline. The developed draft contained 130 recommendations and was evaluated by a panel of interdisciplinary experts in terms of its relatedness, comprehensibility, usefulness, and feasibility in two phases of Delphi. In the first phase of Delphi, the adapted guideline was derived from five guidelines and evaluated by 27 interdisciplinary pundits working in the universities of Tehran, Isfahan, and Yazd cities. After the assessment in Delphi Phase 2, four recommendation categories were removed because they did not receive the required scores. Finally, 126 recommendation items were included in the developed guideline, which were classified into three main categories of palliative care features, essentials, and organization. In the present study, an interprofessional guideline was designed to enhance palliative care information and practice in patients with HF. This guideline can be administered as a valid tool for interprofessional team members to provide palliative care to patients with HF.

INTERPROFESSIONAL TEAM MEMBERS’ PERCEPTIONS OF PALLIATIVE SOCIAL WORKERS’ CONTRIBUTIONS TO PATIENT-CENTERED CARE

Abstract Interprofessional collaborative practice (IPCP) is fundamental to the delivery of high-quality patient-centered care. An IPCP core tenet is that efficient and effective teams are crucial for the delivery of care that achieves patient satisfaction as well as positive patient-level outcomes. Although a growing number of IPCP studies explore how IPCP professionals work collaboratively, the vast majority focus on the interactions of physicians and nurses, few consider other professions or simply lump them into an “other” category. This qualitative study addresses this knowledge gap through the exploration of how hospital palliative care teams utilize the skills of advanced hospice and palliative care certified (APHSW-C) social workers to increase teams’ overall effectiveness. A two-step recruitment process was used to create matched samples of 17 palliative social workers and 24 interprofessional team members (i.e., physicians, nurses, physician assistants, chaplains). Using a constructivist grounded theory approach, semi-structured interviews were conducted, recorded, and transcribed. Analysis revealed six themes surrounding other profession's perceptions of social workers’ contributions: 1) providing continuity during and across admissions, 2) assessing and promoting the patient’s bio-psychosocial needs, 3) offering clinical expertise and support to patients with complex psychosocial needs, 4) allocating time to initiate, process and revisit difficult conversations with patients and families, 5) modulating the pace and intensity of emotionally laden conversations, and 6) supporting team well-being. Findings underscore that interprofessional team members view social workers as playing a significant role in developing, building, and sustaining a therapeutic alliance between the patient and the team.

DEPRESCRIBING IN ASSISTED LIVING

Abstract Deprescribing is defined as the thoughtful process of “tapering, stopping, discontinuing, or withdrawing drugs, with the goal of managing polypharmacy and improving outcomes.” There are multiple clinical issues that deprescribing can address such as: antibiotic resistance caused by inappropriate and excessive use, the ongoing opioid epidemic, as well as over treatment particularly at the end of life. Networks have been established to address deprescribing across settings including assisted living nationally and internationally. Fourteen key informants from these networks were interviewed including different disciplines. From the interviews, six major themes across two domains were identified. The two domains included regional resources and knowledge gaps and the six themes included: (a) network structure, (b) public perception, (c) policy implications, (d) implementation, (e) challenges, and (f) recommendations. Overall, the importance of collaboration among interprofessional team members will be critical to the success of deprescribing as this clinical issue moves ahead.

Primary Care Provider Demographics and Engagement in Interprofessional Collaboration.

Interprofessional care contributes to all components of the quadruple aim. While previous research has identified many facilitators and barriers to the provision of interprofessional care, whether demographic differences might influence the extent to which providers collaborate interprofessionally remains unknown. Using electronic health record data, we characterized the level of primary care providers' (PCPs') interprofessional collaboration based on the percent of their patients who had a visit with an interprofessional team member over a 14-month period. We then obtained demographic data, including gender, years in practice, and provider type, from the electronic health record and publicly available sources. Subsequently, we used linear regression to predict the PCPs' level of interprofessional collaboration based on demographic indicators. The median of each PCP's patients who had a visit with an interprofessional team member during the study period was 12.6%. After controlling for the average age of the PCP's patient panel, the PCP's years in practice, and the PCP's clinic, when compared with male PCPs, approximately 2% more of patients cared for by female PCPs had a visit with an interprofessional team member. Female providers are more likely to share their patients with an interprofessional team.

Interprofessional Interventions to Improve Serious Illness Communication in the Intensive Care Unit: A Scoping Review.

Serious illness communication is fundamental to the provision of quality care for patients in the intensive care unit (ICU). Evidence suggests that including interprofessional team members in such communication is beneficial. This scoping review--conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines-maps existing evidence regarding interprofessional interventions to improve serious illness communication in the ICU. The review yielded 14 studies for inclusion, which were organized by 3 thematic categories of strategies implemented: training curriculum, scheduled meetings, and liaison role. Most used a combination of intervention strategies. Outcome measures varied across the studies but could be broadly categorized as patient/family-focused, provider-focused, or systems-focused. Great heterogeneity between studies exists. More research is needed.

Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness

PurposeFew quality improvement tools specific to patients with persistent or chronic critical illness exist to aid delivery of high-quality care. Using experience-based co-design methods, we sought consensus from key stakeholders on the most important actionable processes of care for inclusion in a quality improvement checklist. MethodsItem generation methods: systematic review, semi-structured interviews (ICU survivors and family) members, touchpoint video creation, and semi-structured interviews (ICU clinicians). Consensus methods: modified online Delphi and a virtual meeting using nominal group technique methods. ResultsWe enrolled 138 ICU interprofessional team, patients, and family members. We obtained consensus on a quality improvement checklist comprising 11 core domains: patient and family involvement in decision-making; patient communication; physical comfort and complication prevention; promoting self-care and normalcy; ventilator weaning; physical therapy; swallowing; pharmacotherapy; psychological issues; delirium; and appropriate referrals. An additional 27 actionable processes are contained within 6 core domains that provide more specific direction on the actionable process to be targeted. ConclusionsUsing a highly collaborative and methodologically rigorous process, we generated a quality improvement checklist of actionable processes to improve patient and family-centred care considered important by key stakeholders. Future research is needed to understand optimal implementation strategies and impact on outcomes and experience.