Members Of Health Care Team Research Articles

American Association of Clinical Endocrinology Clinical Practice Guideline on Pharmacologic Management of Adults With Dyslipidemia.

To review the evidence and provide updated and new recommendations for the pharmacologic management of adults with dyslipidemia to prevent adverse cardiovascular outcomes. These recommendations are intended for use by clinicians, health care team members, patients, caregivers, and other stakeholders. This guideline was developed by a multidisciplinary task force of content experts and guideline methodologists based on systematic reviews of randomized controlled trials or cohort studies from database inception to November 7, 2023. An updated literature search was completed for any additional articles published by May 31, 2024. Clinical questions addressing nonstatin medications and patient-important outcomes were prioritized. The task force assessed the certainty of the evidence and developed recommendations using the Grading of Recommendations Assessment, Development, and Evaluation framework. All recommendations were based on the consideration of the certainty of the evidence across patient-important outcomes, in addition to issues of feasibility, acceptability, equity, and patient preferences and values. This guideline update includes 13 evidence-based recommendations for the pharmacologic management of adults with dyslipidemia focused on patient-important outcomes of atherosclerotic cardiovascular disease (ASCVD) risk reduction. The task force issued a good practice statement to assess the risk of ASCVD events for primary prevention in adults with dyslipidemia. The task force suggested the use of alirocumab, evolocumab, or bempedoic acid for adults who have ASCVD or who are at increased risk for ASCVD in addition to standard care. The task force suggested against the use of these medications in adults without ASCVD. There was insufficient evidence to recommend for or against the addition of inclisiran. For adults with hypertriglyceridemia and ASCVD or increased risk of ASCVD, the task force suggested the use of eicosapentaenoic acid but not eicosapentaenoic acid plus docosahexaenoic acid and strongly recommended against the use of niacin. There was insufficient evidence for recommendations regarding pharmacologic management in adults with severe hypertriglyceridemia (≥500mg/dL). The task force suggested a low-density lipoprotein cholesterol treatment goal of <70mg/dL in adults with dyslipidemia and ASCVD or at increased risk of ASCVD. Pharmacotherapy is recommended in adults with dyslipidemia to reduce the risk of ASCVD events. There are several effective and safe treatment options for adults with dyslipidemia who have ASCVD or at increased risk of ASCVD who need additional lipid-lowering medications. Shared decision-making discussions are essential to determine the best option for each individual.

A Social Network Lens to Community Health Worker Influence and Impact.

Community Health Workers (CHWs) are members of healthcare teams that are integrated in, and often share language, beliefs, and lived experiences with their communities. They use their formal and informal social networks to promote healthy behavior, to connect community members to resources, and to build more resilient community networks. We propose a framework to conceptualize CHW interventions aiming to operationalize and optimize CHW social relations and networks. CHW-mediated network interventions can focus on the dissemination and diffusion of health messages, using the channels of trust and formal and informal relations, as well as, engaging communities to enhance the cascade of spreading/diffusion. Network interventions can also focus on network-building and community dialog, relying on the role of CHWs in bringing the community members together in facilitating conversation, promoting social justice and inclusion, and mobilizing the community in collective action. In addition, the network interventions can aim for boundary-spanning and bridging activities, to facilitate the community's access to health services and external resources, as well as bringing the community voice to health systems to influence priorities and policies. Similar to any other complex interventions, CHW network interventions should be fine-tuned and adapted to local and community needs, capacities, and network structures, and actively involve community members in the conceptualization, delivery, and evaluation.

Preparing Nurses to Support the Family During Resuscitation: An Exploratory-Descriptive Qualitative Study.

The family support person role during resuscitation is complex and requires role preparation; however, there is a lack of guidance on preparing nurses for this crucial role. To examine how critical care nurses prepared for the role of supporting families during resuscitation and their perceptions of the preparation needed to fulfill this role. An exploratory-descriptive qualitative design guided the study. Individual, semistructured interviews with 16 critical care nurses yielded data for thematic analysis. All participants had been in the family support person role. Three themes emerged: who should perform the family support person role, why role preparation is important, and how to prepare for the role. The themes captured participants' views about identifying and preparing individuals to support families during resuscitation. Nurses are the ideal health care team member to support families during resuscitation. However, participants felt unprepared for this role, especially for communicating with families. Education and experience are important to prepare nurses to effectively enact the role to ensure positive outcomes for family members.

Motivational Interviewing to Address Vaccine Hesitancy in a Rural Population.

Background: Individuals experience vaccination hesitancy for many reasons. However, not receiving vaccinations leaves individuals at increased risk for vaccine-preventable illnesses. Individuals in rural areas are more likely to experience vaccine hesitancy. Objective: Motivational interviewing is an effective strategy for addressing behavior change, including vaccine hesitancy. This evidence-based practice project provided an education session for Michigan State University Extension Vaccine Team members, who deliver health care information statewide. Methods: An educational information session on motivational interviewing was delivered via Zoom. This session focused on employing motivational interviewing in rural populations to address vaccine hesitancy. A survey was administered to participants pre and postmotivational interviewing educational sessions to assess changes in knowledge and confidence in using motivational interviewing. Results: Participants' knowledge and confidence regarding motivational interviewing improved. They reported an increased understanding of the concept and confidence in deploying this technique to the rural population. Conclusions: This project highlights the process and need for delivering an educational motivational interviewing session to health care team members who regularly interact with the rural population regarding vaccine hesitancy. Implications for Nursing: Teaching individuals who regularly interact with the rural population the technique of motivational interviewing can help expand the reach of the discussions in health care settings.

Fostering collaborative practice: a pilot study on interprofessional education through simulation-based team-oriented learning sessions among pharmacy and medical students

BackgroundIt is pivotal to implement effective collaboration among professionals from different disciplines in the healthcare sector. As the complexity of patients’ health needs grows, so does the importance of developing innovative and efficient models of patient care that rely on interprofessional collaborative teamwork. Interprofessional education (IPE) is a valuable approach that improves communication, collaboration, and ultimately safe patient outcomes in healthcare settings. Students studying medicine and pharmacy are among the healthcare professionals who could potentially benefit from IPE. Despite the existence of newly added undergraduate curricula for interprofessional communication and professionalism, active implementation to achieve the required competencies and skills is not yet widespread, particularly in developing countries. This article presents a successful implementation of simulation-based team-oriented learning sessions among pharmacy and medical students at Delta University for Science and Technology in Egypt. The purpose of the IPE activity was to train students to work collaboratively as members of an interprofessional healthcare team by simulating a real-life situation.ResultsStudent feedback was very positive with most pharmacy and medical students being satisfied with their IPE experience. Moreover, students’ feedback emphasized the significance of IPE and a simulated team-based environment in improving communication skills and collaborative practice.ConclusionThe high level of student satisfaction with the IPE sessions, particularly regarding the clarity of training objectives and the interactive nature of the experience, suggests that simulation-based learning is an effective tool for developing key interprofessional collaboration skills among healthcare students. This highlights the potential of IPE to cultivate future healthcare professionals who excel in interprofessional collaboration, ultimately leading to improved patient care and outcomes. Overcoming barriers to implementing IPE in Egypt needs a multifaceted strategy and a comprehensive long-term follow-up plan is critical for evaluating the lasting effect of IPE on students’ collaborative practices in real-life healthcare settings.

Embedding Universal Language Promotion in Pediatric Primary Care to Optimize Early Child Development and Reduce Long-Term Health Disparities.

To report on the feasibility and outcomes of universal language promotion intervention (Talk With Me Baby [TWMB]) embedded within routine well-child care for children from birth to 3-years old. Across 2 primary care clinics, 29 health care team members participated in a 12-month trial to deliver TWMB within well-child care visits. Feasibility was based on clinician feedback during the trial, clinician knowledge assessments, and clinic data. Sixty-three parents and their infant/toddlers were enrolled to provide feedback on TWMB and to assess parent language promotion behaviors, specifically, parents' self-reported use of their language-building interactions during daily activities with their child. Clinician feedback and clinic data support TWMB as an acceptable and feasible intervention that can be used successfully within standard of care well-child visits by health care teams. Initial outcome data show positive changes for increasing parent-child language promoting interactions during daily activities. Results support the promise of leveraging primary care as a low-cost, scalable way to deliver universal language promotion intervention to optimize the developmental potential of all young children.

Veteran and healthcare team perspectives on the TeleWound Practice Program within the Veterans Health Administration.

The Veterans Health Administration (VHA) recently piloted the implementation of the TeleWound Practice Program (TWP), which provides interprofessional wound care to Veterans remotely. We assessed the perceptions of Veterans and healthcare team members (HCTMs), and their experiences with the TWP. We surveyed Veterans from four VHA medical centres who had received at least one TWP visit between 1 May 2020 and 31 May 2021, and HCTMs associated with any TWP encounter between 1 September 2019 and 31 March 2021. Survey data were summarised using descriptive statistics and open-ended question responses were analysed using thematic coding. Out of 534 Veterans approached, 194 completed the survey (a 36% response rate). Most were interested in continuing to use TeleWound care (66%), felt more motivated to participate in their wound care due to the TWP (70%), and reported reductions in travel distance (81%) and cost (81%) related to wound care. Of the 32 HCTMs approached, 19 completed the TWP survey (a 59% response rate). Respondents indicated that the TWP improved their own professional decision-making skills (82%) and supported Veterans to take a more active role in their health (100%). Challenges included insufficient training for HTCMs, lack of stakeholder buy-in, and logistical and technical issues. Suggestions for improvement related to equipment, additional training and dedicated TWP staff. In this study, the Veterans were satisfied with the TWP and were more motivated to engage in wound self-management after receiving care through the TWP. HCTMs also perceived the TWP as beneficial to Veterans. However, additional efforts are needed to address barriers to TWP implementation across the VHA system of care.

Pediatric Fever in the Emergency Department: Triage to Caregiver Education.

The number 1 reason children 15 years of age and younger present to the emergency department is fever. To successfully address this common chief complaint, a consistent message must be sent by all health care team members. This consistent message must demonstrate a solid knowledge of the physiology of fever, which includes the benefits of fever and the pattern of fever during an illness. In addition, treatment of fever must be evidence based with a goal of comfort rather than normothermia. Nurses must address caregivers' concerns and consider the age, medical history, and clinical presentation of the child with fever when determining the appropriate triage level and management.

Long-Term Follow-Up After Bariatric Surgery: Key to Successful Outcomes in Obesity Management.

Background/Objectives: Bariatric surgery (BS) is considered one of the most effective interventions for the treatment of obesity. To achieve optimal long-term results, continuous follow-up (FU) within a multidisciplinary treatment team is essential to ensure patient compliance and maximize the benefits of BS. However, many patients find it difficult to maintain regular FU, which can affect the quality of care and lead to postoperative complications. This review aims to highlight factors that may hinder compliance with FU after BS, examine potential causes and consequences of inadequate FU, and identify strategies to improve patient participation in long-term FU. Methods: The literature search was conducted between October 2023 and June 2024 in Medline (PubMed) and the Cochrane Library datasets. Studies were selected for their relevance to adherence to FU, multidisciplinary approaches, and long-term bariatric outcomes. Results: The pre- and postoperative period is critical for educating patients and healthcare team members about the importance of FU, addressing potential barriers (e.g., logistical, psychological, and social challenges), and highlighting the risk of relapse to obesity after surgery. The lack of a standardized FU protocol leads to differences between medical centers, further impacting patient adherence. Conclusions: Tailored and regularly updated strategies are essential to address individual patient needs and improve adherence to FU. Further research is needed to identify the specific factors that influence variability in long-term BS outcomes, highlighting the need for a patient-centered approach to obesity treatment.

Interprofessional collaboration in primary care for patients with chronic illness: a scoping review mapping leadership and followership

BackgroundEffective interprofessional collaboration (IPC) in primary care is essential in providing high-quality care for patients with chronic illness. However, the traditional role-based leadership approach may hinder IPC. Instead, physicians should...

Examining the impact of rhythmic breathing and progressive muscle relaxation on acute pain following inguinal hernia repair: a parallel randomized clinical trial

BackgroundAcute postoperative pain is often reported after repair of inguinal hernia and can negatively impact patient satisfaction and clinical outcomes. This includes delayed wound healing, longer hospitalization, and increased health care costs. Non-pharmacological techniques like Progressive Muscle Relaxation (PMR) and Rhythmic Breathing (RB) have been suggested as possible interventions for managing this type of pain. The purpose of this study was to examine the effects of PMR and RB on postoperative pain following repair of inguinal hernia.MethodsThis parallel randomized controlled trial was conducted to examine 120 patients in the age range of 18 to 75 years with inclusion criteria: Repair of Inguinal Hernia under general anesthesia and no addiction to drugs and narcotics. These patients were randomly assigned to one of three groups: the RB group, PMR group, or the control group (which received standard care). The RB and PMR interventions were administered at 3, 6, 12, and 24 h after surgery. The primary outcome measure was the intensity of pain at the surgical site, assessed using the Visual Analog Scale (VAS). The secondary outcome measure was the amount of rescue analgesic (Pethidine). The one-way analysis of variance, Chi-square, post-hoc test, and repeated measures ANOVA were used for data analysis.ResultsFollowing the interventions, participants in both the RB and PMR groups exhibited significantly lower levels of acute pain after inguinal hernia repair compared to the control group across all four time periods, except at 12 h postoperatively in the RB group. However, there was no statistically significant difference between the RB and PMR groups. Additionally, the amount of pethidine consumed in the control group was significantly higher compared to the two experimental groups.ConclusionsBased on the results, both RB and PMR were found to be effective techniques in reducing patients’ pain. Therefore, it is recommended that healthcare team members, particularly nurses, actively learn and teach both RB and PMR.Trial registrationRegistered in the Iranian registry of clinical trials (www.irct.ir) in 31/01/2023 with the following code: IRCT20200206046395N2.

Birthing parent and companion verbal reactions following interactions with inpatient postpartum health care team members: an observational study using naturalistic filming

BackgroundRespectful, equitable, and supportive health care team interactions with patients and their companions are a key part of quality health care services. Despite the importance of communication and other aspects of engagement during inpatient postpartum care, little is known about how care is experienced during this period from families’ perspectives.MethodsThis study collected video and audio data with 15 birthing families (n = 9 English-speaking and n = 6 Spanish-speaking) and their health care team members during inpatient postpartum care in a southeastern United States academic medical center. This analysis quantifies health care team member presence in family hospital rooms, assesses linguistic appropriateness of health care team member verbal communication, and describes birthing parent and companion verbal reactions to health care team member interactions. A behavioral taxonomy was applied to identify these codes in the 12 h prior to hospital discharge. Additionally, we transcribed the birthing parent and companion verbal reactions for 10-minutes each time the health care team member departed their room. This content was inductively coded to identify topics and develop themes.ResultsA total of 160 h of video and audio data were coded across 15 participating families for this analysis. There were 19.9 h of missing data in the 12 h prior to hospital discharge due to equipment being turned off across five participants. At least one health care team member was present in the postnatal unit rooms within the observation period in 200 instances (median 13 times, range 5 to 19 times per participating family). Communication with Spanish-speaking birthing parents was linguistically appropriate for between 20.0% and 75.0% of interactions. Following health care team member presence, birthing parent and companion reactions were indeterminate 1 time, no verbal reaction 107 times, positive 25 times, confused 38 times, and negative 52 times. Many parents expressed more than one reaction. Reaction topics included clarity of information provided, postpartum pain management, hospital discharge coordination, health care team member conduct, and access to supplies.ConclusionThere are strengths in postpartum patient engagement as well as areas for health care team improvement. More appropriate communication including setting of clearer expectations surrounding various aspects of services on the postnatal unit may improve patient experiences. As a part of this improved quality of inpatient postpartum care, consistent utilization of interpretation services could decrease patient confusion, enable shared decision-making, and promote positive patient-provider relationships.

Venous Thromboembolism Subsequent to the Management of Panfacial Fracture- A Clinical Paper and Review.

Venous thromboembolism (VTE) is a major factor responsible for death in patients suffering from prolonged immobilisation due to various causes like old age, pregnancy, stroke, and prolonged surgical procedures to mention a few. Long-duration surgeries as in fixation and reconstruction in panfacial fractures and facial orthognathic surgeries can be potential cases predisposed for VTE in maxillofacial surgery. A fifty-eight-year-old patient suffered from pulmonary thromboembolism following long-duration surgery for panfacial fracture fixation and reconstruction under general anaesthesia. He was promptly managed via medical management and recovered well. Pulmonary thromboembolism is a severe complication that can lead to severe morbidity or even death. Owing to the characteristics of venous thrombosis, all collaborating healthcare team members should be trained to assess risk factors for efficient diagnosis which can facilitate specialised intervention that can result in better patient outcomes. Maxillofacial surgeons need to evaluate the risk of thromboembolism in patients and institute efficient diagnosis whenever required to deliver optimised and better patient care. Although thromboembolism is a preventable disease state, the key is to keep a close eye on the patient's clinical features to identify and treat them at the right time for better patient care and survival.

C.E. Credit Practice Quiz for “Sustainability in Dentistry: An Overview for Oral Healthcare Team Members”

C.E. Credit Practice Quiz for “Sustainability in Dentistry: An Overview for Oral Healthcare Team Members”

Qualitative Study of Health Care Team Perception of the Benefits and Limitations of Remote Symptom Monitoring.

Remote symptom monitoring (RSM) using electronic patient-reported outcomes (ePROS) connects patients and health care teams between appointments. Patient-perceived benefits and drawbacks of RSM are well-known, but health care team members' perceptions are less clear. Health care team members from the University of Alabama at Birmingham and the University of South Alabama Health Mitchell Cancer Institute participated in semi-structured qualitative interviews to explore their experiences and perspectives on RSM benefits and limitations. Interviews were audio-recorded, transcribed, and analyzed inductively using NVivo software to identify recurring themes and exemplary quotes. Thirty oncology health care team members, including physicians (n = 9), nurse practitioners (n = 2), nurses (n = 8), nonclinical navigators (n = 7), and administrators (n = 4), were interviewed. Findings were organized into five major themes: three benefits (Proactive, Improved Patient-Health Care Team Relationship, and Patient Engagement and Symptom Reporting) and two limitations (Health Care Team-Perceived Limited Patient Buy-In or Awareness and Workload and Workflow Issues). Health care team members perceived that RSM improved their ability to support patients and the quality of care delivered to patients by promoting proactive management, strengthening the patient-health care team relationship, and engaging patients in symptom reporting. Despite positive perceptions, health care team members also voiced drawbacks of RSM related to the lack of patient buy-in or awareness and increased workload and disrupted workflow. Although health care team members recognized the benefits of RSM as a standard of care, future work is necessary to address identified limitations to support wide-scale implementation of RSM in oncology practices.

Birthing parent perspectives on measuring the quality of perinatal care: metrics, timing, and process.

Centering birthing parents is critical for improving reproductive health policies and practices. This study investigates patient perspectives on measuring the quality of perinatal care. A cross-sectional qualitative research study was conducted at an academic medical center in the Southeastern United States. Individuals who had recently given birth participated in audio-recorded interviews between May 2020 and September 2020. This analysis addresses the research question, "If we were providing quality healthcare for families, how would we know?" Transcribed and translated responses were inductively coded to develop categories and identify themes. Forty birthing parents participated in the study. Metrics, timing, and process were identified as important components of meaningfully measuring the quality of perinatal care. Recommended metrics included asking patients whether their health priorities were addressed. Additional metrics of importance were whether coping strategies were provided, the clarity of information provided, patient comprehension of health information, the extent to which care planning was collaborative among patients and their healthcare team members, whether clinicians alleviated patient doubts, patient feelings of being taken care of, healthcare team mannerisms, clinician demonstrations of respect for patient autonomy, and postpartum visit attendance. With regard to timing, patients desired that their healthcare team members "check-in" with them as part of an ongoing, direct dialog. Birthing parents also wanted opportunities to provide feedback soon after encounters. As part of a robust measurement process, they wanted to share their insights with someone who was not a part of their healthcare team, for maintaining confidentiality. The patients desired a "serious platform" with accessible methods for all birthing parents to be able to convey nuanced accounts of their care. They also wanted to hear from the healthcare institutions about their feedback. Birthing parents sought assurances for their perinatal care feedback to be de-identified to protect them from potential retaliation. The participants recognized that they might need to utilize healthcare services from the same institution and individuals in the future. Birthing parents expressed desire for their perinatal healthcare experiences to be understood. Meaningful quality measurement may be promoted through transparent and multimethod opportunities for patients to securely share insights. In addition to healthcare systems communicating assurances of patient confidentiality, institutional feedback in response to patient-reported experiences is recommended.

Patient perspectives on dietitians’ role in nutrition management among cancer patients: Implications for proactive care and communication

Objective: This study aimed to determine patients’ perspectives regarding the role of dietitians in nutrition management. Methods: This study was conducted at our hospital’s oncology outpatient clinics. It used a questionnaire previously reported in the literature. One hundred sixty-two adult volunteers were included in this study. Patients’ knowledge of nutritional information, preferences for nutrition care, and perspectives on the dietitian’s role were measured. Descriptive statistics were used to describe the continuous variables. The degree of agreement was assessed using a 5-point Likert scale. Results: Nutritional care was a high priority for most volunteers (74.7%). Almost half of the patients expressed a need for dietitians to address their dietary challenges proactively. Most patients (64.2%) first met with a dietitian during ongoing treatment. They emphasized the need for frequent meetings and were willing to be referred to a dietitian earlier in their treatment. Conclusions: Most patients are referred to a dietitian after malnutrition, indicating the need for earlier intervention. Patients strongly desire improved communication among the healthcare team members regarding their nutritional concerns. Proactive nutritional management can reduce the incidence of malnutrition and enhance patient outcomes.

Students’ Engagement in Learning Nursing Pharmacotherapeutics: A Self-reported Volunteer Experience

Hands-on experiential learning within a clinical setting and the integration and translation of theoretical knowledge to practice have been explored as pedagogical methods to enhance nursing education. This study reports nursing students’ self-assessment of volunteer learning experience at hospitals and community pharmacies to enhance nursing pharmacologic knowledge. The study quantitatively evaluated the self-reported assessment of nursing students at hospital and community pharmacies in Belize using a convenient sampling technique. Forty-six nursing students spent 48 hours at assigned community and hospital pharmacies under the supervision of a licensed pharmacist. Self-assessment questionnaires and the grades from preceptors were analysed and reported. Students described a positive experience with high mean scores indicating self-reported learning of new medications, drug side effects, labelling of drugs, dispensing prescriptions, patients’ assessment, communication and experience working alongside interprofessional healthcare team members. This study shows that undergraduate nursing students can benefit from volunteer learning at community and hospital-based pharmacies to enhance hands-on learning of pharmacotherapeutics knowledge. Daily interactions with pharmacists, medications and patients complemented students’ learning of medications and skills acquisition. Nursing educators should explore nonconventional pedagogical approaches, such as pharmacy clinical sites, to complement students’ pharmacologic learning.

The Role of Telemedicine in Transforming Palliative Nursing Care: Challenges and Implications for End-of-Life Care

Telemedicine is undoubtedly a powerful solution to transform nursing practices in palliative care, with a particular focus on improving care for terminally ill patients. This report highlights the value of telemedicine in end-of-life care by examining issues related to compensation, emphasizing communication and ethics, and addressing the social implications of the field. The telemedicine model of palliative services results in universally accessible healthcare that overcomes geographical barriers and provides equitable care. Additionally, it plays a crucial role in establishing better communication among healthcare team members, including doctors, patients, and patients’ families, thus fostering collaboration and coordination in patient treatment and health management. Conversely, the challenges associated with technological obstacles and depersonalization due to digital interactivity require careful consideration. Socially, telemedicine may also exacerbate healthcare disparities, disproportionately impacting under-resourced and ethnic communities. Furthermore, the shift towards telecare may alter caregiver-patient relationships, as advancing technology could affect these dynamics unless the approach incorporates the patience and compassion essential in caregiving. Healthcare providers bear a social responsibility to ensure equitable access to telemedicine while upholding the fundamental principles of end-of-life care.

Training providers to implement heart failure shared medical appointments: A qualitative evaluation.

Shared medical appointments (SMA) help patients learn skills to self-manage chronic medical conditions. While this model of care delivery is thought to improve access to care with an efficient use of healthcare providers' time, many healthcare teams struggle to implement this healthcare model. Guidance and training resources on the implementation of SMAs is expected to improve adoption, implementation and sustainability of SMAs. Our evaluation team collaborated with the HF SMA trainer to complete a developmental formative evaluation of a two-day training program with a goal of adapting the training program and to better suit the needs and resources of healthcare teams interested in implementing HF-SMAs. Our evaluation team interviewed members of healthcare teams participating during each stage of training: pre-training, post-training, and post-implementation. The evaluation team also observed training sessions and reviewed minutes from debrief and training team meetings. Qualitative data collected from interviews, observations and document reviews were analyzed using matrix analysis with a focus on identifying potential adaptations to improve the HF-SMA training program. Data summaries were presented by the evaluation team to the training team for consideration. Training program participants found the training comprehensive, useful, and helpful; they highlighted how the trainers were experienced SMA providers who shared lessons learned. While participants found the training to be useful, opportunities for improvement, success of the virtual format and identified six adaptations: 1) the two-day training was reduced to short online modules, 2) curriculum was adapted to fit local site's needs, 3) added periodic one-on-one coaching, 4) shifted training to focus on skills and knowledge needed for each team member requirements, 5) adapted curriculum provides for more team building during premeeting assignments, and 6) training had more information included. We offer/present an improved model for a HF-SMA training program. Future studies, potentially using comparative designs to measure success and sustainability are needed.