Members Of Health Care Team Research Articles

Measuring Patient Well-Being During Whole-Person Clinical Care: Lessons From the Veterans Health Administration Well-Beings Signs Implementation Pilot.

Measuring patient well-being during clinical care may enhance patient-centered communication and treatment planning. The Veterans Health Administration (VHA) piloted the use of the Well-Being Signs (WBS), a self-report measure of psychosocial well-being, in clinical care. To understand early WBS implementation and health care team member experiences with its use before developing detailed support materials and finalizing the measure. We conducted a mixed-methods evaluation of the WBS implementation pilot at 4 VHA facilities, including surveys of (n=4) Whole Health (WH) leaders/clinical leads, and semi-structured interviews with (n=11) clinical leads and team members. Survey data were characterized using descriptive statistics; interview data were analyzed using rapid qualitative analysis. Facilities supported WBS implementation by disseminating information to clinical team members, primarily during staff meetings (3/4 facilities), individual discussions (3/4), and email (3/4); only half provided training sessions. In interviews, some care team members expressed the need for more training on using the WBS in clinical care. Some interviewees also provided suggestions for changes to the draft measure, including response option format and question look-back period. Although there have been growing calls for attention to patient well-being in clinical care, our results suggest barriers to the implementation of well-being measures in this context. Findings were used to inform the development of enhanced training materials and make modifications to enhance the acceptability of the WBS to providers. Other identified barriers will need to be addressed in future implementation efforts, including bolstering leadership support and easing the added time and burden of administration.

Physician experiences of team-based clinical microsystems: implications for the future of inpatient interprofessional communication

ABSTRACT Healthcare clinical microsystems are small, goal-oriented groups of healthcare professionals that work together on a regular basis to provide care to discrete patient populations. They often include team-based frameworks such as bedside interprofessional rounds, geographic colocation of healthcare team members, interprofessional staff leadership, and unit-level data sharing. In inpatient settings, microsystems improve interprofessional communication and collaboration. In this qualitative study, we examined physician experiences of clinical microsystems and the mechanisms underpinning interprofessional communication in this environment. We interviewed 51 resident and hospitalist physicians. Thematic analysis of physician experiences revealed three key themes: (a) Clinical microsystem effect on workflow, (b) Open forum and work relationships, and (c) Face-to-face vs technology-based communication. Physicians described strong interprofessional relationships based on frequent face-to-face communication. Familiarity with healthcare team members, often resulting from being co-located to the same units, created a comfortable work environment, advanced patient care, and accelerated workflow. Physicians preferred in-person communication with interprofessional colleagues over technology-based communicationand described how in-person interactions enriched subsequent technology-led interactions. As the use of technology-based communication grows in inpatient settings, decreasing face-to-face interactions and facilitating dispersed care, understanding and implementing optimal conditions for effective interprofessional communication is essential.

Abstract 4139192: Remote monitoring platform improves communication and clinical decision making for pediatric interstage healthcare team members

Background: Asynchronous remote patient monitoring (RPM) is increasingly common in healthcare models for infants with congenital heart disease (CHD). Using a downloadable mobile application with a software platform like CHAMP App ® allows parents to proactively engage in data entry, providing pediatric healthcare teams (HCT) timely information without relying solely on parent messaging or calls. Research Question: How does the use of RPM impact family communication and clinical decision-making experiences for HCTs? Goals: To identify the HCT’s experience through a secondary review of the CHAMP Cardiac Repository, using parent-entered interstage data from home for infants with CHD. Methods: This retrospective multi-institution cohort (Table 1) spanned from 5/2019-8/2023, collecting HCTs feedback via Likert responses (Table 2) about experiences with infant monitoring endpoint, which were analyzed in SPSS. Results: Response rates of 75.8% (493/650) were achieved across 10 pediatric cardiac care centers. HCTs reported improved communication (4.5 + .77) and clinical decision-making with video reviews (4.47 + .79). Parents' data engagement averaged 268 + 195.3 total points (oxygen saturation, weights, and/or videos) per infant. Higher engagement correlated with better HCT communication (p <.001) and decision-making (p <.0001), both with small effect sizes. Improved clinical decision-making was noted in families who used study-provided iPads for video recordings (mean score 4.63 ± 0.84) compared to those using personal devices (mean score 4.42 ± 0.734, p = .03), with 69.2% using personal devices. Conclusions: In this modern cohort, families engaged well with data entry through a remote monitoring platform, and HCTs reported significant improvements in communication with families for their child’s data from home and clinical decision-making after reviewing videos. Future research should explore barriers to mobile data engagement and assess HCT preferences for video review.

Navigating Voluntarily Stopping Eating and Drinking in Hospice Settings: A Multidisciplinary Approach.

This article explores current global research on voluntarily stopping eating and drinking (VSED) and presents a detailed, deidentified case study of a patient who elected VSED in a hospice setting in the Southeastern United States. It highlights the collaborative efforts of health care professionals in effectively supporting the patient and family, sharing multiple perspectives from various health care team members who cared for the patient and family. It offers evidence-based recommendations to guide health care teams through the ethical, medical, and emotional challenges of VSED, ensuring compassionate and competent care. The article emphasizes the importance of structured protocols and empathetic care in hospice settings, advocating for the education and preparation of health care teams and families to address the complex challenges associated with VSED. By promoting open communication, interdisciplinary collaboration, and comprehensive support, hospices can respect the autonomy of patients and families choosing VSED, ensuring a compassionate and dignified end-of-life experience.

Sustainability in Dentistry: An Overview for Oral Healthcare Team Members

Sustainability in Dentistry: An Overview for Oral Healthcare Team Members

Implementing and Evaluating a Pilot Interprofessional Training Program to Engage Health Care Teams in Cost of Care Conversations.

This study evaluated the impact of Financial and Insurance Navigation Assistance-Training - a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology-oncology clinic. A pre-post study design was used to evaluate the impact of Financial and Insurance Navigation Assistance-Training on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected via surveys administered at baseline/pretraining, immediate post-training, and 12-month post-training. Most health care team members (n= 21) reported improvement in their knowledge of available financial (66.7%) and legal resources (86.7%) and ability to address social needs (93.3%), financial needs (93.3%), and facilitate CoC conversations with patients and caregivers (66.7%). Improvements in attitudes and behaviors toward engaging in CoC conversations, screenings, and referrals were relatively improved as a result of the training. However, there was a lower positive rate for actual behaviors around routine screening and initiating discussions on out-of-pocket costs, suggesting a need to address barriers. Study findings highlight the importance of interprofessional education in helping health care teams address social determinants of health through effective CoC conversations.

A Qualitative Study of Patient and Interprofessional Healthcare Team Member Experiences of Bedside Interdisciplinary Rounds at a VA: Language, Teamwork, and Trust.

Patient and interprofessional healthcare team member experiences of bedside interdisciplinary rounds (BIDR) are generally positive. Overall, there is large heterogeneity in existingBIDR frameworks, and best practices have not been defined. Understand patients' and interprofessional healthcare team members' experiences of BIDR. Academic VA Medical Center (VAMC) with daily structured BIDR. Inpatients, nurses, pharmacists, and care coordinators who participated in BIDR. We conducted semi-structured qualitative interviews with study participants about their experiences with BIDR between January and June 2020. All interviews were recorded and professionally transcribed. We used thematic analysis to identify key themes. We interviewed 14 inpatients and 18 interprofessional healthcare team members, including nurses, pharmacists, and care coordinators. Patients participating in BIDR reported positive perceptions of being included in the discussion of their healthcare plans and increased trust in providers; patient discomfort resulted from physician use of technical language and frombeing presented with unclear, vague careplans. Interdisciplinary healthcare team members participating in BIDR reported an increased understanding, respect, and trust for other team members and improved patient care; challenges were posed by lack of supportive structural elements to interprofessional workflow and prolonged physician presentations. BIDR can build trust between patients andhealthcare providers and within the interprofessional team by creating a setting where teamwork interactions can be observed. Based on our findings, we recommend trust-building practices for BIDR, which include sharing BIDR goals with patients, using patient-centered language, creating structures for interprofessional inclusion, defining team roles, using standardized communication, and addressing interprofessional inputs in real time.

Strategies and Determinants of Knowledge Management and Sharing in Healthcare Organizations: A Narrative Review

Background. Effective and efficient sharing of knowledge in health care can lead to the clarification of health data and dissemination of up-to-date health information among employees, decision-makers, and other stakeholders, thereby improving the probability of occurrence of desirable health outcomes. The current study aimed to identify the determinants of effective knowledge management and sharing in healthcare. Methods. This study was conducted to identify the facilitators and barriers of knowledge sharing in healthcare and also identify successful strategies in this field using the approach of review studies in 2023. A thorough literature review was conducted using relevant keywords in PubMed, Scopus, and SID databases and the Google Scholar search engine. Data extraction was done by two researchers using the data extraction table. The content analysis method was used to analyze the data. Results. Reviewing 21 studies revealed 176 determinants of knowledge management and sharing in healthcare organizations. Among the determining factors, 96 were facilitators, and 80 were barriers to knowledge sharing. After removing duplicate factors and merging similar cases, 54 facilitators and 55 barriers were obtained uniquely. The determining factors were classified into four categories: organizational factors, infrastructure factors, individual factors, and factors related to the information system. Also, 35 effective strategies for knowledge management in healthcare organizations were identified, the most important of which was related to the empowerment of managers in information technology (IT). Conclusion. The success of knowledge sharing in healthcare requires a strong IT infrastructure, supportive leadership, an organizational culture that governs knowledge development, commitment and cooperation among healthcare team members, and effective knowledge management.

Physiotherapy in acute geriatrics wards: What (de)motivates patients? A qualitative study based on self-determination theory

BackgroundWhile the benefits of physiotherapy for hospitalized older patients (HOPs) are well established, these patients are often considered demotivated by healthcare team members (HTMs), which is perceived as a hindrance to their rehabilitation. The quantitative data currently available on the lack of involvement of HOPs are mainly measures of mobility. Motivation as such has, to our knowledge, never been measured. Therefore, this study aims to quantify for the first time the motivation levels of HOPs in their participation in activities of daily living (ADLs) and physiotherapy, and to explore the motivating factors behind their participation in physiotherapy.MethodsThe motivation of 60 older patients hospitalized in an acute geriatrics ward was quantified using the Scale of Demotivation Assessment (SDA). Out of these participants, 14 were interrogated through individual semi-structured face-to-face interviews. After transcription, data were analyzed according to Self-Determination Theory, which has been proven effective in the understanding of motivational mechanisms.ResultsThe prevalence of demotivation was 47% (95% CI: [0.34;0.6]) for ADLs and 35% (95% CI: [0.23;0.48]) for physiotherapy. The main demotivating factors were the feeling of external control (lack of autonomy) and dependance experienced by HOPs, as well as the limited availability of staff during hospitalization. Conversely, feelings of competence, security, respect for limits, and commitment from the HTMs were important motivating factors.ConclusionA large number of relational factors have an impact on the motivation of HOPs regarding their participation in ADLs and in physiotherapy sessions. Appropriate time and space organizing and the provision of suitable equipment, combined with a genuine caring and respectful attitude from the HTMs, could considerably encourage the expression of intrinsic motivation and thus the involvement of HOPs in their own care program.

Veteran Preferences and Willingness to Share Patient-Generated Health Data.

Technologies, including mobile health applications (apps) and wearables, offer new potential for gathering patient-generated health data (PGHD) from patients; however, little is known about patient preferences for and willingness to collect and share PGHD with their providers and healthcare systems. Describe how patients use their PGHD and factors important to patients when deciding whether to share PGHD with a healthcare system. Cross-sectional mailed longitudinal survey supplemented with administrative data within the Veterans Health Administration (VHA). National sample of Veterans who use VHA healthcare. Survey questions asked about demographics, willingness to use different devices to collect and share PGHD, what Veterans do with their PGHD, and factors important to Veterans when deciding whether to share PGHD with VHA. Administrative data provided information on Veteran health conditions. Multiple logistic regression models assessed factors associated with sharing PGHD with VHA. Overall, 47% of our analytic cohort (n = 383/807) indicated that they share PGHD collected through apps or digital health devices with VHA. In adjusted logistic regression models, Veterans who believed the following factors were Very Important (versus Somewhat/Not At All Important) had higher odds of sharing PGHD with VHA: if their doctor (OR = 1.4; 95%CI, 1.0-2.0) or other healthcare team members (OR = 1.4; 95%CI, 1.0-1.9) recommended they do so; and knowing that their healthcare team would look at the data (OR = 1.4; 95%CI, 1.0-2.0) or use the information to inform their healthcare (OR = 1.5; 95%CI, 1.1-2.1). Our data suggest that healthcare team members can influence patient sharing of PGHD, as can a patient's knowledge that PGHD will be used in clinical practice. Efforts to increase the number of patients who share PGHD with a healthcare system may benefit from buy-in among healthcare team members, who appear to play an influential role in patient decisions to share data.

Dental and dental hygiene students' perceptions on intraprofessional education.

Interprofessional education and intraprofessional learning experiences are fundamental to becoming an efficient member of the healthcare team for dental and dental hygiene students. The purpose of this study is to determine the attitudes and perceptions of The Ohio State University's dental and dental hygiene students on intraprofessional education and collaboration. Dental and dental hygiene students at The Ohio State College of Dentistry were surveyed in this cross-sectional study about their readiness for intraprofessional learning. The questionnaire was modeled after a study conducted by Brame etal. which focused on assessing students' readiness for intraprofessional education and determining their perceptions towards the use of intraprofessional education. Two hundred and seventy students completed the questionnaire for a 61.3% response rate. Dental hygiene students agreed more to how incorporating shared learning would help to think more positively about other oral health care professionals (p=0.025) and would help students to become better oral health care team members (p=0.002). Dental students agreed more than dental hygiene students that the function of a dental hygienist is to provide support for dentists (p ≤ 0.001) and that they must acquire more knowledge than other oral health care students (p ≤ 0.001). Most students (93%) agreed that intraprofessional learning would help in becoming a more effective oral health care team member. Dental hygiene students feel more strongly than dental students about including intraprofessional education in their learning. However, all students were receptive to the idea of incorporating intraprofessional practices.

Quality Improvement Initiative: Identifying Barriers to Reducing Time to First Feed With Human Milk in Low Birth Weight Infants.

Early exposure to human milk and time to first trophic feed in low birth weight (LBW) infants (<2 kg) is associated with a decreased risk of mortality, sepsis, and length of hospital stay. This project, focused on infants born at less than 2 kg, aimed to identify the mean time to first feed after birth, identify barriers to initiation of the first feed, and meet the target of having 90% of infants receive their first feed within the first 6 hours of life. This quality improvement (QI) project occurred in a thirty-bed level III NICU over 29 months using two Plan-Do-Study-Act (PDSA) cycles. A first-feed audit tool and a multifaceted educational plan were at the forefront of this initiative. Interventions were multidisciplinary, targeted, and extended to all healthcare team members caring for LBW infants, including staff of Labor and Delivery, the NICU, and the Child Health Transport Team. At the end of the QI project, 91.3% of inborn infants and 27.5% of outborn infants were being fed by 6 hours of age, compared with 78.8% and 12.5%, respectively, prior to the project. The mean time to first feed for inborn infants after the PDSA cycles was reduced to 4.4 hours, having a decrease of 80 minutes. A multidisciplinary approach was a key factor in the success of this QI initiative. Increasing staff education and improving clinical practice guidelines regarding the importance of early exposure to human milk are associated with reducing first feed times after birth.

Artificial Intelligence Adoption and Project Success: A Mixed-Method Study

AI&amp;apos;s growing acceptance is changing project management&amp;apos;s human-centric approach. Project management is using AI to automate and support duties. This change could improve workflows, decision-making, and project efficiency. The full influence of AI on project success is unknown. There is little empirical evidence linking AI use to project outcomes. This ignorance highlights the necessity to study AI&amp;apos;s impact on project management. The project management AI industry is expected to expand 38% annually. Since the late 1980s, AI has improved project management by providing more intelligent and autonomous help. Data privacy, accountability, strategic leadership, communication, innovation, and emotional intelligence are important ethical issues. This study examines how AI adoption affects project success through communication and feedback. This mixed-method study examines how AI adoption affects project success. The quantitative phase measured AI communication, feedback, and project progress via a predefined questionnaire. The sample includes construction, IT, manufacturing, healthcare, and finance project managers and team members. Multiple regression analysis and structural equation modelling were employed in IBM SPSS AMOS to examine AI adoption and project success measures. A qualitative phase of semi-structured interviews with respondents contextualised the quantitative data. Thematic analysis gleaned insights from interview transcripts. AI&amp;apos;s impact on project success was examined using integrated data, with ethics in mind. The study examined AI tool-project success relationships using a structural equation model. Communication mode, feedback style, and frequency explained 3% of project success variance. Quantitative research showed that AI communication frequency improves project success, whereas mode and style negatively impact it. Participants&amp;apos; qualitative comments indicated six themes that match quantitative findings, and their replies enhance quantitative results and recommend improvements. The study concluded that AI communication frequency positively increases project success, while mode and style negatively affect it. The mixed-methods approach showed that AI tools alone cannot ensure project success; communication style and frequency are. The study recommended among others that organisations should integrate AI tools into project management systems, match AI communication modes to project team preferences, optimise feedback styles, and provide regular updates to improve AI communication. Project teams need ongoing training.

User-Centered Design and Usability of Voxe as a Pediatric Electronic Patient-Reported Outcome Measure Platform: Mixed Methods Evaluation Study.

Electronic patient-reported outcome measures (ePROMs) are standardized digital instruments integrated into clinical care to collect subjective data regarding patients' health-related quality of life, functional status, and symptoms. In documenting patient-reported progress, ePROMs can guide treatment decisions and encourage measurement-based care practices. Voxe is a pediatric and user-centered ePROM platform for patients with chronic health conditions. We aimed to describe the user-centered design approach involving feedback from end users and usability testing of Voxe's platform features to support implementation in a pediatric health care setting. Purposive sampling was used to recruit patients aged 8-17 years from 2 chronic illness populations in 2 pediatric hospitals in Canada. Patients' health care team members were also purposively recruited. One-on-one iterative testing sessions were conducted digitally by research team members with participants to obtain feedback on the appearance and functionalities of the Voxe platform prototype. Patients and health care providers (HCPs) completed Voxe-related task-based activities. International Organization for Standardization key performance indicators were tracked during HCP task-based activities. HCPs also completed the System Usability Scale. To test platform usability, the think-aloud technique was used by participants during the completion of structured tasks. After completing all task-based activities, patient participants selected 5 words from the Microsoft Desirability Toolkit to describe their overall impression and experience with the Voxe platform. Qualitative data about likes, dislikes, and ease of use were collected through semistructured interviews. Feedback testing sessions were conducted with patients and HCPs until Voxe was acceptable to participating end users, with no further refinements identified. Quantitative and qualitative data analysis were completed using descriptive statistics and content analysis. A total of 49 patients and 38 HCPs were recruited. Patients were positive about Voxe's child-centered design characteristics and notification settings. HCPs rated Voxe as user-friendly and efficient, with the time to complete tasks decreasing over time. HCPs were satisfied with the Voxe platform functionalities and identified the value of Voxe's system notifications, summarized display of ePROM results, and its capacity to integrate with electronic medical records. Patients' and HCPs' high satisfaction rates with the Voxe prototype highlight the importance of being responsive to user suggestions from the inception of eHealth platform developments to ensure their efficient and effective design. This paper describes the user-centered creation and usability testing of Voxe as an ePROM platform for implementation into clinical care for pediatric patients with chronic health conditions. As a patient-facing platform that can be integrated into electronic medical records, Voxe aligns with measurement-based care practices to foster quality patient-centered approaches to care. End users' positive feedback and evaluation of the platform's user-friendliness and efficiency suggest that Voxe represents a valuable and promising solution to systematically integrate patient-related outcome (PRO) data into complex and dynamic clinical health care settings. RR2-10.1136/bmjopen-2021-053119.

Codesigning a Community Health Navigator program to assist patients to transition from hospital to community

Background This study aimed to identify the potential roles for Community Health Navigators (CHNs) in addressing problems faced by patients on discharge from hospital to the community, and attitudes and factors which may influence their adoption. Methods Twenty-six qualitative interviews and an online codesign workshop were conducted with patients, nurses, general practice staff, health service managers, community health workers, general practitioners, medical specialists, and pharmacists in the Sydney Local Health District. Qualitative themes from the interviews and workshop transcripts were analysed inductively and subsequently grouped according to a socio-ecological model. Results CHNs could assist patients to navigate non-clinical problems experienced by patients on discharge through assessing needs, establishing trust, providing social and emotional support that is culturally and linguistically appropriate, engaging family and carers, supporting medication adherence, and helping to arrange and attend follow up health and other appointments. Important factors for the success of the CHNs in the performance and sustainability of their roles were the need to establish effective communication and trust with other healthcare team members, be accepted by patients, have access to information about referral and support services, receive formal recognition of their training and experience, and be supported by appropriate supervision. Conclusions This study was unique in exploring the potential role of CHNs in addressing problems faced by patients on discharge from Australian hospitals and the factors influencing their adoption. It informed training and supervision needs and further research to evaluate CHNs’ effectiveness and the acceptance of their role within the healthcare team.

Setting the Agenda for Patient-Centered Research in Infant and Young-Child Feeding: Results from the Academy of Breastfeeding Medicine and Reaching Our Sisters Everywhere.

Background: Breastfeeding is critically important for optimal health of both birthing people and their infants. Shared, patient-centered goals of how health care team members, community groups, and families can help facilitate breastfeeding success are needed, as are ways to define and measure what breastfeeding success looks like from the patient's perspective. Methods: The Academy of Breastfeeding Medicine and Reaching Our Sisters Everywhere's collaborated in a multi-methods approach to identify breastfeeding priorities most important to parents. Results: We identified (1) Key components of a successful breastfeeding journey defined by parents and families, (2) Research priorities that will enable families to achieve breastfeeding. Conclusion: Dissemination of these findings can foster research efforts that are codesigned with birthing parents and families and reflect their priorities.

Registered Dietitian Nutritionists’ Attitudes Toward Interprofessional Health Care Teams: A Cross-Sectional Survey

BackgroundRegistered dietitian nutritionists (RDNs) are important members of interprofessional health care teams; yet, there is limited research of RDN perspectives of interprofessional teams. ObjectiveTo examine associations between the characteristics of RDNs and their attitudes of team-based care (TBC). DesignA cross-sectional electronic Qualtrics survey encompassing demographic questions, the Attitudes Toward Interdisciplinary Health Care Teams (ATIHCT) scale, and additional interprofessional-related items was distributed to RDNs during January 2020. Participants/settingA total of 5018 RDNs from various regions/specialties in the United States were recruited primarily via direct email from a random list of RDNs obtained through the Commission on Dietetic Registration. The final sample was N = 616; 12.3% of RDNs and 88.1% of RDNs who initiated the survey. Main outcome measuresATIHCT subscale scores, which measure attitudes regarding efficiency of TBC and service quality of TBC. Statistical analyses performedMultiple linear regression modeled area of specialty, time with RDN credential, location, sex, frequency of TBC, and how valued the RDN perceived him or herself to be as independent variables, with ATIHCT subscales as outcome variables. Data were subjected to confirmatory factor analysis to determine appropriate use of the ATIHCT scale in the sample. ResultsFoodservice (β = –1.48; P = .004) and sports nutrition RDNs (β = –2.58; P = .014) had lower scores for attitudes regarding efficiency of TBC (subscale 1) than clinical RDNs. Greater perceived value of the RDN was associated with higher scores for attitudes regarding efficiency (β = .66; P < .001). Greater perceived value of the RDN (β = .13; P = .03) was associated with higher scores for attitudes regarding service quality of TBC (subscale 2). ConclusionsSpecialty and perceived RDN value are associated with more favorable interprofessional attitudes among RDNs. To support positive attitudes regarding interprofessional collaboration, efforts should be honed to foster appreciation and clarity of the RDN’s role in TBC.

Transition of Clinical Pharmacy from Theory to Practice

Since the 1960s, the world has witnessed a significant development in the role of clinical pharmacists, as the pharmacy profession has shifted toward improving drug treatment, promoting health, and preventing diseases. Clinical pharmacists are in high demand around the world and are now recognized as indispensable members of health care teams. Key competencies required in a clinical pharmacist include patient care, medical knowledge, collaboration with health care teams, professionalism, delivery of exceptional care, and ensuring the safe use of medications. Modern competency-based pharmacy education focuses on specific outcomes that graduates are expected to achieve, in alignment with professional standards. This curriculum prepares students to excel in changing and evolving health care delivery, ultimately leading to improved patient outcomes and more efficient health care delivery. Therefore, the future of clinical pharmacy looks bright as pharmacists play vital roles in patient care using advanced technology and personalized medicine. Collaboration with other health care professionals is also key to improving outcomes. Therefore, pharmacy education must be changed by focusing on clinical skills, combined professional training, and career development. Challenges such as regulations, differences in practices, and lack of recognition must be addressed through collaboration between health stakeholders, educators, and policy makers. This review article aims to explore the evolving role of clinical pharmacists in the health care system, highlighting their key competencies, the impact of competency-based education, and future prospects for the clinical pharmacy profession in the context of advancing technology and personalized medicine.

Navigating the Impact of the Dobbs Decision: Perspectives from Pediatric Surgeons on Reproductive Healthcare.

Nationwide abortion restrictions resulting from the Dobbs v Jackson Women's Health Organization (2022) decision have generated confusion and uncertainty among healthcare professionals, with concerns for liability impacting clinical decision-making and outcomes. The impact on pediatric surgery can be seen in prenatal counseling for fetal anomaly cases, counseling for fetal intervention, and recommendations for pregnant children and adolescents who seek termination. It is essential that all physicians and healthcare team members understand the legal implications on their clinical practices, engage with resources and organizations that can help navigate these circumstances, and consider advocating for patients and themselves. Pediatric surgeons must consider the impact of these changing laws on their ability to provide comprehensive and ethical care and counseling to all patients.

An activity theory perspective on interprofessional teamwork in long-term care.

Teamwork in healthcare is shaped by reciprocal interactions among individual team members and their clinical context. Cultural Historical Activity Theory (CHAT) provides a framework to study teamwork from a developmental perspective. We observed interactions between members of an Interprofessional Healthcare Team (IHT) to identify practical guidelines for educators. Three Health Care Providers (HCPs) with more than 22-years' experience in a semi-urban LTC facility participated. We video-recorded two regular IHT meetings and selected excerpts for subsequent video-recall interviews. The excerpts were shown and discussed first with each team member, then with members in pairs and finally with all members reunited. We prompted participants to explain what was happening on the videos. All interviews were recorded, transcribed, and analyzed using CHAT's unit of analysis based on Activity Systems. We observed contradictions within the Activity Systems involving diverging views on outcomes of enhancing or maintaining quality of life; using non-traditional tools and spaces to sustain resident mobility; safeguarding community and patient safety despite time constraints and job titles, and unease for being paid to perform unconventional interventions. The contradictions have been grouped into three themes reflecting the Activity Systems: 1) enhancing versus maintaining quality of life; 2) improvising to achieve care goals; and 3) role fluidity. Our findings show that practical goal-oriented and contextual adaptations rely heavily on improvisation and dialogue. Educating HCPs for interprofessional teamwork should focus on developing situational awareness to foster continuous adaptation of disciplinary interventions.