Team Perspective Research Articles

Using the SEIPS Model to Assess a Maternal Hemorrhage Risk Alert Tool

Deaths resulting from maternal hemorrhage (MH), for example, excessive blood loss related to childbirth, are preventable if the hemorrhage is identified in a timely manner. One approach to support timely identification is the use of alerts. However, alerts with low utility have negative, unanticipated consequences for both clinician and patient outcomes. This study has two objectives: (1) use the Systems Engineering Initiative for Patient Safety model to describe how the MH risk alert tool is used in the care process, and (2) evaluate the utility of the MH risk alert tool from the perspective of the care team. We performed observations to understand the care process and fielded a survey to evaluate the alarm utility. Our results showed that the MH risk alert tool is used throughout the care process, both antepartum and postpartum. Additionally, our results showed that workflow integration, usefulness, and trustworthiness of the alert need to be improved.

Team-centered IDAC: Modeling and simulation of operating crew in complex systems - Part 2: Simulation aspects and application

Complex systems operations, such as Nuclear Power Plants (NPPs), generally require professional operating teams. Factors associated with teamwork, such as inappropriate communication and coordination, are important contributing factors to accidents and unsafe behavior. The impact of crew interactions on team effectiveness and, consequently, on the entire system, has yet to be fully and quantitatively explored in high-risk environments such as NPPs. Since a team is an interactive social system, team-specific issues must be studied and evaluated from a “team perspective”—based on team dynamics and processes. This paper is a part of a two-papers series that presents a simulation-based Team Model for NPP control room operations. Part 1 describes the theoretical fundaments of the model and details its elements. The current paper, Part 2, describes the simulation aspects and a full application of the method to an NPP four-steam generator feedwater system pipe break. It presents how to set up the simulation elements, such as hardware and humans within a team, using MATLAB Simulink. The method is demonstrated through a case study of an NPP four-steam generator feed water system pipe break. The results are discussed and assessed against theoretical and experimental findings.

The financial impact of participant attrition from randomised trials: a case-study from the Occupational Therapist Intervention Study (OTIS).

Loss to follow-up of participants can compromise the statistical validity of randomised trials. Moreover, it can have financial consequences for trial teams and funders. This study explores the Occupational Therapist Intervention Study (OTIS) where, despite a withdrawal rate of less than 10%, the trial team incurred opportunity costs related to participants who were initially recruited but subsequently decided to withdraw from the trial. To estimate the cost of participant losses to follow-up in the OTIS trial and thus introduce a costing framework to research teams on how they could estimate the opportunity costs of participant withdrawal from their randomised trials. The participants lost to follow-up are differentiated by (1) the time point at which they were lost to follow-up; (2) the treatment group they were allocated to; (3) their response patters to follow-up questionnaires; these elements were considered to identify the relevant types of attrition. Protocol-driven costs of trial materials, including administration, print, and shipping, were gathered. We calculated unit costs for each type of attrition by multiplying protocol-driven and intervention costs with the relevant number of participants. Summing up unit costs by type of loss to follow-up yields aggregate figures, enabling the estimation of aggregate and average opportunity costs of attrition. The average cost per participant loss to follow-up in the OTIS trial is £98.41. The aggregate cost of participant loss to follow-up is £10,234.90 from the economic perspective of the trial team. Therefore, 1.42% of the allocated funding has been misallocated because of participant loss to follow-up. Despite the low attrition rate of the OTIS trial, loss to follow-up has still generated considerable opportunity costs. It is recommended that decision makers focus on identifying strategies which could improve participant retention in randomised trials to optimise their budget.

An investigation of the impact of ‘Living with COVID’ on workplace COVID-19 transmission risk, response and resilience - lessons learnt and future challenges

BackgroundPrevious research has highlighted links between occupation and risk of COVID-19 transmission and suggests that occupational risk is influenced by covariates including socio-economic status, and deprivation. This study examined the perspectives of local authority teams of how changes in policy and advice, as set out in the UK government report ‘Living with COVID,’ affected COVID-19 transmission risk, response and resilience in workplace settings in Greater Manchester, an area that was disproportionately affected by the pandemic.MethodsThe project, which took place between August and November 2022, undertook a mixed methods approach to incorporate wide-ranging reflections of changes following the publication of ‘Living with COVID’. Quantitative data was collected from local employers (n = 149) and employees (n = 397) using online surveys, and qualitative interview data was collected from Greater Manchester local authority teams (n = 19).ResultsThe research highlighted the inequitable impact of the pandemic on those already experiencing health inequalities, including people on more precarious employment contracts or those who were unable to work from home during the pandemic.The study found that the facilitators that helped local authorities to support employers to manage transmission included clear, detailed and timely national and local guidance, good communication, partnership working, funding, and timely access to data. Barriers to supporting employers included contradictory or confusing national guidance, structural inequalities, lack of funding, and delayed access to data. Interview participants reported that they were now utilising lessons learnt during the pandemic, along with the that partnerships developed, in order to tackle wider health issues and to prepare for future pandemics or health crises.ConclusionThe findings of the study, which concur with previously published research conducted as part of the PROTECT project, highlight the importance of active reflection on the lessons learned during the course of the pandemic. The study draws on PH and EH teams’ perspectives of managing COVID-19 transmission, in an area that was disproportionately affected by the pandemic, in order to add to our understanding of the best ways to ensure preparedness for future pandemics or health crises at a national level.

Engaging Indigenous communities in research to inform practice: The multisite implementation evaluation of Tribal home visiting.

Community engagement (CE) is widely acknowledged as a way to enhance the ethics, rigor, and impact of research. Additionally, CE is a demonstrated way to integrate Indigenous and colonial (western) research systems. For these reasons and others, designers of the Multi-site Implementation Evaluation of Tribal Home Visiting (MUSE) used a community-engaged approach to study the implementation of federally funded home-visiting programs across 17 Indigenous communities throughout the United States. This paper describes MUSE's community-engaged approach and its practical applications from the perspective of the MUSE study team. The paper highlights key outcomes attributable to CE, addresses barriers to CE, and details responses to these barriers and their impacts. Adding to the rich evidence base demonstrating the value of community-engaged approaches, MUSE demonstrates that in-depth CE is feasible and valuable in multisite studies done in partnership with Indigenous communities.

Navigating transitions: a qualitative study of nursing teams' experiences of educational and cultural transitions in Germany.

The global migration of health professionals in general and nurses in particular, has led to nursing shortages and socioeconomic impacts on health systems in both source and destination countries. Adding to the complexity of the situation is the fact that the nursing profession itself is evolving from a vocational to an academic one. Although nursing migration and academization have been studied from either an institutional or an individual perspective, there is a gap in the literature regarding how nursing teams experience these transitions. This study aims to explore how nursing teams navigate through the transitions of academization and internationalization of the current dynamic nursing landscape in Germany. Based on social constructivism epistemology this qualitative study involved face-to-face focus group discussions conducted at several hospital sites in Germany from September 2021 to May 2023. The focus group discussions were audio-recorded, transcribed, and analysed using content analysis; the four dimensions of transition theory according to Schlossberg's Four S (4S) framework (self, situation, support, and strategy) were used as a priori items to construct the coding framework. Nine focus group discussions were conducted with a total of 40 nurses from different educational and migrant backgrounds. The analysis showed that the transition experiences of the nursing teams were heterogeneous, with educational and national backgrounds playing an important role in how realistic their expectations of their professional roles and identities were. The dynamic situation characterized by a shortage of qualified nursing staff, increases the pressure on nursing teams and underscores the importance of employer-provided and peer support. Onboarding and communication are key strategies used depending on the duration of the employee turnover. This study provides insights into the challenges and coping strategies of nursing teams in the current dynamic scene of migration, academicization and professional socialisation in Germany. Extending the Schlossberg 4S framework from the individual to the team perspective provides a comprehensive view of the transitional experiences of nursing teams. Within each domain of the framework, the experiences of nursing teams are remarkably diverse. Educational background (vocational or academic) and origin (German or foreign trained) play an important role in shaping the transitional experiences of nursing teams.

Team-centered IDAC: Modeling and simulation of operating crew in complex systems – Part 1: Team model and fundamentals

Operation of highly complex systems such as Nuclear Power Plants (NPPs) generally require highly trained professional operating teams. Factors associated with teamwork, such as ineffective communication and coordination, can be important contributing factors to accidents and unsafe behavior. The impact of crew interactions on team effectiveness and, consequently, on the entire system, has not been fully and quantitatively explored in high-risk environments such as NPPs. Since a team is an interactive social system, team-specific issues must be studied and evaluated from a “team perspective”—based on team dynamics and processes. This paper is part of a two-papers series that presents a simulation-based Team Model for NPP control room operations. The current paper, Part 1, describes the theoretical fundaments of the model and details its elements. The accompanying paper describes the simulation aspects, and a full application of the method to a pipe break accident in a four- four-loop steam generator feedwater system. The proposed model is based on the IDAC (Information, Decision, and Action in Crew context) cognitive model framework. The resulting model, Team-centered IDAC (Tc-IDAC), examines the team activities “Collaborative information collection,” “Shared decision making,” and “Distributed action execution” through specific modules for Team Error Management. These modules include error detection, error indication and error correction, and team performance shaping factors.

S146 Addressing the Third Person in the Room: A Multidisciplinary Team Perspective on the Accuracy of AI Models to Deliver Information on Pancreatic Cancer and Reliable Reference

S146 Addressing the Third Person in the Room: A Multidisciplinary Team Perspective on the Accuracy of AI Models to Deliver Information on Pancreatic Cancer and Reliable Reference

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.

A multidisciplinary team and patient perspective on omission of surgery after neoadjuvant systemic therapy for early breast cancer: A European Society of Surgical Oncology (ESSO) Research Academy survey

BackgroundSurgical de-escalation aims to reduce morbidity without compromising oncological outcomes. Trials to de-escalate breast cancer (BC) surgery among exceptional responders after neoadjuvant systemic therapy (NST) are ongoing. Combined patient and clinician insights on this strategy are unknown. MethodsThe European Society of Surgical Oncology Young Surgeons Alumni Club (EYSAC) performed an online survey to evaluate the perspective of multidisciplinary teams (MDTs) on omission of surgery (“no surgery”) following complete response to NST for early BC. The aim was to identify MDT considerations and perceived barriers to omission of BC surgery. Patient insights were obtained through a focused group discussion (FGD) with four members of the patient advocacy group, Guiding Researchers and Advocates to Scientific Partnerships (GRASP). ResultsThe MDT survey had 248 responses, with 229 included for analysis. Criteria for a “no surgery” approach included: patient's tumor and nodal status before (39.7 %) and after (45.9 %) NST and comorbidities (44.3 %). The majority chose standard surgery for hypothetical cases with a complete response to NST. Barriers for implementation were lack of definitive trials (55.9 %), “no surgery” not being discussed in MDTs (28.8 %) and lack of essential diagnostic or therapeutic options (24 %). Patients expressed communication gaps about BC surgery, lack of trust regarding accuracy of imaging, fear of regret and psychosocial burden of choosing less extensive surgery. ConclusionsBefore accepting “no surgery” after complete response to NST, MDTs and patients need level 1 evidence from clinical trials, access to standard diagnostic modalities and treatments. Patient's fear of regretting less surgery need to be acknowledged and addressed.

Optimizing Patient Engagement in Treatment for Opioid Use Disorder: Primary Care Team Perspectives on Influencing Factors.

Opioid use disorder (OUD) care engagement rates in primary care (PC) settings are often low. Little is known about PC team experiences when delivering OUD treatment and potential factors that influence their capacity to engage patients in treatment. Exploring PC team experiences may inform needed supports that can optimize OUD care delivery and improve outcomes for patients with OUD. We explored multidisciplinary PC team perspectives on barriers and facilitators to engaging patients in OUD treatment. Qualitative study using in-depth interviews. Primary care clinical teams. We conducted semi-structured interviews (n = 35) with PC team members involved in OUD care delivery, recruited using a combination of criterion and maximal variation sampling. Data collection and analysis were informed by existing theoretical literature about patient engagement, specifically that patient engagement is influenced by factors across individual (patient, provider), interpersonal (patient-provider), and health system domains. Interviews were professionally transcribed and doubled-coded using a coding schema based on the interview guide while allowing for emergent codes. Coding was iteratively reviewed using a constant comparison approach to identify themes and verified with participants and the full study team. Analysis identified five themes that impact PC team ability to engage patients effectively, including limited patient contact (e.g., phone, text) in between visits, varying levels of provider confidence to navigate OUD treatment discussions, structural factors (e.g., schedules, productivity goals) that limited provider time, the role of team-based approaches in lessening discouragement and feelings of burnout, and lack of shared organizational vision for reducing harms from OUD. While the capacity of PC teams to engage patients in OUD care is influenced across multiple levels, some of the most promising opportunities may involve addressing system-level factors that limit PC team time and collaboration and promoting organizational alignment on goals for OUD treatment.

Patient and care team perspectives on an app to support Hospital at Home admission decision making.

Hospital at Home (HaH) programs are used throughout the United States and are beneficial in both providing patients care in environments most comfortable to them and freeing up inpatient beds. Better informing patients about HaH programs, while promoting shared decision-making (SDM), should be prioritized by health systems. SDM apps may promote increased patient agency and understanding of complex HaH care decisions. We previously developed, usability tested, and refined a HaH SDM app. To evaluate the utility of SDM apps in assisting pneumonia patients with HaH admission. Usability surveys (N = 16) and semistructured interviews with patients (N = 9) and nurse navigators (N = 3) were utilized to evaluate our app in assisting pneumonia patients as they contemplated HaH admission. Recruitment occurred at three hospitals in the southeastern United States. Surveys were analyzed consistent with their validated measures, while interviews were analyzed using inductive coding methodologies. Patients supported receiving HaH information via an app, with many noting that presenting content via multiple modalities (e.g., videos, pictures, text) was helpful and that the app assisted their care decision. App-guided inquiries into patients' care preferences helped patients visualize their priorities and promoted feelings of agency, while providing important information to care teams. Participants found visuals effective at conveying program details, for example, HaH's in-home setup, which may assist with health literacy challenges. Potential barriers included the need to expand app accessibility for vision impaired and non-English speaking patients. SDM apps may better inform patients' HaH care decisions, allowing patients self-directed access to information and engagement with visual content, which may address challenges related to health literacy and navigating complex, time-sensitive decisions.

Primary care team perspectives on approaches to engaging patients in treatment for opioid use disorder

IntroductionEngagement is a critical component of successful treatment for opioid use disorder (OUD). However, rates of patient engagement in OUD treatment, especially in outpatient settings, are variable and often low. Little is known about the specific strategies members of primary care teams use to initiate and encourage ongoing participation in OUD treatment. In a national cohort of primary care clinics in the U.S., we explored the perspectives of primary care team members on the meaning of and approaches to OUD treatment engagement. MethodsWe conducted semi-structured interviews with 35 providers from multidisciplinary primary care teams in an existing national cohort of 13 clinics across seven states. Teams were delivering OUD treatment via the Collaborative Care Model, a model that combines primary care providers (PCP), behavioral health care managers (BHCM) and consulting psychiatric providers (CPP) in a structured way to provide patient-centered, team-based, and measurement-based care. Interview participants included 14 PCPs, 13 BHCMs, and 8 CPPs. Interviews asked open-ended questions about provider experiences and practices that aided or hindered patient engagement in OUD treatment. Interview transcripts were double-coded by trained qualitative researchers and analyzed using a combination of deductive and inductive approaches to identify themes. ResultsTwo themes emerged that describe provider perspectives on the meaning of engagement: 1) qualifying engagement by the volume of contact with patients, and 2) the need for more multidimensional measures of engagement. Six themes emerged that characterized provider engagement practices: 1) creating an environment of disclosure, 2) normalizing OUD treatment, 3) offering gentle but persistent outreach, 4) providing human connection and encouragement, 5) tailoring treatment to patient needs, and 6) avoiding stigmatizing responses. Analysis identified multiple replicable strategies that providers used to support these engagement practices. ConclusionsProviders consistently apply a range of strategies when trying to engage patients in OUD treatment. Specific engagement strategies used embodied compassion and pragmatism, hallmarks of patient-centered care. Further research is needed to understand the impact of scaling engagement approaches across all care settings.

Shifting towards Electric Vehicles: A Case Study of Mercedes-Benz from the Perspective of Cross-Functional Teams and Workforce Transformation

The automotive industry’s shift towards electric vehicles (EVs) is driven by technological advancements and environmental concerns. This paper examines Mercedes-Benz’s strategy in this transition, highlighting the challenges and opportunities involved. Using thematic analysis of semi-structured interviews with key professionals at Mercedes-Benz, the study reveals a dual strategy: integrating new talents with specific EV competencies and upskilling the existing workforce. This approach reflects the company’s recognition of evolving vehicle development requirements and commitment to maintaining a skilled workforce. Emphasis on data-driven functions highlights the industry’s shift towards technological advancements. The transition significantly impacts workforce roles, necessitating role reassignment and collaborative planning, indicating a culture of inclusivity and proactive change management. Challenges include the importance of mindset change and adaptability among employees, as well as managing overlapping traditional and EV projects, leading to increased workloads and compressed timelines. Tailored training and development strategies are essential for a comprehensive transition. Mercedes-Benz’s commitment to an electric-only strategy signals a clear future direction. However, this raises questions about workforce preparedness and ongoing skill development. The study offers insights into managing workforce transformation in the EV transition, contributing to academic discussions and providing practical guidance for industry professionals.

W92 - Primary Care Team Perspectives on Approaches to Engaging Patients in Treatment for Opioid Use Disorder

W92 - Primary Care Team Perspectives on Approaches to Engaging Patients in Treatment for Opioid Use Disorder

The Impact of Teamwork Quality (TWQ) on Agile Software Development Team Performance

Purpose: The study examined the extent to which teamwork quality (TWQ) impacts team performance in the Agile software development space in the U.S. and how the TWQ factors (Communication, coordination of expertise, cohesion, trust, mutual support &amp; value sharing) are ranked in terms of importance to team performance Materials and Methods: The study used correlation and regression analysis to determine the degree of the relationship and the effect of the extended TWQ factors on Agile software team performance. Additionally, the study assessed the relative importance of the TWQ factors to team performance. Participants in the study included IT workers from the software development team in U.S. companies with in-house teams using the Agile methodology. Data was collected using an online survey through survey monkey. The data was presented through descriptive statistics and analyzed using regression analysis. Findings: The study found all the extended TWQ factors were strongly correlated to the team performance. The analysis showed that a statistically significance predictive relationship exists between the extended TWQ factors and Agile software development team performance. However, only mutual support and value sharing contributed statistically significantly to the model. Among these factors, mutual support was ranked as the most important TWQ factor in relation to team performance, while trust was ranked as the least. Implications to Theory, Practice and Policy: This empirical study tested and extended the TWQ model on team performance in the Agile software development space in the U.S. for software development teams and how these TWQ factors are ranked in terms of importance to team performance. The findings provide insight to project teams and team leaders, product owners, scrum masters, and project managers about the TWQ model from the perspective of agile software development teams. The findings also address the critical TWQ factors that are needed for building effective and efficient Agile software development teams.

Improving Virtual Team Collaboration Paradox Management: A Field Experiment

Virtual teams are ubiquitous in the workplace, yet they experience frequent collaboration challenges. Successfully managing the team collaboration paradox, in terms of maintaining a unified team perspective and diverse individual perspectives, presents a potentially important lever to improve virtual team performance. However, scholars have conflicting opinions regarding whether such improvement is possible. We argue that team collaboration paradox management will positively relate to team performance over time and can be improved via a theory-based intervention. This intervention draws from theory on paradoxes for its content (paradoxical thinking) and team development interventions for its structure (general content knowledge, team-specific feedback, action-focused planning). Given the complexity of paradoxes, it is unclear whether a single training session could substantively improve their management; therefore, one intervention condition was comprised of a single training session and the other condition included a follow-up session. Analyzing two waves of multisource quantitative data from a sample of 76 virtual teams from 37 organizations, we find a positive relationship between team collaboration paradox management and team performance at both time periods. We also find that only the intervention condition with the follow-up session, as compared with untreated control teams, significantly improved how well teams managed the collaboration paradox and thereby facilitated subsequent changes in team performance. Supplementary qualitative insights from the intervention sessions illuminate the actions virtual teams took to improve their collaboration paradox management. These results have important implications for the paradox and teams literatures, as well as the managers and members of virtual teams. Funding: This work was supported by the SHRM Foundation [Project 166].

Codesigning youth diversion programmes with community-led organisations: a case study

Background:We explore the feasibility of applying methods of participatory codesign to collaborative service development with community-led youth diversion programmes. Collaborative partnerships can support wealth redistribution and community mobilisation, a goal of governments aiming to implement equity-focused policy. There is little systematic exploration of methods aiming to structure the relationship between government and community-led programmes as part of youth criminal-legal diversion efforts. Methods:We use case study methodology to assess the feasibility and impact of a curriculum codesign approach between a university research team and two community-led organisations providing diversion services through a county juvenile court. The codesign method was informed by participatory design and use of research evidence frameworks. Findings:The analysis focuses on the feasibility of the approach from the perspective of the university research team and community organisations as well as how well the approach successfully navigated critical components of participatory process, including shared power, deference to community vision and values, and a valued end product. We conclude that the approach was generally feasible as a quality improvement strategy and well-received by the community-led organisations. Discussion and conclusions:Codesign is a promising strategy for reconciling public administration and health equity goals. The approach used in this case study adds to a small literature on methods of using codesign as a quality improvement process with applications for government contracting and monitoring, programme development and capacity-building.

Perceptions of families and healthcare providers about feeding preterm infants in the neonatal intensive care unit: protocol for a qualitative systematic review

IntroductionThe underdevelopment of preterm infants can lead to delayed progression through key early milestones. Demonstration of safe oral feeding skills, constituting proper suck-swallow reflex are requirements for discharge from the...

Vagal Nerve Stimulation in the Pediatric Population and Correlation Between Family and Treatment Team Perspectives: Single-center Experience.

Vagal nerve stimulation (VNS) is an adjunctive therapy to pharmacological treatment in patients with drug-resistant epilepsy. This study aimed to assess the efficacy of VNS therapy for seizure frequency reduction and improving quality of life (QOL) measures in children with refractory epilepsy and to evaluate the correlation between the perspectives of families and those of the treating team. This was a prospective cohort study conducted at Abha Maternity and Children's Hospital, Saudi Arabia, from 2018 to 2022. A total of 21 pediatric patients who completed one year of follow-up after VNS implantation were included. Patients were aged between 2 and 14 years, with a mean age of 8.14 ± 3.92; 11 (52.4%) patients were female. Family and physician assessments were collected blinded to each other using Clinical Global Impression of Improvement (CGI-I) scores and QOL assessments to evaluate the correlation between the families' and treating team's perspectives on VNS outcomes. In this study involving 21 patients with intractable epilepsy, VNS showed significant efficacy in reducing the frequency of seizures. VNS significantly reduced the number of seizures per week from a baseline median of 35 to a median of 0.25 at the end of the follow-up period, representing a dramatic reduction of 99.3% (p < 0.001). The number of emergency department visits per year decreased from a baseline median of 12 to a median of 2, a reduction of 83.3% (p < 0.001), whereas the number of hospital admissions per year decreased from a baseline median of 3 to a median of 1, a 66.7% decrease (p < 0.001). The number of antiepileptic medications taken decreased from a median of 4 to 3 (p < 0.001). Notably, 28.57% of the patients achieved complete seizure freedom, and 38% exhibited significant improvement, with at least 50% reduction in seizure frequency. Importantly, none of the patients experienced an escalation in seizure frequency following VNS treatment. The family and physician assessments showed varying degrees of alignment in perceptions, with "concentration" exhibiting a significant positive correlation (r = 0.498, p = 0.022), indicating noteworthy agreement, whereas verbal communication did not show a substantial correlation (r = -0.062, p = 0.791), indicating a divergence of views. VNS is a promising and well-tolerated therapy for individuals with intractable seizures, offering clinical benefits and potential enhancements in various aspects of QOL. The varying perceptions between family and physician assessments highlight the importance of considering multiple perspectives when evaluating treatment outcomes.