Responsibility Of Team Research Articles

The efficiency of the political process in the Republic of Moldova in the context of increasing global threats in tearm of a realistic approach (Part II)

The article deals with the problem of political process and political participation in the Republic of Moldova. The author draws on the realistic concept of Danilo Zolo about the “social complexity” in the context of the post-industrial era in the studying of this issue. Th e author shows that the evolution of the political process in the Republic of Moldova refl ects the global processes of democracy crisis, being a product of the modern age development. The author pays a special attention to the problem of political participation, concluding that such a problems like the “COVID-19”, finally remove demos from political life. Actually, the mane subject of the political process become the executive branch. The concentration of political power requires strengthening of the professionalism and of the responsibility of the management team.

QUALITY DEVELOPMENT MANAGEMENT IN IMPROVING THE COMPETITIVE ADVANTAGE OF PRIVATE VOCATIONAL SCHOOLS IN JAMBI PROVINCE

This study aims to find a profile of Quality Management Implementation in three Private Vocational High Schools with a detailed aim of finding an implementation model to provide information to all other private vocational high schools that have not achieved “A” accreditation so that they can achieve “ A “ accreditation. This research is a qualitative research, where the reseach is conducted in three private vocational high schools in Jambi city which are accredited “A” represented in Yadika, PGRI 2, Pelita Raya schools. Data collection techniques using observation, interview and documentation, data Analysis using the Cresweel model and data valiidity techniques using data triangulation. The results of the research on Implementation of Quality Development Management at private vocational high schools in the form of innovative ideas that are applied in the field, cover a number of aspects that are quite broad because the customers of a Bujan scholl are only students but also administrative staff, teachers, and stakeholders or the community. The Conclusion of this study is that the Quality development management in Increasing the Competitive Advantage of Private vocational high schools in Jambi Provinces is the existence of a solid and responsible team commitment and cooperation in order to get special attention from the community and become an option for the community, the success factor of the Implementation of Quality development management, what can increase competitive advantage in private vocational schools in Jambi Province is organized management, supported by reliable human resources, good relations with the enviroment and the world of work, mature leadership policies, support from foundations and a solid work plan.

SP2.2.11Improving the quality of the documented weekend surgical handover: Implementation of a handover sticker within an urban teaching hospital

Abstract Aim Effective, high-quality patient handovers between the surgical team are essential for safe transfer of responsibility for patient care whilst ensuring continued patient-safety and supporting good clinical governance. Weekend handovers provide a particular challenge, with error potential, when patients are cared for by multiple different healthcare professionals. This project aimed to improve the documentation of the weekend handover for the surgical inpatients of a busy UK teaching hospital. Method Quality Improvement project performed within a single General Surgical department between August and October 2020. An initial casenote audit on 3 consecutive Fridays compared available handover information against RCS guidance. A comprehensive surgical weekend handover sticker was designed and all members of the surgical team educated in its use. Following sticker introduction, handover quality was similarly re-audited. **=p<0.00001 using Chi-squared/Fisher exact. Results 138 inpatient records were evaluated in cycle 1 and 135 in cycle 2, with the proportion containing a weekend handover increased post-intervention (96 vs. 82%,p=0.0004). Handover quality improved following sticker introduction with more frequent documentation of: diagnosis (96 vs. 21%**); need for imaging review (94 vs. 29%**); intravenous fluid plan (84 vs. 21%**); blood test requirements (94 vs. 24%**); mode of nutrition (90 vs. 24%**); antibiotics (90 vs. 30%**); drug monitoring (90 vs. 1%**); discharge planning (94 vs. 44%**) and escalation plan (87 vs. 0%**). Conclusion Introduction of a sticker has significantly improved the quality of documented handover available to the responsible on-call team. Future work will assess sticker impact on quality of care and clinical outcomes.

How to Respond to a Ransomware Attack? One Radiation Oncology Department's Response to a Cyber-Attack on Their Record and Verify System

The digitization of healthcare for patient safety and efficiency introduced third party networks into closed hospital systems increasing the probability of cyberattacks and their consequences(1). In April 2021, a major vendor of a Radiation Oncology (RO) record and verify system (RVS) suffered a ransomware attack, affecting our department and many others across the United States. This article summarizes our response to the ransomware event including workflows, team member roles, responsibilities, communications and departmental recovery. The RVS created or housed accurate patient dose records for 6 locations. The immediate response to the ransomware attack was to shut down the system including the ability to treat patients. With the utilization of the hospital EMR and pre-existing interfaces with RVS, the department was able to safely continue patient radiotherapy treatments innovatively utilizing a direct Digital Imaging and Communications in Medicine (DICOM) transfer of patient data to the linear accelerators and implementing paper charting. No patients were treated in the first 24 hours of the attack. Within 48 hours of the ransomware event, 50% of patients were treated, and within 1 week, 95% of all patients were treated using direct DICOM transfer and paper charts. The RVS was completely unavailable for 2.5 weeks and full functionality was not restored for 4.5 weeks. A phased approach was adopted for re-introduction of patient treatments back into the RVS. Human capital costs included communication, outreach, workflow creation, quality assurance and extended clinical hours. Key lessons learned were to have a back-up of essential information, employ ‘dry run’ emergency training, having consistent parameter requirements across different vendor hardware and software, and having a plan for the recovery effort of restoring normal operations once software is operational. The provided report presents valuable information for the development of cyber-attack preparedness for RO departments.

Partnerships, Succession, and Student Engagement: A Perioperative Immersion Program

The current shortage of operating room (OR) nurses will be critically impacted by the planned retirement of 65% of its workforce by 2022 with more vacancies expected in the years to come. Another likely contributor to the OR nursing shortage may be because most clinical education experiences in nursing programs do not include rotations in the perioperative setting, thus limiting student exposure. One solution to introduce student nurses to the perioperative environment and mitigate the limitations of passive learning for today’s learners is providing an on-site perioperative immersion experience delivered by the OR nurse education team. Nurse educators teaching in a baccalaureate nursing program at a midwestern college collaborated with the perioperative nursing education team from a large metropolitan hospital to implement a perioperative immersion program for entry-level undergraduate nursing students. In qualitative evaluations, the perioperative immersion increased knowledge of the patient perioperative experience, exposed students to both OR nursing and interdisciplinary team roles and responsibilities, and generated interest in the OR as a future career path.

A season long investigation of social emotional learning associated with high school basketball participation

This qualitative, longitudinal investigation had three purposes: (1) to investigate social emotional learning (SEL) outcomes athletes reported from participating in high school basketball; (2) to identify critical incidents that occurred over the course of a season that were associated with SEL outcomes; and, (3) to explore the processes identified as leading to the athletes’ SEL outcomes. High school varsity basketball players (four males, five females) were interviewed five times over the course of their season. Content analysis revealed that major categories of SEL outcomes identified included: psychological dispositions (e.g., accountability, discipline); psychological skills (e.g., emotional regulation, time management); and interpersonal competencies (e.g., communication, friendship). Student-athletes reported several critical incidences (competitive outcomes, shifting team responsibilities, team conflict, and emotional regulation events) and these were directly related to SEL outcomes. Student-athletes reported learning SEL outcomes from both the totality of their sport experience and from specific critical incidents such as winning and losing big games or handling team conflict. Results are discussed in light of the social emotional learning literature in education and Larson and Brown’s propositions regarding how youth learn via extracurricular activity participation. Lay summary: This study tracked high school basketball players SEL outcomes across a season and identified critical incidences associated with those outcomes. Evidence is provided for the value of scholastic sports in promoting positive youth development and how athletes on their own experience SEL outcomes in programs where these outcomes are not explicitly taught. Hot emotional issues were also identified as an important source of SEL.

The surgical debrief: Just another checklist or an instrument to drive cultural change?

IntroductionPost-procedural debrief is recommended to improve patient safety. We examined operating room (OR) clinicians’ perceptions of the impact of a multi-disciplinary debrief on OR culture. MethodsA survey was administered to 182 OR clinicians at a major academic medical center. Attitudes toward the surgical debrief and its effect on patient safety and OR culture were evaluated. ResultsMajority of clinicians (58.2%) believed creating a culture of safety in the OR was a shared care team responsibility, however, surgical attendings and trainees were more likely to assign this responsibility to the surgical attending. Few circulating nurses and trainees felt comfortable initiating a surgical debrief. Overall clinicians agreed that a debrief would impact both patient safety outcomes and OR culture. ConclusionsClinicians felt implementation of a surgical debrief would positively affect the OR culture of safety by improving interdisciplinary communication and influencing the power hierarchy that exists in many ORs.

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

PurposeTo obtain information on how family visitor restriction during the COVID-19 pandemic has impacted the workplace experience of physicians and nurses in the medical intensive care unit, and to assess differences by profession. Materials and methodsWe developed a survey containing closed- and open-ended questions, applying both quantitative and qualitative analyses to our results. ResultsOf the 74 respondents, 29 (38%) were nurses and 45 (62%) were physicians. Nurses reported positive changes to daily workflow and the ability to provide medical care, while physicians reported negative changes in these areas. Both groups reported decreased comprehension and increased distress among families, and decreased ability to provide end-of-life care. For the qualitative analysis, eight themes were identified: the patient’s room as space, creation of a new space through virtual communication, time, increased complexity of care, challenges around the use of technology, adjustments to team roles and responsibilities, desire for families to return, and internal tension. ConclusionIntensive care physicians and nurses reported both positive and negative effects of family visitor restriction during the COVID-19 pandemic, with significant differences based on profession. Both groups expressed concern for an overall negative impact of visitor restriction on healthcare workers, patients, and their families.

Credentials and Core Clerkships: Who's Training Our Physician Assistant Students (and Does It Matter)?

Evaluating the effectiveness of supervised clinical practice experiences (SCPEs) is a primary responsibility of the clinical education team. Physician assistant (PA) education is unique because preceptors are not confined to one professional credential. This study evaluated the relationship between students' perceptions of rotation experiences and the professional credentials of the preceptor of record. This retrospective data analysis evaluated data from 3 cohorts (2016-2018) across 4 PA programs. Preceptors of record were categorized as MDs/DOs or advanced practice providers (APPs). Analysis of 209 SCPEs found 91 APP preceptors (43%) and 119 MD/DO preceptors (57%). APP preceptors were most prevalent in family medicine/primary care (57%), internal medicine (50%), and emergency medicine (49%). Students' evaluation scores were higher for APP preceptors compared to MD/DO preceptors, but not statistically significant. This study showed that a considerable number of APPs are serving as preceptors and were found to have similar student evaluation scores to those of MD/DO preceptors.

Ethical responsibilities of European children's teams facing the resurgent COVID-19 pandemic.

The COrona VIrus Disease 2019 (COVID-19) pandemic is posing an unprecedented challenge to healthcare systems around the globe. Europe has been struggling for 1 year now, and despite some encouraging progress (above all, the beginning of vaccination), the second wave is ongoing. Even though children are less affected than adults, the COVID-19 pandemic—and in particular the measures to counter it—is having a considerable impact on the paediatric healthcare setting. It is, therefore, the duty of paediatric teams in Europe to prepare for the challenges ahead. We wish to contribute to this necessary preparedness in two ways: firstly, by assessing the direct and indirect impact of the pandemic on children and on the paediatric setting; secondly, and more importantly, by identifying the various responsibilities of paediatric healthcare professionals, in light of established ethical principles. Only abiding by these responsibilities will it be possible to ensure that ill children and their families are properly supported even in these difficult times and to grant that decisions about children’s healthcare remain morally justified and lawful. What is Known:• The COVID-19 outbreak is posing an unprecedented challenge to healthcare systems around the globe• Despite the children are less affected than adults, the COVID-19 pandemic is having a huge impact also on paediatric settingWhat is New:• The COVID-19 pandemic lays out specific responsibilities of paediatric professionals towards our pa-tients, society and ourselves• The paediatric teams in Europe should assess the direct and indirect impact of the pandemic on the chil-dren and on the paediatric settings, ensuring consistency between centres and across regions in Europe

Do Tax Professionals Act Like Auditors when Evaluating Tax-Related Audit Evidence?

ABSTRACTThe audit of the financial statement income tax accounts is ultimately the responsibility of the audit engagement team; however, tax professionals are often involved because of their knowledge of the tax functional area. Auditors are expected to exercise professional skepticism and independence when performing audits, while tax professionals are expected to be advocates for their tax clients. This study investigates whether the auditor and/or tax professionals' typical role influences how they evaluate evidence on an audit engagement, especially when provided evidence by individuals with whom they are closely affiliated. Results of an experiment with experienced auditors and tax professionals suggest that despite differing in their trait skepticism and client advocacy attitudes, tax professionals and auditors make similar judgments when in the role of an audit engagement team member. We also find evidence that both auditors and tax professionals are more persuaded by individuals with whom they have a closer affiliation.Data Availability: Data are available from the corresponding author.

المسؤولیة المدنیة عن أخطاء الفرق الطبیة والتعویض عنها

المسؤولیة المدنیة عن أخطاء الفرق الطبیة والتعویض عنها

KONTRIBUSI SIS (SISTEM INFORMASI SANTRI) DALAM INOVASI MANAJEMEN KEUANGAN PONDOK PESANTREN

The objectives set from this study are: (1) To find out the planning of SIS in the financial management of Blokagung Tegalsari Banyuwangi Islamic Boarding School, (2) To find out the supporting and inhibiting factors of the application of SIS in the financial management of Blokagung Tegalsari Banyuwangi Islamic Boarding School. This research uses descriptive qualitative research methods. The research was the researcher himself who became an instrument (human instrument) with supporters of the interview guide grid. Data collection is more emphasized on observation, interview, and documentation. The validity of the data in this study uses data triangulation.The results of his research: SIS (SantriInformation System) as an innovation in the financial management of the Darussalam Boarding School Blokagung Tegalsari Banyuwangi is implemented with several stages which include: (1) Determination of payment system innovation, (2) Determination of santri payment budget.(3) Appointment of the system responsible team. (4) Appointment of a payment system service team.supporting and inhibiting factors of the application of SIS to the financial management of the Darussalam Boarding School, Blokagung Tegalsari Banyuwangi, they are: Supporting factors (1) Productivity of the person in charge, (2) Socialization strategies for implementing SIS. Inhibiting factors: (1) Lack of supporting facilities, (2) Timeliness of payment reporting.

Strengthening of district mental health services in Gauteng Province, South Africa.

In response to the Life Esidimeni tragedy, the Gauteng Department of Health established a task team to advise on the implementation of the Health Ombud's recommendations and to develop a mental health recovery plan. Consistent with international human rights and South African legislation and policy, the plan focused on making mental healthcare more accessible, incorporating a strategy to strengthen district mental health services to deliver community-based care for people with any type and severity of mental illness. The strategy included an organogram with three new human resource teams integrated into the district health system: a district specialist mental health team to develop a public mental health approach, a clinical community psychiatry team for service delivery, and a team to support non-governmental organisation governance. This article discusses the strategy in terms of guiding policies and legislation, the roles and responsibilities of the various teams in the proposed organogram, and its sustainability.

Secret sauce in collaborative tumor boards: Team-based characteristics that optimize tumor board functionality.

e23015 Background: Interdisciplinary teams are an indispensable characteristic of modern organizations, particularly in healthcare settings that require specialists to work together to solve multifaceted patient care problems. Multidisciplinary tumor boards (TBs) aim to coordinate multidisciplinary perspectives to help the oncology team devise the best treatment program for the patient. Yet, while this is their purpose, studies have found that TBs do not always achieve that goal effectively. Why are some tumor board (TB) teams more effective than others? This study shed light on key characteristics found among highly effective TBs. It provides a theoretical explanation of their organizational behaviors and structures and their effect on cancer treatment decision-making. The research is grounded in organizational behavior theories that have historical prominence in group decision-making, social hierarchy, and interdisciplinary collaboration, and are used to explain the phenomenon under investigation best. Methods: Qualitative research was used in the study. Data from 44 different TB observations and 18 interviews were gathered over four years at seven research hospitals in the United States and United Kingdom. The data were then coded, analyzed and synthesized with organizational behavior theory to explain the social phenomena under investigation. Results: The study revealed that certain TBs practice strong collaboration displaying high levels of partnership, cooperation, equality, and interdependency, which was incorporated explicitly into their meeting systems to achieve their common goal. Team-based characteristics such as members’ consistent shared preferences and identity, coordinated interactions, a collective learning process, and shared power and partnership are key markers found within these teams that positively influenced treatment decision-making processes and outcomes, earmarking best practices in TB groups. Conclusions: Organizational theory that suggests that for a collaborative process to be effective, team-based mechanisms need to be adopted in which each member respects, trusts, and acknowledges the skills and expertise of other disciplines in the organization, shares team values, decision-making processes, responsibilities, and planning, relies mutually upon other team members, and works outside normal professional boundaries openly and willingly. In an egalitarian structure like that of the TBs reviewed in this study, where preferences and identities are consistent and groups are collaborative, treatment decisions are less biased and incorporate multidisciplinary perspectives. Thus, this study suggests that by possessing both team- and task-based characteristics and practices, TBs engage in best practices, and thereby optimize their functionality.

Patient positioning before minimally invasive surgery

Introduction: Patient positioning for surgery is a shared responsibility between the surgeon, anesthesiologist and nurses in the operating room. The optimal position may require a compromise between the best position for surgical access and the position the patient can tolerate. Before starting the operation, the theatre nurse positions the patient in a certain way depending on what type of operation will be performed. Accurate patient positioning, careful padding of all pressure points, and proper application of anti-slip materials are essential to prevent complications in minimally invasive surgery. Material and Methods: In nine hospitals in Bulgaria the opinion of operating room nurses working in minimally invasive surgery on the positioning of patients before surgery was studied. The applied methods were documentary analysis and direct anonymous survey. Conclusion: Minimally invasive surgery is the present and the future and involves the responsibility of the entire team of specialists. The precise and correct positioning of the patient before surgery ensures its normal course and avoids a number of complications. From the study, we can say that half of the respondents among the operating room nurses find differences in the positioning of the patient before minimally invasive surgery and conventional one. With the increase in the number of operations and their complexity, the need for training programs in which there is a theoretical and practical part for healthcare professionals increases.

Structured evaluation of stress triggers in prehospital emergency medical care : An analysis by questionnaire regarding the professional groups.

BackgroundEmergency medical services work in the environment of high responsibility teams and have to act under unpredictable working conditions. Stress occurs and has potential of negative effects on tasks, teamwork, prioritization processes and cognitive control. Stress is not exclusively dictated by the situation—the individuals rate the situation of having the necessary skills that a particular situation demands. There are different occupational groups in the emergency medical services in Germany. Training, tasks and legal framework of these groups vary.ObjectiveThe aim of this study was to identify professional group-specific stressors for emergency medical services. These stress situations can be used to design skills building tools to enable individuals to cope with these stressors.Material and methodsThe participants were invited to the study via posters and social media. An expert group (minimum 6 months of experience) developed a set of items via a two-step online Delphi survey. The experts were recruited from all professional groups represented in the German emergency medical service. We evaluated the resulting parameters for relevance and validity in a larger collective. Lastly, we identified stress factors that could be grouped in relevant scales. In total 1017 participants (paramedics, physicians) took part in the final validation survey.ResultsAfter validation, we identified a catalogue of stressors with 7 scales and 25 items for EMT (Emergency Medical Technician) paramedics (KMO [Kayser-Meyer-Olkin criterion] 0.81), 6 scales and 24 items for advanced paramedics (KMO 0.82) and 6 scales and 24 items for EMS (Emergency Medical Service) physicians (KMO 0.82). For the professional group of EMT basic, the quality parameters did not allow further processing of the items.Professional group-specific scales for EMT paramedics are “professional limitations”, “organizational framework”, “expectations” and “questions of meaning”. For advanced paramedics “appreciation”, “exceptional circumstances” and “legal certainty” were identified. The EMT physicians named “handling third parties”, “tolerance to ambiguity”, “task management” and “pressure to act”. A scale that is representative for all professional groups is “teamwork”. Organizational circumstances occur in all groups. The item “unnecessary missions” for EMT paramedics and “legal concerns with the application of methods” for advanced paramedics are examples.DiscussionDifferent stressors are relevant for the individual professional groups in the German emergency medical service. The developed catalogue can be used in the future to evaluate the subjective stress load of emergency service professionals. There are stressors that are inherent in the working environment (e.g. pressure to act) and others that can be improved through training (teamwork). We recommend training of general resistance as well as training of specific items (e.g., technical, nontechnical skills). All professionals mentioned items with respect to organizational factors. The responsible persons can identify potential for improvement based on the legal and organizational items. The EMT basic requires further subdivision according to task areas due to its variable applicability.Supplementary InformationThe online version of this article (10.1007/s00101-021-00968-x) contains additional tables on stress factors of the surveyed groups. The article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field. The additional material can be found in the article under supplementary information.

An Evaluation of Challenges of Rural Road Construction Management in Budhinanda Municipality, Nepal

The overall objective of the study was to evaluate the management related challenges on upgrading and maintenance of the rural road and to find causes of road construction on an impromptu basis in Budhinandha Municipality.A questionnaire was developed after a literature survey in five-point Likert Scale and surveyed purposively and ranked by Relative Importance Indices (RII). This study revealed that five top-ranked management challenges were found to be dispute on alignment selection, improper water management, release of the budget at end of the fiscal year, land acquisition problem during track opening and widening, lack of clear technical specification and weak geology. And five top-ranked causes of road construction on an ad-hoc basis were budget allocation at end of the fiscal year, political and committee interference during the selection of road alignment, lack of preparation of Transportation Master Plan (TMP), lack of sufficient Technical staff and lack of proper project monitoring by a responsible team of Municipality.The high amount of repair and maintenance cost and environmental protection due to haphazard use of dozer on road construction could significantly be reduced, if government authority enforces to follow design standards, understanding the community value, and implementation of bioengineering approach during road construction.

Knowledge and Awareness of Authorship Practices Among Health Science Students: A Cross-Sectional Study.

BackgroundThe International Committee of Medical Journal Editors has published clear guidelines on the authorship of scientific papers. It is the research team’s responsibility to review and ensure those guidelines are met. Authorship ethics and practices have been examined among healthcare professionals or among particular health science students such as medical students. However, there is limited evidence to assess the knowledge of authorship roles and practices among health science students.MethodsWe conducted a cross-sectional study to assess the knowledge of authorship guidelines practices among health science students at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A survey was developed and distributed. It covered several domains, including demographic characteristics, participant’s knowledge and attitude of authorship practices, knowledge and experience with ghost and guest authorships, and knowledge of institutional authorship policies. Moreover, a score was computed to reflect the respondents’ knowledge about authorship practices.ResultsAmong the 321 participants who agreed to take the survey, two-thirds agreed with and supported that multi-authored articles’ credit allocation should be based on the most significant contribution and contributions to the manuscript writing. Almost 47% agreed that team relationships would influence authorship allocation. The majority of the participants were not aware of their institutional research and publication policies. Also, around 50% of participants were not aware of guest or ghost authorships. Finally, the knowledge score about authorship credits, allocation, contribution, order, and guidelines was higher among students who were assigned as corresponding authors and those who were aware of their institutional authorship guidelines and policies.ConclusionIn conclusion, our findings suggest that health science students may have limited knowledge about authorship guidelines and unethical behaviors involved in a scientific publication. Universities and research centers should make more efforts to raise the awareness of health science students regarding authorship guidelines while ensuring that they comply with those guidelines.

Systems-Based Practice: Time to Finally Adopt the Orphan Competency.

Systems-Based Practice: Time to Finally Adopt the Orphan Competency.