Consultation Team Research Articles

04 Care for adolescents with substance use: A national survey of paediatric hospitals

Abstract Background Substance use is a recognized Paediatric health care issue. More than 9 in 10 individuals receiving treatment for substance use disorders report that their first use of substances occurred by young adulthood. The Canadian Institute for Health Information reported that 5% of hospital stays among Canadian youth in 2017-2018 were related to harmful substance use. In a study of youth with a first-time emergency department visit for a mental health problem between 2010 and 2014, most visits were due to substance related disorders. Despite this, little is known about practices relating to substance use in children's hospitals. Objectives 1. To describe how adolescents who present to Paediatric hospitals with substance use disorders or substance-related health issues are identified, assessed, and treated. 2. To identify best-practices that can inform national standards of care. Design/Methods An online questionnaire was utilized to obtain information on: 1. Clinical practices in the emergency department, inpatient services and ICU; 2. Hospital policies and practice guidelines; and 3. Hospital and community programs and resources. Recruitment emails were sent to hospital leaders (CEO or equivalent) at all 13 Paediatric hospitals. Leaders were asked to identify one individual to complete the survey on behalf of their hospital with input from relevant stakeholders in the various clinical areas. The survey was developed iteratively by a national group of 9 adolescent medicine clinicians and 2 Paediatric trainees. The survey was piloted at a single Paediatric hospital and refined. The survey was administered via RedCap technology. Results Survey response rate was 70% (9/13 hospitals). The mean number of contributors to each survey was 9 (range of 1-35). Overall, few hospitals utilized best practices consistently. There was inconsistency in the use of validated screening tools, use of clinical practice guidelines for monitoring and ongoing care and prescribing of nicotine replacement therapy and opioid agonist therapy. These inconsistencies were noted within each clinical setting (emergency department, inpatient services, and ICU), across services in each hospital, and between hospitals. With respect to hospital services, 5/9 had some type of consult team related to substance use (e.g., adolescent medicine), 4/9 had specialized substance use outpatient services, and 2/9 offered partial hospitalization/day treatment for patients with substance use issues. Local community-based substance use resources were identified as insufficient to address needs by 8/9 hospitals. Conclusion Inconsistencies in the care of adolescents with substance use disorders or substance-related health issues highlights the need for national guidelines for Paediatric hospital-based assessment and care, and enhanced coordination between services and systems of care for this patient population.

Integrating deep phenotyping with genetic analysis: a comprehensive workflow for diagnosis and management of rare bone diseases.

Phenotypes play a fundamental role in medical genetics, serving as external manifestations of underlying genotypes. Deep phenotyping, a cornerstone of precision medicine, involves precise multi-system phenotype assessments, facilitating disease subtyping and genetic understanding. Despite their significance, the field lacks standardized protocols for accurate phenotype evaluation, hindering clinical comprehension and research comparability. We present a comprehensive workflow of deep phenotyping for rare bone diseases from the Genetics Clinic of Skeletal Deformity at Peking Union Medical College Hospital. Our workflow integrates referral, informed consent, and detailed phenotype evaluation through HPO standards, capturing nuanced phenotypic characteristics using clinical examinations, questionnaires, and multimedia documentation. Genetic testing and counseling follow, based on deep phenotyping results, ensuring personalized interventions. Multidisciplinary team consultations facilitate comprehensive patient care and clinical guideline development. Regular follow-up visits emphasize dynamic phenotype reassessment, ensuring treatment strategies remain responsive to evolving patient needs. In conclusion, this study highlights the importance of deep phenotyping in rare bone diseases, offering a standardized framework for phenotype evaluation, genetic analysis, and multidisciplinary intervention. By enhancing clinical care and research outcomes, this approach contributes to the advancement of precision medicine in the field of medical genetics.

Rythu Bharosa Kendram: Rejuvenating the Indian Rural Economy

Rythu Bharosa Kendram (RBK) serves as one stop shop for all of the needs of farmers at the Panchayat level. They offer services like e-crop booking for crop insurance, an agricultural input store, farmer knowledge centers, a technical advisory team, YSR Rythu Bharosa, Polambadi (Farmer Field School), CCRC cards, D-Krishi Seed distribution, and others. The objective is to study the extent of adoption of technologies and services of RBKs by the farmers. The present study is conducted in Prakasam district of Andhra Pradesh state as it is has significant area under crop cultivation. Multi stage simple random sampling technique has been adopted to select the sample farmers for the study. The data was collected from 75 respondents by personal interview method and analyzed using statistical analytical techniques such as Mean scale value and adoption Index. The study revealed that the majority of respondents 58.67% adopted technology at a medium level followed by low adoption 26.67% and high adoption 14.67% levels. The study concludes that RBKs are vital in serving farmers, with moderate adoption levels influenced by farmers’ age and education.

Strategic Implementation of a New Robotic Mitral Repair Program: Early Experience and Outcomes

BackgroundDespite numerous reported benefits of robotic mitral repair, the absolute number of procedures performed remain low in part to uncertainties about the necessary steps to launch a program. In this report, we describe our early outcomes and strategy with launching a successful new robotic mitral repair program. MethodsOur multimodal strategic plan emphasized team education, hands-on technical preparation, stepwise advancement, and careful patient selection. Consultant service analytics and team debriefings allowed for iterative improvements. ResultsBetween March 2022 through February 2024, 50 patients underwent robotic mitral repair at our institution. Average age at time of operation was 62 with an STS risk score of 0.58. Successful repairs were performed in 98% of patients. There was one conversion to sternotomy. There were no deaths and minimal perioperative morbidity. On both predischarge and follow-up echocardiography, no patients had greater than mild mitral regurgitation. ConclusionsOur work provides a model for establishing a successful robotic mitral program. An upfront emphasis on team education, careful preparation, proper patient selection, and feedback-driven improvements can accelerate the attainment of standards set by high-volume centers.

EP.17F.04 Challenges and Opportunities in Multidisciplinary Team (MDT) Consultations for Advanced-Stage Lung Cancer Patients in China

EP.17F.04 Challenges and Opportunities in Multidisciplinary Team (MDT) Consultations for Advanced-Stage Lung Cancer Patients in China

Navigating new assessment policy

The last issue of Assessment News (Darr & Cosslett, 2024) outlined NZCER’s position on possible assessment policy directions that had been signalled by parties within the new coalition government. Since then, the Government has released a plan for consistent assessment, which requires all primary schools to use standardised assessment tools twice yearly. The PATs are one of three choices of assessment tools that schools can use for progression monitoring in Years 3–8. This edition of Assessment News is written by members of NZCER’s Assessment Services and Education Advisory teams. The team reflects on how they are going about providing the support needed to help schools to navigate the new policy settings and build assessment and data analysis capability according to where each school is at and what they want to achieve.

Editorial

E ngā kaipānui o Set: Research Information for Teachers, kia ora, kia kaha, kia māia. Ko tēnei te wā o Whiringa-ā-Nuku. The sun is trying its best to warm the ground, still with a chill in the air. This issue aims to provide some warm support to teachers who have received crisp directions over the winter months on how to structure teaching and learning. Two commissioned supporting articles provide the bookends. For Q&A I asked the lead developer of social and emotional learning resources for teachers, Aha and Oto, to share her wisdom. Cat Lunjevich explains how collaborating with researchers, schools, and their communities influenced the design of the cards and the support they provide for teachers to foster social and emotional learning. For Assessment News I asked the Progressive Achievement Tests’ (PAT) Assessment Services and Education Advisory team to explain how they will support schools to manage the Ministry of Education’s new assessment requirements. Ben Gardiner and advisers draw on the concept of wayfinding to understand each school’s starting point and guide them toward their preferred destination. The article follows up the previous edition of Assessment News, which outlined the position of the New Zealand Council of Educational Research (Darr and Cosslett, 2024) on potential policy directions prior to the Ministry’s July announcement. Between the two bookends readers will find articles across Practitioner Inquiry, He Rangahau Whakarāpopoto, and He Whakaaro Anō.

Endoscopy and endoscopic ultrasound for embedded or migratory digestive foreign body.

Embedded or migratory ingested foreign bodies (FBs) may be a disaster when not found intraluminally and can be seriously life-threatening. Endoscopic ultrasound (EUS) has advantages of transmural, close range and real-time imaging. Under its guidance, minimally invasive endoscopic removal of FBs and abscess drainage become available and safe to avoid unnecessary surgery. However, relatively few diagnostic applications of EUS have been reported. Endoscopic removal and abscess drainage with or without EUS-guidance were even scarce. We found 21 cases of migratory FBs reported in which EUS was used to diagnose and/or treat including our case. We further summarized clinical characteristics and EUS manifestations of embedded or migratory FBs for future differentiation, and treatment strategies by endoscopy and EUS. EUS is a valuable tool in recognizing and differentiating embedded or migratory FBs. EUS-guided endoscopic removal is a minimally invasive, safe and innovative solution. EUS with novel device also assists in sufficient and secure drainage for FBs related abscess collections. A multidisciplinary team consult is sometimes mandatory for complicated cases. This would break a conceptual barrier in therapeutic endoscopy.

Implementation Of A Specialist Geriatric Ward; Outcomes One Year After Inception

Abstract Background Older adults being admitted to an acute hospital setting have care needs that would benefit from coordinated care on a Specialist Geriatric Ward (SGW). Prior to May 2023, older patients admitted to our institution received input from geriatric medicine through a variety of avenues. There was a clear need for dedicated and formal access to specialist geriatric services. It was hypothesised that care delivered on a SGW would improve patient access to the Right Care, in the Right Place at the Right Time. It has long been recognised in the literature that a dedicated SGW with appropriate access to Health and Social Care Professionals is the gold standard of care for older adults admitted to the acute setting. Methods An evidence based SGW was designed and implemented in May 2023. This consisted of a 32-bed dementia and delirium friendly ward, staffed with a consultant geriatrician, medical team, frailty and dementia Clinical Nurse Specialists, a multidisciplinary team and a dedicated patient flow lead for older persons. Ingress pathways to the ward included emergency department medical admissions, Frailty at the Front door referrals and patients selected from geriatric medicine consults. Egress pathways availed of included offsite rehabilitation, rehabilitation at home services and integrated care team input. All patients received early discharge planning and a comprehensive geriatric assessment was initiated on admission to the ward. Key performance indicators included length of stay (LoS), reduction in “Safari Rounds” which improves Clinician/Patient contact, daily whiteboard rounds, improved predicted discharge date (PDD) compliance. Data and outcomes were reviewed weekly. Results After one year, the SGW demonstrated improvements across all metrics with percentage cohorted patients improving by 24% and both average and median LoS reduce by 19 days. Total number of bed days saved was 1,513. Conclusion Multidisciplinary care delivered on a SGW improves patient and service outcomes.

Abbreviated in-situ inter-professional debriefing simulation training in peri-operative care environments: Minimizing the impact on clinical care using standardized videos

IntroductionOur facility leadership posed questions to the perioperative leadership team regarding the presence of collaborative communication during the reconciliation of events occurring in several perioperative care areas (operating rooms {OR}, clinic procedure areas, Intensive Care Unit {ICU}). Our team* collaborated to pilot a rapid cycle performance improvement project focused on improving the effectiveness of debriefings and handoffs that could conceivably lead to more effective after-action reviews following events which were complicated by multiple simultaneous unexpected factors. We proposed we could implement standardized abbreviated low-fidelity point of care (in-situ) inter-professional simulation training across the healthcare system with minimal impact on clinical schedules. We believed this would improve the perception of teamwork and collaboration among surgical team members. MethodsInter-professional in-situ simulation training exercises were designed and performed in perioperative care areas systemwide at our three major facilities (Main hospital and two Healthcare Community Centers [HCC]). Multiple iterations of styles of training were conceived and trialed. In the end, preconstructed videos were used to standardize the processes that framed the simulation role-playing of a debriefing after a complex situation. These videos contain the pre-simulation pre-briefings, the clinical situation that preceded the clinical debriefing and the simulation debriefing. Successful reconciliation of the multiple events required team members to exercise closed-loop communication, mutual trust, reengagement, and de-escalation of disengaged team members. Anonymous institutional review board reviewed, and Association of Federal Government Employees (AFGE) approved retrospective pre/post implementation surveys were made available to participants immediately after and sixty to ninety days following simulation exercises. ResultsBetween July 2023 and March 2024, one hundred and six staff in the perioperative care areas participated in twenty-two inter-professional simulation trainings (eleven OR, eight clinic, and three ICU simulations). Fourteen simulation scenarios in seven surgical disciplines were created. Eleven videos were produced covering cases in the O.R., clinic and ICU. Ultimately, the simulations were completed within twenty minutes in the three perioperative care clinical areas. Seventy-nine staff responded to the initial surveys after the simulation training. Eighty percent of the respondents gave favorable assessments regarding the effectiveness of the training in improving components of teamwork and agreed this program should continue. ConclusionsThe pilot program affirmed that we could implement simulations across the healthcare system in a format that minimally impacted the staffs’ clinical schedule. The process was standardized through the creation of multiple specialty specific videos. We proposed that perioperative team leadership could utilize these videos in the future to conduct spontaneously arranged simulations when they identified the presence of members naïve to this training and opportunities in the clinical schedule.*Refer to the acknowledgments for construct of our perioperative leadership simulation advisory team

A 4-Month-Old With Jaundice, Lethargy, and Emesis.

Acute liver failure is rare in the neonatal and infant population; however, when encountered, it requires timely diagnosis, management, and identification of the underlying etiology to provide the best clinical outcomes. Here, we present a case of new-onset liver failure in a 4-month-old infant. She had previously been diagnosed with neonatal mucocutaneous herpes simplex virus disease, but had been healthy in the interval, and was referred to our hospital for evaluation of possible need for liver transplantation because of a rapidly progressing pace of disease. In this diagnostic dilemma article, we review the case history and presentation and consider the differential diagnosis from the points of view of the primary and consultative teams. We then follow the clinical evolution of disease, identify a final diagnosis, and explore the short- and long-term management and health implications of the diagnosis. This case should be of interest to primary care providers, intensivists who care for neonates or infants, and specialists who encounter liver failure in their clinical practice.

Exploring the impact of team engagement on patient satisfaction: insights from social support and transactive memory system

PurposeResearch on the impact of the engagement of online medical teams (OMTs) on patient evaluation, for example, satisfaction, remains insufficient. This study attempts to recognize the underlying mechanism of how OMTs’ engagement influences patient satisfaction by adopting social support as the mediator. This study also scrutinizes the moderating effects of the transactive memory system (TMS) on the link between OMTs’ engagement and social support.Design/methodology/approachWe utilized a linear model that had fixed effects controlled at the team level for analysis. A bootstrapping approach using 5,000 samples was employed to test the mediation effect.FindingsOur results reveal that OMTs’ engagement improves informational and emotional support, thereby promoting patient satisfaction. Specialization and credibility strengthen the impact of OMTs’ engagement on informational and emotional support. Simultaneously, coordination has an insignificant influence on the link between OMTs’ engagement and social support.Originality/valueThis study contributes to the literature on OMTs, social support, and TMS, providing insights into patients’ perceptions of OMTs’ engagement during online team consultation. This study also generates several implications for the practice of online health communities and OMTs.

Mapping Dialectical Behavior Therapy Skills to Clinical Domains Implicated in Contemporary Addiction Research: A Conceptual Synthesis and Promise for Precision Medicine

Recent addiction research has identified clinical domains that are central to the development and maintenance of alcohol use disorder (AUD). Yet existing psychotherapy approaches are not typically organized around these clinical domains and are often limited in scope. Dialectical behavior therapy (DBT) is an intensive, multicomponent cognitive behavioral treatment that includes individual psychotherapy, group-based skills training, phone coaching, and consultation team for DBT therapists. Despite its efficacy on various mental health conditions, access to full DBT is often a challenge. In this paper, we describe how the skills training component of DBT can be flexibly applied to target clinical domains that underlie the three stages of the addiction cycle or impair quality of life during recovery from AUD. Using three clinical case vignettes, we illustrate how DBT skills can be mapped onto addiction clinical domains (e.g., Dialectical Abstinence and Clear Mind on executive function, STOP and TIP skills on incentive salience, Check the Facts and Opposite Action on negative emotionality, and ABC PLEASE skill on quality of life). Based on this integrated framework, we offer practical recommendations for case conceptualization, stigma reduction, and implementation through multiple delivery options. Implications on precision medicine were also discussed. Together, this conceptual synthesis serves as a bridge for practitioners to learn about contemporary addiction theories and for addiction researchers to appreciate the value of DBT in substance use treatment. The promotion of DBT skills training as a standalone or adjunctive intervention may help address the significant treatment gap in alcohol and substance use behaviors.

Psychologists aspiring to leadership positions in public sector health care.

Psychologists are well-positioned to take on leadership roles in health care systems as a result of the broad-based skills included in doctoral level, professional training programs. These include knowledge of evidence-based practice, extensive training in applied research and clinical practice, emphasis on critical thinking in scientific methods and hypothesis testing, teaching, supervision, team consultation, and continuous learning (APA Presidential Task Force on Evidence-Based Practice, 2006; Korman, 1974; McFall, 2007). Formal opportunities to learn how to apply these skills in leadership and organizational management roles are, however, limited during graduate training. There have been recent efforts within the American Psychological Association to foster interest and readiness for leadership roles among psychologists. These efforts have included a leadership development fellowship, on-demand webinars, and online learning for continuing education (American Psychological Association, 2023). The content of these training opportunities is typically general in nature so that it can be applied to all types of organizational settings. Psychologists interested in leadership positions within public sector health care organizations are likely to benefit from information that aligns more specifically with the mission and organizational structures of such systems. This article presents a conceptual framework to prepare psychologists aspiring to leadership positions in public sector health care. Leadership theories and models from organizational management science are outlined which capture the context and organizational goals of such programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Digital Clock Drawing Test on Tablet for the Diagnosis of Neurocognitive Disorders in Older Adults.

The diagnosis of neurocognitive diseases is an important health issue for patients, families and healthcare professionals. The need to develop rapid, high-performance screening tools would improve access to care. The Clock Drawing Test (CDT) is widely used and validated with the older adults, and its digital version is becoming increasingly widespread. We propose to confirm its validity in a population of old patients hospitalized in a geriatric unit, and secondly to verify its performance in comparison with the reference diagnosis made by a specialized team in a memory consultation. CDTs were collected from older hospitalized patients, both in paper form and digitally on a touchscreen tablet. The results show good agreement between the paper and digital versions (kappa coefficient = 0.81). Sensitivity and specificity of the digital CDT were 0.84 and 0.59 respectively for the diagnosis of major cognitive disorders. The corresponding values were 0.72 and 0.59 for the diagnosis of mild neurocognitive disorders. User questionnaires indicate that older participants find the digital tablet easy to use. However, they prefer to use paper, even if they are open to learning how to use the tablet.

Two Approaches of ‘Proactive Consultation’: Towards Well-Functioning Clinical Ethics Consultation

AbstractIn recent years, the global need for clinical ethics consultation services (CECS) has increased to address ethical challenges, dilemmas, and moral distress in clinical environments. In Japan, many hospitals have introduced CECS over the past decade, but few such services work effectively because of the small number of consultations. To address this, we propose two proactive ethics consultation methods: inter-professional ethics rounds and patient note reviews. This paper provides a detailed explanation of these methods, complete with scenarios based on actual cases. These methods can make CECS ‘well-functioning’ by shifting the starting points of consultation from consultees to CECS providers. We then examine the impact and value of proactive ethics consultation as well as four critical factors for its success including attitude, positioning, and competency of proactive consultation teams. We believe our suggestions will provide valuable insights for future clinical ethics consultations and stimulate academic debate about what constitutes a ‘well-functioning’ CECS.

Readmissions Among Patients With Surgically Managed Drug Use Associated-Infective Endocarditis Before and After the Implementation of an Addiction Consult Team: A Retrospective, Observational Analysis.

Patients who undergo cardiac surgery for drug use-associated infective endocarditis (DUA-IE) have high rates of readmissions for recurrent endocarditis, substance use disorder (SUD), and septicemia. Our primary objective was to assess whether exposure to an addiction consult team (ACT) was associated with reduced readmissions in this population. This single-center retrospective analysis identified patients who underwent cardiac surgery for DUA-IE between 1/2012-9/2022 using the Society for Thoracic Surgeons database, and compared the cumulative incidence of readmissions at 1, 3, 6, and 12 months among those cared for before and after the implementation of an ACT in 9/2017, accounting for competing risk of mortality and adjusted for measured confounders using inverse probability of treatment weighting. The 58 patients (35 pre-ACT and 23 post-ACT) were young (36.4 +/- 7.7 years) and predominantly White (53.4%) and male (70.7%). The post-ACT cohort had a significantly lower risk of readmission at 1 month (adjusted risk difference [RD] -23.8% [95% CI -94.4%, -8.3%], P = 0.005) and 3 months (RD -34.1% [-55.1%, -13.1%], P = 0.005), but not at 6 or 12 months. In a sensitivity analysis, the post-ACT cohort also had significantly lower risk of readmissions for SUD complications at 3 months. ACT exposure was associated with a lower risk of short-term readmission among patients with surgically managed DUA-IE, possibly due to a reduction in SUD-related complications. Additional studies are needed to replicate these findings and to identify ways to sustain the potential benefits of ACTs over the longer term.

Extracorporeal membrane oxygenation (ECMO) in pregnancy and peripartum: a focused review

As the medical complexity of pregnant patients increases, the rate of maternal morbidity has risen. Maternal cardiovascular disease is a leading cause of maternal morbidity and mortality followed closely by sepsis and infection, both of which may be associated with respiratory failure. There has been an expansion in the application of extracorporeal life support in pregnant and peripartum patients which requires obstetric anesthesiologists to understand the indications, obstetric and medical considerations, relative advantages and potential complications of this invasive technology in this population. Obstetricians and anesthesiologists who care for women on the labor floor must strive to recognize at-risk and deteriorating patients, facilitate escalation of care when appropriate, and engage consultant teams to consider the need for extracorporeal support in high-risk circumstances. This article reviews the epidemiology, indications, specific considerations, potential complications, and outcomes of extracorporeal life support in pregnant and peripartum patients.

Glucometrics utilisation in an urban teaching hospital in ireland: current practice and future aims.

Dysglycaemia in hospitalised patients is associated with poorer clinical outcomes, including cardiovascular events, longer hospital stays, and increased risk of mortality. Therefore, glucose monitoring is necessary to achieve best outcomes. This audit assesses use of point-of-care (POC) blood glucose (BG) testing in Tallaght University Hospital (TUH) over an 8-day period. It evaluates compliance with international and TUH glucose monitoring protocols and determines frequency of diabetes team consultations for inpatient adults. Data from an 8-day period (12/03/2023-19/03/2023) were extracted from the TUH COBAS-IT system and analysed. Invalid tests were excluded. Hyperglycaemia was defined as ≥ 10mmol/L and hypoglycaemia as ≤ 3.9mmol/L. Persistent hyperglycaemia was defined as two BG results of ≥ 10mmol/L. A chart review was conducted on adult patients with persistent hyperglycaemia to assess for HbA1C results, diabetes diagnosis, and diabetes consult. 3,530 valid tests were included and analysed. 674 individual patients had tests done. 1,165 tests (33.00%) were hyperglycaemic and 75 (2.12%) were hypoglycaemic. 68.25% of adults with persistent hyperglycaemia had an HbA1C test performed or documented within three months. 42.71% of inpatient adults with persistent hyperglycaemia and a known diabetes diagnosis received a consult from the diabetes team. Increased adherence to hospital protocols for testing HbA1C in adults with persistent hyperglycaemia could improve treatment and clinical outcomes. Increased diabetes team consultation could facilitate appropriate treatment and improve patient outcomes in persistently hyperglycaemic adult patient populations.

Influence of team emotional intelligence on the performance of construction design teams

Emotional Intelligence (EI) is an important competence in teamwork settings. Predominantly, previous EI studies on teams have focused on individual-level EI, neglecting the synergy of team members in a team. Therefore, this study aimed to assess the influence of team EI on the performance of construction design teams. A mixed method approach was used to collect data by means of a questionnaire survey and focus group interviews. The questionnaire was used to collect data on team EI and team performance, while the focus group interview was conducted to give insights on team activities based on the results from the questionnaire survey. A total of 50 projects were selected, constituting eight (8) teams through convenience and purposive sampling techniques. The 8 teams consisted of 38 individuals. Thus, the questionnaire was administered to 38 respondents, of whom 17 valid responses were received, while the focus group interview was conducted with members of one team. Means, percentages and correlational analysis were utilised in the analysis of the quantitative data, while content analysis was used to analyse the qualitative data. The results obtained for team EI and performance were used for correlational analysis, which revealed that team EI has a significant positive association with the team’s self-direction and average (overall) performance, as indicated by the correlation results (τb= .432, p=.046) and (τb= .401, p=.042) respectively. The content analysis revealed that team norms improved with participation in multiple projects. This suggests that TEI contributes significantly to the performance of the construction design teams. This study holds significant practical implications for the training of construction professionals, with the potential to foster the development of high emotional intelligence (EI). Furthermore, it extends its relevance to client organizations seeking to hire design team consultants who possess emotional intelligence. To achieve improved team performance, it is suggested that client organisations consider incorporating a team-based EI assessment alongside the evaluation of technical expertise during the hiring process.