Team Coordination Research Articles

Leveraging the Science of Teamwork to Sustain Handoff Improvements in Cardiovascular Surgery.

Improving the reliability of handoffs and care transitions is an important goal for many health care organizations. Increasing evidence shows that human-centered design and improved teamwork can lead to sustainable care transition improvements and better patient outcomes. This study was conducted within a cardiovascular service line at an academic medical center that performs more than 600 surgical procedures annually. A handoff process previously implemented at the center was poorly adopted. This work aimed to improve cardiovascular handoffs by applying human factors and the science of teamwork. The study's quality improvement method used Plan-Do-Study-Act cycles and participatory design and ergonomics to develop, implement, and assess a new handoff process and bundle. Trained observers analyzed video-recorded and live handoffs to assess teamwork, leadership, communication, coordination, cooperation, and sustainability of unit-defined handoff best practices. The intervention included a teamwork-focused redesign process and handoff bundle with supporting cognitive aids and assessment metrics. The study assessed 153 handoffs in multiple phases over 3 years (2016-2019). Quantitative and qualitative assessments of clinician (teamwork) and implementation outcomes were performed. Compared with the baseline, the observed handoffs demonstrated improved team leadership (p < 0.0001), communication (p < 0.0001), coordination (p = 0.0018), and cooperation (p = 0.007) following the deployment of the handoff bundle. Sustained improvements in fidelity to unit-defined handoff best practices continued 2.3 years post-deployment of the handoff bundle. Participatory design and ergonomics, combined with implementation and safety science principles, can provide an evidence-based approach for sustaining complex sociotechnical change and making handoffs more reliable.

Modeling Team Interaction and Decision-Making in Agile Human–Machine Teams: Quantum and Dynamical Systems Perspective

In this study, we define team agility as a function of exploration and exploitation of team coordination. Based on these two coordination concepts, we examined interactive decision-making in a dynamic task environment by applying: first, the principles of quantum cognition for the decision-making processes at the confluence of teamwork and taskwork (to discern the effects of ontic uncertainty for each human team member in the case of having incomplete teamwork) and second, nonlinear dynamical systems modeling for the teamwork (to capture epistemic uncertainty). In this study, there were the following three conditions based on manipulation of the pilot role: first, synthetic condition—the pilot role was played by a synthetic agent, second, control condition—it was a randomly assigned participant, and third, experimenter condition—it was an expert who used a role-specific coordination script. Overall findings indicate that when teams in the experimenter condition come across the targets, they tend to explore alternatives by coordinating as a team rather than exploiting existing team strategies, which may not work best for the situation at hand. In contrast, teams in control and synthetic conditions tended more toward exploitation than exploration in coordination. We consider this a sign of agility in teamwork.

Examining the Relationship Between Socially-Shared Emotion Regulation and Building Team Coordination Mechanisms During a Hackathon

Examining the Relationship Between Socially-Shared Emotion Regulation and Building Team Coordination Mechanisms During a Hackathon

Transforming existing local ecosystems to circular economy ecosystems for plastics: The case of the PlastiCity ecosystem

AbstractThis paper discusses the transition toward a circular economy ecosystem (CEE) for plastics by assessing and mapping existing ecosystems and coordinating efforts among ecosystem actors. The PlastiCity ecosystem is used as a case study. The study employs ecosystem analysis and mapping to identify the new activities and actors needed to transition toward a CEE. These include local and eco‐friendly transportation, plastic recycling knowledge management, and upgrading the existing recycling infrastructure. The findings emphasize the significance of the joint orchestration of ecosystem actors facilitated by an ecosystem coordinator and knowledge team to achieve a CEE. It presents a tangible and feasible approach to achieving a local plastic CEE. The policymakers are encouraged to support collaborative orchestration efforts among ecosystem actors and establish knowledge management practices that facilitate ecosystem transitions.

Determinant Factors in the Implementation of Covid-19 Vaccination Program in Mowewe District East Kolaka Regency Southeast Sulawesi, Indonesia

The COVID-19 vaccination program has become a national priority in efforts to protect the public from the spread of the virus and control the pandemic. To achieve this goal, it is important to ensure that the medical human resources involved in the implementation of the vaccination program have sufficient qualifications and competence. Mowewe District, which is located in East Kolaka Regency, is one of the areas undergoing the COVID-19 vaccination program. In this context, it is important to understand the qualifications and competencies of the medical human resources involved in implementing the vaccination program in this region. Medical human resource qualifications refer to the formal education obtained, such as their academic background. This qualification is an important basis for understanding and carrying out COVID-19 vaccination procedures safely and effectively. However, in conditions where the COVID-19 vaccination service is still very limited, there is a lack of socialization carried out, a lack of cross-sectoral coordination, resulting in low community participation in realizing COVID-19 vaccination services . In conclusion, the success of the COVID-19 vaccination program in Mowewe District, East Kolaka Regency is highly dependent on the qualifications and competence of the medical human resources involved. Therefore, the resource factor and the lack of dissemination of information on the Covid-19 vaccination are important to continue to implement. In addition, it is also necessary to make efforts to strengthen team coordination and management, collaboration across sectors to ensure the implementation of the vaccination program runs effectively and efficiently. This study aims to analyze the qualifications and competencies of medical human resources in implementing the COVID-19 vaccination program in Mowewe District, East Kolaka Regency. The COVID-19 vaccination program is a national priority to control the spread of the virus and protect the public. However, the success of this program is highly dependent on the qualifications and competence of the medical human resources involved in its implementation.

Care coordination in primary care: mapping the territory.

To document the current approaches to care coordination among different types of care systems in Minnesota. Observational survey of leaders of most of the care systems in Minnesota that have implemented care coordination. Survey questions about organizational structure, size, and approach to care coordination were sent to the leaders of 42 care systems with a total of 327 primary care clinics. Surveys were completed by leaders at every care system participating in this study (100% response rate); 16 small care systems (each with 1-2 clinics) had a total of 26 primary care clinics, 15 medium care systems (3-9 clinics) had 57 clinics, and 11 large care systems (> 9 clinics) had 244 clinics. The large care systems had larger clinics (clinicians per clinic, 8.6 in large vs 4.3 in small and 5.2 in medium; P = .03) and more clinicians per care coordinator (5.7 vs 3.3 and 4.0; P = .04). They also more frequently included a social worker in their care coordination team: 82% vs 25% of small and 40% of medium care systems (P = .01). However, the services provided and complexity tools used were similar. Nearly all reported addressing both medical and social needs for their complex patients with multiple chronic conditions. Although there are large differences in resources and capabilities between large and small care systems, they were not associated with much difference in the approach taken to care coordination. This map of the care coordination territory in Minnesota has the potential to be valuable to researchers and care system leaders for understanding current implementation trends and directing further evaluations.

Evaluation of the Operative Programming at the CHU Gabriel TOURE of Bamako-Mali

In Mali, particularly in CHU Gabriel TOURE, organization of block activities is always problematic due to operative programming ignorance by staff of sector and other proximity, thus causing a blow to the good functioning of block. Objectives: Determine the knowledge level of staff intervening in block; to describe the existence of block operative charter functioning, know the existence of block operative components, Analyze the unrolling operative program. Methodology: We carried out a prospect, descriptive and transversal study to CHU Gabriel TOURE close to staff practicing to the operative blocks and other relation services; the sampling was probabilistic, based on systematic random technic. Result: Decisional proceedings and coordination in the block are ignored by the all respondent staff (100%). 50, 57% of respondent staff have witnessed the inobservance of hygiene rules concerning the patient, professionals, staffs in training, visitors, equipments, locals and environment. 75, 87% of respondents have testified a specify date and hour existence of programming meetings, but which are not surely respected according to 58, 63% of those same respondents. As far as 72, 44% have testified a fix hour existence to the bloc opening while.77, 01% have found regular hour inexistence to the startup of program. It also exists that a room is defined for each specialty working in the block say 65, 52% of respondent staff. 63, 22% of respondents affirmed that there is no own channel pour patient and material. Moreover it states that none of investigated staff does not know the responsible of block team coordination (100%). There are no established punishments at the block also supporting modalities of dysfunction and conflicts, respectively say 57, 48% and 70, 12% of respondent staff. 100% of respondents testified collegiality’s absence in operative; programming meeting and that 51,72% of respondent staff judged that topics reading are not done during programming meeting ...

Systems thinking for general surveillance programs – using leverage points to guide program management

With the increasing threat of pests, weeds and diseases to agriculture, the environment and our way of life, governments are becoming more reliant on general surveillance to fill biosecurity surveillance gaps. That is, engaging people from all walks of life in the monitoring and reporting of pests, weeds and diseases. It is often thought that instigating a general surveillance program simply requires the development of reporting tools and creating awareness of the program among intended target groups, but this is a simplistic view. This paper explores whether a broader approach identifies better ways to implement general surveillance programs to meet their goals and remain sustainable over the long-term, and therefore assist in program management. A systems thinking approach was used to identify the components within general surveillance programs, and their interactions. These components are the actors or people involved and their relationships; infrastructure like reporting tools and resources; formal and informal rules; and species or diseases of interest and their environment (included to account for the biophysical context). We explored what helped and hindered the design and implementation of general surveillance programs, drawing on international literature and the experiences of people in nine case studies from across Australia and New Zealand. Systems thinking helped to identify leverage points in the case studies, including feedback loops and information flow paths, and facilitated thought on how they can be used to improve programs. For example, sharing knowledge and experiences of actors from throughout the program being notifiers (i.e. the people who report pests, weeds and diseases), laboratory or herbarium staff, funding bodies, policy makers and others, built trust and ownership in the program and facilitated learning and self-organisation. This increased the capacity for innovation, adaptation, and continual improvement, leading to ongoing program benefits. Approaching program management using systems thinking helps structure program monitoring and evaluation and better target effort and resources to improve performance. However, this requires a dedicated program coordinator (or coordination team) with adequate resources to identify challenges and opportunities and adapt the program accordingly.

Implementation of Project of Strengthening The Pancasila Student Profile on MTsN 3 Banyuwangi

Learning of Project of Strengthening The Pancasila Student Profile is a co-curricular learning that functions as a support for intra-curricular learning which is quite vigorously discussed in the Independent Curriculum. This project aims to improve the ability and build the character of students as Pancasila Students Profile through projects based learning related to problems that exist in the surrounding environment. This study aims to find out and analyze the application of the project learning to Strengthen Pancasila Student Profiles at Madrasah Tsanawiyah Negeri 3 Banyuwangi, the obstacles faced and how to overcome these obstacles. This type of research is qualitative research. The research was conducted in grade 7 for 7 months starting from August 2022 to February 2023. The participants in this study were 12 teachers at MTsN 3 Banyuwangi consisting of 10 class team coordinators and two project learning teachers, as well as several classes. Data collection in this study was carried out by means of semi structured interviews. The results of this study can be seen that MTsN 3 Banyuwangi has implemented the learning of The Pancasila Student Profile Strengthening Project but it is still not maximum yet due to several obstacles experienced especially in the project learning process. The solutions carried out by Madrasah are giving dissemination regarding this project or about independent curriculum more often, forming expert team invited to discuss problems in the field with the project team of each class, forming a class coordinator group (trough with the whats app group) consisting of 10 teachers from 10 classes to facilitate coordination, strengthening class teams with frequent coordination between team members and also coordinating with the expert team, the teacher makes plans in the form of project time plans, teaching modules or teaching materials, the team of experts supervises the class regarding the implementation of project learning. The implications of solutions that have been carried out by Madrasah are that the application of project learning is getting better and more optimal, this is reinforced by an increase in teachers understanding on project learning as evidenced by project products of each theme from students who are in accordance what the expert team wants. As well as the existence of a copy study from several other Madrasahs both from within the city and out side the city to MTsN 3 Banyuwangi and asking about the process of implementing the independent curriculum, especially project learning.&#x0D;

Architecture of a mobile transport route selection system by a team of volunteers in the conditions of the military state

The work is devoted to the issue of designing the architecture of a mobile system for choosing the route of cargo transportation and passenger transportation by a team of volunteers under martial law. The system provides support to the decision-maker -the coordinator of the volunteer team in conditions of information uncertainty and dynamic changes in the external environment. The system allows you to receive and take into account operational information about the state of the route segments, which is provided by experts in the role of volunteers.The architecture of the mobile system for the volunteer team in the conditions of dynamic changes is client-server. The client sends data entered by volunteer experts to the server using a mobile phone or Internet connection. The volunteer team coordinator's mobile device is the server of the volunteer team's mobile decision support system. The server has a three-tier architecture: the presentation tier, the application logic tier, and the data tier. At the program logic level, a decision-making subsystem based on the multi-criteria modified Smart method is implemented. As a backup, data from the database on the volunteer team coordinator's device is uploaded to the database located on a remote web server.Based on the developed architecture, a mobile system for building a recommended route for a team of volunteers was developed in Java in Android Studio. As an application of the developed mobile system, a practical example of determining the best of five existing cargo transportation routes is considered

Cleft palate surgical perspectives: A pilot study

ABSTRACT Purpose: The current pilot study aimed to collect craniofacial surgeon’s personal perspectives regarding the timing of cleft palate surgical repair, medical considerations for surgical repair (i.e., age, weight, type of cleft, and potential for surgical complications), and social considerations (i.e., speech–language development, socioeconomic status, and familial support). Materials and Methods: Fifteen plastic surgeons currently practicing cleft palate repair participated in this study. Surveys were distributed electronically to team coordinators of the American Cleft Palate-Craniofacial Association-accredited craniofacial teams and included a combination of Likert scales, closed multiple-choice questions, and open-ended qualitative questions for free-text responses. Results: Preliminary data obtained in this study suggest that the most common age range for palate repair in nonmedically complex infants is 10–11 months of age (n = 10). Notably, 20% of respondents (n = 3) reported a typical surgical repair time of 7–9 months of age. While medical and social priorities differed, all surgeons rated speech–language development as an important factor when determining the timing of surgical intervention. Conclusion: Given the limited consensus on surgical timing and intervention for children with cleft palate, further research is needed to determine the optimal timing of palate repair that considers both medical safety and near age-appropriate speech sound acquisition and production.

Editorial introductions.

Editorial introductions.

Processing of Corn Weevil and Elephant Grass (Pennisetum Purpureum) to Improve the Quality of Cattle Feed Production

Cows are one of the farm animals that are very popular with farmers. In the villages many people have cattle in their homes. Likewise with the Wono Asri 3 Farmer Group which also has several members who choose to become cattle breeders. Raising cattle is indeed very profitable, but farmers need to have skills and understanding in order to get these benefits. One of the things that needs to be considered in raising cows is feed. Cattle farmers have various types, including some who like to give forage feed (such as grass, weeds, and corn weevils) only, and some like to mix it with concentrate feed. Forage feed is relatively cheaper, but it requires more effort in providing it, while concentrate feed is easier to provide but the price is more expensive. This then affects the farmer's expenditure on feed preparations. Therefore, there is a need for new innovations so that farmers can provide feed at a lower price, but it is easy to provide and of course the quality of the products produced. The activities offered from this PkM are mentoring, and training on processing Corn Weevil and elephant grass (pennisetum purpureum) for members of the Wono Asri 3 Farmer Group. This activity aims to equip the knowledge and skills of processing Corn Weevil and elephant grass into quality animal feed. This activity will be carried out using various appropriate implementation methods such as deliberation, brainstorming, interviews, demonstrations and practices. The planned stages of activities are coordination of teams and partners, identification of target group learning needs including farm conditions and corn weevil processing equipment needed, planning activities involving target groups, training, and mentoring.

In control or along for the ride? Lessons for anesthesiologists from air traffic control.

Anesthesia professionals work in an unpredictable, rapidly changing environment in which they are quickly diagnose and manage uncommon and life-threatening critical events. The perioperative environment has traditionally been viewed as a deterministic system in which outcomes can be predicted, but recent studies suggest that the operating room behaves more like a complex adaptive system, in which events can interact and connect with each other in unpredictable and unplanned ways. The increasing complexity of the healthcare environment suggests that the complete elimination of human error is not possible. Complex clinical situations predispose to errors that are the result of high workload, decision making under stress, and poor team coordination. The theory behind complex adaptive systems differs from medicine's traditional approach to safety and highlights the importance of an institutional safety culture that encourages flexibility, adaptability, reporting and learning from errors. Instead of focusing on standardization and strict adherence to procedures, clinicians can improve safety by recognizing that unpredictable changes routinely occur in the work environment and learning how resilience can prevent adverse events. A better understanding of automation, complexity, and resilience in a changing environment are essential steps toward the safe practice of anesthesia.

Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training

IntroductionThe influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training on resuscitation performance in Rwanda. MethodsParticipants in this mixed method study are members of resuscitation teams in three district hospitals in Rwanda. The intervention was participation in a 2-day Advanced Cardiac Life Support course followed by the 3-day Vital Anaesthesia Simulation Training Course. Quantitative primary endpoints were time to initiation of cardiopulmonary resuscitation, time to epinephrine administration, and time to defibrillation. Qualitative data on workplace implementation were gathered during focus groups held 3-months post-intervention. ResultsForty-seven participants were recruited. Quantitative data showed a statistically significant decrease in time to cardiopulmonary resuscitation, epinephrine administration, and defibrillation from pre- to post-Advanced Cardiac Life Support, with times of [43.3 (49.7) seconds] versus [16.5 (20) sec], p = <0.001; [137.3 (108.9) sec] versus [51.3 (37.9)], p = <0.001; and [218.5 (105.8) sec] versus [110.8 (87.1) sec], p = <0.001; respectively. These improvements were maintained following the Vital Anaesthesia Simulation Training Course, and at 3-month retention testing. Qualitative analysis highlighted five key themes: ability to initiate cardiopulmonary resuscitation; team coordination for task allocation; empowerment; desire for training and mentorship; and advocacy for system improvement. ConclusionA modified 2-day Advanced Cardiac Life Support course improved resuscitation time indicators with retention 3-months later. Combining the Vital Anaesthesia Simulation Training Course and Advanced Cardiac Life Support led to better team coordination, empowerment to act, and advocacy for system improvement. This pairing of courses has promise for improving Advanced Cardiac Life Support skills amongst healthcare workers in low-resource settings.ClinicalTrials.gov Identifier: NCT05278884.

Implementation of the Merdeka Curriculum and Its Challenges

Based on the Ministry of Education, Culture, Research, and Technology (Kemendikbudristek) Number 56 of 2022 concerning Guidelines for Curriculum Implementation in the context of Curriculum Learning Recovery During the Covid-19 Pandemic which requires schools to gradually use the Merdeka curriculum. The Merdeka Curriculum is a curriculum that provides flexibility to schools and teachers in exploring according to the needs of the school, especially the needs of students. This study aims to describe the implementation of the Merdeka curriculum and its challenges in SD Muhammadiyah Warungboto schools in Yogyakarta. This research uses a qualitative approach to the case study method. The subjects of this study were the principal, curriculum coordination team, teachers, students at SD Muhammadiyah Warungboto Yogyakarta city. Data collection techniques use interviews, and observation. The results of the study are as follows: (1) Application of the Independent Curriculum in the Changing Curriculum status. (2) The learning model used by teachers is still by lecturing and learning is not all student-centered. (2) There are still many teachers who are not ready regarding the implementation of the Merdeka curriculum. (3) Students based on interests and talents are still just following the choice of friends even because of pressure. (4) Lack of enthusiasm of teachers who are not ready for curriculum changes, especially changing learning tools. (5) Schools develop various strategies to be used regarding the implementation of the Independent Curriculum

Maximizing Solid Organ and Face Transplant Procurement Team Coordination: The Posterior Tibial Artery Flap as an Ideal Sentinel Flap

Face transplantation became a reality with the first case performed in 2005. Facial tissue allograft procurement is technically complex and time-intensive. Brain-dead deceased donors are frequently, if not always, multiorgan donors. Every effort should be made during face allograft recovery to minimize any risk to the recovery of lifesaving solid organs. Some programs require the procurement of a myofascial vascularized skin graft to function as a sentinel flap allowing frequent monitoring for rejection without negatively impacting the esthetics of the face graft. Up till now, the flap used has been the radial forearm flap. Procuring the radial forearm flap places the procuring team in close proximity to the head and torso, where the face recovery and the solid organ recovery teams would require unhindered access. Here, we present the posterior tibial artery flap as an alternative flap that would provide benefits to the coordination of the multiple teams working to procure organs from a deceased donor.

What’s next? Some priorities for young planning scholars to tackle tomorrow’s complex challenges

ABSTRACT Many European planning schools recently celebrated their 50th anniversary: a sign that planning education became a distinct and established discipline in Europe. Simultaneously, political regimes, paradigms, cultures, and economies continue fuelling mixed connotations within the planning sector. Additionally, growing wicked problems in built areas emphasize an even greater need for well-trained planners. These challenges span climate crises, wars, authoritarian regimes, socio-political instability, and constantly changing global geopolitics. The increasingly complex demands on planners are highly pertinent for Young Academics (YA). They require political, regulatory, and technical knowledge to navigate the profession. To support them and represent their voices in planning debates, the YA network (YAN) of AESOP was established in 2003. We, the current Coordination Team, use this paper to voice our take on the question of what planning challenges dominate and what can be done to prepare YAs better for the future. Building on plenty discussions within the YAN, literature, and AESOP’s activities at large, we propose: A challenge compilation for the profession, a list of core capacities, and a framework for future education. This shall aid in enabling YAs and educators today to set the foundation for planning sustainable and people-centered settlements tomorrow.

When do teams generate valuable inventions? The moderating role of invention integrality on the effects of expertise similarity, network cohesion, and gender diversity

Research has demonstrated that certain team composition factors—high expertise similarity, high network cohesion, and mixed‐gender teams—have predominantly negative effects on the teams’ invention outcomes. Yet these factors have also been shown to improve team coordination, which should (in theory) lead to better invention outcomes. We address this tension by highlighting the need to consider the invention's integrality, which increases task interdependencies among team members and thereby strengthens the positive relationship between team coordination and invention value. We hypothesize that (i) the main effects of these team composition factors reduce a team's invention value but, more importantly, that (ii) invention integrality positively moderates those effects. We support these claims with evidence from utility patent data filed in the United States during the period 1983–2015.

Examining molecular testing practices and targeted therapy use in advanced/metastatic non-small cell lung cancer (mNSCLC): A quality improvement initiative across ten community cancer centers.

e21191 Background: A growing number of targeted therapy approvals for mNSCLC have dramatically increased requirements for molecular testing. Identifying and addressing real-world challenges mNSCLC care teams face due to resulting workflow shifts is essential to optimize patient outcomes. Methods: In March–September 2022, 126 health care professionals (HCPs) who treat NSCLC at 10 US community oncology clinics completed surveys assessing practice patterns, challenges, and confidence related to biomarker testing and targeted therapy use. HCPs (N = 105) participated in interdisciplinary audit and feedback (AF) sessions to examine clinical evidence and develop clinic-specific action plans to address identified gaps. Results: Participants represented the interprofessional NSCLC care team: medical oncologists (32%), pathologists (1%), radiation oncologists (1%), pulmonologists (2%), PCP/other physicians (5%), advanced practice professionals (22%), nurses (19%), and other HCPs (e.g. patient navigator, practice manager; [19%]). At the time of the program there were 9 NCCN-recommended biomarkers for mNSCLC. Less than half of HCPs reported regular testing for 4 of these biomarkers (Table 1). The majority of HCPs were somewhat (52%) or very/extremely (23%) likely to start treatment prior to receiving molecular testing results. Top reported barriers to integrating molecular diagnostics into routine practice were biopsy tissue availability/quality (45%) and determining whether to begin treatment prior to receipt of molecular testing results (43%). Gap-oriented clinic action plans aimed to improve communication between oncologists, pulmonologists, and pathologists to increase quality and efficiency of testing. A targeted therapy toolkit was developed with a panel of oncology and pathology experts and distributed to participants to address gaps in knowledge of testing practices and guidelines. HCP confidence in biomarker testing increased from 72% to 92% following the intervention. More HCPs correctly answered knowledge (43% pre-AF vs 61% post-AF) and competence (29% pre-AF vs 54% post-AF) questions following participation in the AF sessions. Conclusions: While molecular testing is critical for mNSCLC care, HCPs report sub-optimal rates of conducting testing prior to treatment and incorporating results into treatment planning. Here, we highlight an unmet need for improved interdisciplinary communication and coordination in mNSCLC care teams and an educational intervention strategy that can be used to improve HCP biomarker and targeted therapy use in mNSCLC. [Table: see text]