Practice Team Research Articles

Retrospector: Rapid collaborative reflection to improve collaborative practices

Online platforms for freelancing allow teams performing complex work to be assembled in a matter of minutes and dispersed nearly as quickly. With such short time frames, ad hoc and virtual teams have few opportunities to learn strategies and effective team practices to work with their colleagues. Without such practices, teams are prone to work sub-optimally and lack direction. One key challenge in virtual teams discovering effective team practices is that because the practices ought to involve situated knowledge, it takes time to coalesce, as team members learn about each other over time. This work introduces Retrospector, that ad hoc teams can use to reflect collaboratively and reinforce effective team practices. Our interface accelerates the discovery of practices in situ and then guides them in reinforcing and applying these practices to future tasks. We conducted a between-subjects experiment (N=75) to assess our design with crowdworkers from the Amazon Mechanical Turk platform. This randomized controlled experiment showed that teams using our system for approximately six minutes of collaborative reflection were able to discover effective practices more successfully and had significantly improved team performance and viability. These results indicate that deliberate support for improving team practices can improve outcomes even through very short interaction. We conclude with design implications and opportunities for future work.

Physician Assistants als Zukunftsmodell in der hausärztlichen Versorgung – Erfahrungen, Bedarfe, Potenziale und Hürden

IntroductionIn the coming decades, demographic change will dramatically increase health care needs, especially for general practitioners (GPs). However, there is a shortage of young primary care physicians, with signs of (impending) underuse already becoming apparent in rural and structurally weak areas. Innovative care concepts are needed to counteract this development and ensure the future of primary care. In addition to medical assistants (MFA), academically trained physician assistants (PAs) could be considered for more demanding delegation tasks and be involved in direct patient care under the responsibility of a physician in the practice team. In England, the Netherlands and the USA, PAs have been a part of the health care systems for many years. Research questions1) What are the potentials for delegation/possibilities for PAs working in primary care practices in contrast to medical assistants? 2) What structural requirements are necessary to regularly integrate PAs in primary care practices? MethodsAfter preliminary interviews with PA experts and primary care researchers and practitioners (n=29), four expert interviews (n=4) with GPs and PAs were performed in a case analysis in order to elicit experiences with PAs in family practice. Based on this, three focus groups were conducted with GPs and practice staff (n=15) to discuss the extent, the need and the willingness to delegate physician services to PAs, as well as existing barriers. After transcription, analyses were performed using qualitative content analysis according to Mayring. ResultsThe participants acknowledged the potential to reduce physician workloads and showed a high willingness to delegate tasks. Practical examples suggest that a clearly defined delegation of medical tasks to PAs, e.g. participation in infection consultations, is possible after only a few weeks working in family practices. Thus, the cooperation between GPs, PAs and medical assistants can be successful. Uncertainties exist regarding the legal possibilities and limits of delegation as well as the current and future financial reimbursement of PAs. DiscussionThe legal and financial framework for the utilization of PAs in ambulatory care should be reliably clarified as well as transparently communicated so that the considerable potentials of delegating tasks to academically trained staff, e.g. PAs, especially in the GP sector, can be exploited in the future. ConclusionParticipation of PAs in the GP team could be key to overcoming the often threatening or already existing under-provision of medical care in structurally weak regions.

Framing Machine Learning Opportunities for Hypotension Prediction in Perioperative Care: A Socio-technical Perspective

Hypotension during perioperative care, if undetected or uncontrolled, can lead to serious clinical complications. Predictive machine learning models, based on routinely collected EHR data, offer potential for early warning of hypotension to enable proactive clinical intervention. However, while research has demonstrated the feasibility of such machine learning models, little effort is made to ground their formulation and development in socio-technical context of perioperative care work. To address this, we present a study of collaborative work practices of clinical teams during and after surgery with specific emphasis on the organisation of hypotension management. The findings highlight where predictive insights could be usefully deployed to reconfigure care and facilitate more proactive management of hypotension. We further explore how the socio-technical insights help define key parameters of machine learning prediction tasks to align with the demands of collaborative clinical practice. We discuss more general implications for the design of predictive machine learning in hospital care.

Professional learning and an emergent community of practice on the Scottish islands as viewed through Biesta’s educational domains

ABSTRACT The Scottish Island Schools Network is a community of practice for leadership teams working in island schools in Scotland. This paper reflects on the emergence of the network within an island community context. The paper discusses how the emergence of an island network aligns with Biesta’s (2009) three educational domains of qualification, socialisation and subjectification. Drawing on the OECD (2019) report on rural education, this paper explores the professional learning needs of teachers in remote, Scottish communities, highlighting issues of rurality, benefits and challenges. It considers the role of identity and the tensions that can exist between the different ‘faces’ of a teacher living and working in an island community - as an islander, community member, teacher, and within a wider educational context. In an increasingly digital age, the paper explores the opportunities and limitations for those in less digitally connected rural areas to take part in professional learning opportunities, along with other practical considerations. Finally, the paper discusses the importance of preserving personal and social identities in a remote rural school, and how the unique experiences of rural educators may offer insights which are useful for the wider education population.

Introducing Self-Organization to Finnish Home Care Teams: Expectations and Outcomes

The purpose of this paper is to understand better what kinds of expectations Finnish home care workers have about self-organizing teams and what kinds of outcomes Finnish early adopters have experienced after self-organizing principles have been introduced to their organization. To this end, we share results from two research projects that have coached Finnish home care and assisted living teams towards self-organizing team practices. We will identify expectations about self-organization by interviewing and gathering information from home care workers who will soon be coached toward self-organizing practices. We will then evaluate outcomes of self-organization by comparing personnel survey results between teams working in home care and assisted living facilities that have and have not been coached towards self-organizing work practices. Our findings reveal that, although management and team members perceive their current organizational environment differently, both parties share the will to evolve towards self-organizing work practices. The early results of coaching home care teams towards self-organization suggest that achieving change is likely to be a slow process.

The Development and Innovation of Social-Emotional Learning in China

In todays society, implementing social-e motional learning (SEL) is an important way to promote childrens all-round development fromthesmallsense, and the key to building global citizenship fromthelargesense. With the concept of social-emotional learning being proposed by the Collaborative for Academic, Social and Emotional Learning (CASEL), and SEL was putting on the global policy agenda by the United Nations Educational, Scientific and Cultural Organization (UNESCO), many countries have begun to explore and carry out relevant practices according to their actual conditions. This study takes the practice of MOE-UNICEF SEL Programme Team in China as an example to analyse how the policies and practices related to social-emotion learning were diffused and innovated in China. Onthisbasis, some preliminary suggestions on policy formation, theoretical framework, areas requiring special attention, programme implementation and evaluation can be put forward, which are hoped to provide a little reference for the better promotion of SEL.

The processes of developing the coach-athlete relationship: a case study in women’s university sport

ABSTRACT The purpose of this research was to describe and interpret the processes of developing the coach-athlete relationship in a women’s university sports team across one competitive season. Data were generated from observations of 19 team practices and 11 games, and two individual interviews with the coach and three athletes. Participants’ unique perspectives of developing the coach-athlete relationship were examined through the use of Jowett’s (2007) 3 + 1Cs model. Findings highlight the ambiguous and often contradicting ways that participants understood and interpreted the processes of their coach-athlete relationship, due in part by the performance and social agendas at play. This research makes a contribution to knowledge about the processes of the coach-athlete relationship in a team environment and application of the 3 + 1 Cs model by primarily attending to its processes rather than outcomes. In doing so, we showed some of the complexities in these processes and the challenges this offers to coaches and athletes.

What Works in Collaboration? Identifying Key Ingredients to Improve Service Delivery in Schools.

This survey study examined factors that may influence interprofessional collaboration in schools to support children with oral and written language impairments, namely, knowledge, collaborative beliefs and practices, and resources. A survey was conducted across 319 school-based professionals, in a partnering public school district, to examine these constructs within the context of each individual participant's professional role. Between-groups comparisons were made between special educators, general educators, paraprofessionals, and indirect educators (i.e., those whose roles do not explicitly include language-based instruction). Special educators had significantly higher levels of learning experiences and knowledge about language disorders compared to other groups. Those who engaged in the most independent learning (i.e., learning outside of pre- or in-service learning) exhibited the highest levels of knowledge. Collaborative beliefs among professionals were best predicted by access to resources and overall professional learning experiences. More positive collaborative beliefs, in turn, predicted higher rates of collaborative behaviors. Resources were predicted by a small negative relationship with years of experience and by working in specific school buildings within the district. Those with less experience in specific buildings reported more resources. Individuals with higher levels of individual learning and positive attitudes toward collaboration may enhance the interprofessional collaborative practices of teams supporting children with language disorders. https://doi.org/10.23641/asha.24059178.

Developing consensus on the principles and key actions for collaborative working between general practices and community pharmacies: a modified eDelphi study

ObjectivesTo develop consensus on the principles and key actions for collaborative working in practice between general practice, community pharmacy and patients and their carers.DesignThree-round modified eDelphi study, starting from an...

Environmental Sustainability and the National Hockey League: A Review of the Seven Canadian Teams

Environmentalists consistently note that the way we live and work is having devastating impacts on the environment, and immediate change is required if the planet is to be saved. Legislation is being enacted to force industries and companies to change their business practices so the impact of their programs and services is less damaging to the environment. Some organizations, including professional sports teams and facilities, have implemented environmentally friendly programs and practices to reduce their environmental impact. They have subsequently celebrated these developments as part of their corporate social responsibility (CSR) and corporate environmental responsibility (CER) programs. The researchers reviewed the programs and practices of the seven National Hockey League (NHL) teams based in Canada and, based on these assessments, offered suggestions for improvement based on the best practices of teams and facilities from other sports and facilities across the globe. These environmental programs should serve as the most critical component of their corporate social responsibility program. Keywords: corporate environmental responsibility, National Hockey League, Canada

Relational coordination in value-based health care.

An important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels of interprofessional collaboration between clinical and nonclinical staff in IPUs are assumed rather than proven. Factors that may stimulate interprofessional collaboration in the context of VBHC are underresearched. The aim of this study was to examine relational coordination (RC) in VBHC and its antecedents. A questionnaire was used to examine the association of both team practices and organizational conditions with interprofessional collaboration in IPUs. Gittell's Relational Coordination Survey was drawn upon to measure interprofessional collaboration by capturing the relational dynamics in coordinated working. The questionnaire also included measures of team practices (team meetings and boundary spanning behavior) and organizational conditions (task interdependence and time constraints). The number of different professional groups participating in team meetings is positively associated with RC in IPUs. Boundary spanning behavior, task interdependence, and time constraints are not associated with RC. In IPUs, the diversity within interprofessional team meetings is important for establishing high-quality communication and relationships. Hospital managers should prioritize facilitating and encouraging shared meetings to enhance RC levels among professional groups in IPUs.

Emergence of creativity in IS development teams: A socio-technical systems perspective

Despite the crucial role of creativity in the dynamic and intricate practice of Information Systems Development (ISD), our understanding of its emergence in ISD teams is limited. Prior research has focused on isolated interventions into the people, structure, task, and technology components of ISD practices. However, the synergistic interactions between these components are often overlooked, resulting in interventions that may be ineffective or counterproductive. Drawing on Leavitt’s Socio-Technical Systems (STS) theory, this paper explores creativity as a synergistic outcome of interactions within and between the people, structure, task, and technology components. Our qualitative study at a multinational banking software provider reveals that creativity emerged from within-component interactions when innovators and facilitators in ISD teams interact empathetically during idea generation and evaluation, visualize ideas using technologies for representation and collaboration, and align their creative styles with the organization's formal and informal structures. Additionally, we found that interactions between the STS components in ISD team practices created stimulating environments for creativity to emerge. Our study advances an STS perspective on the emergence of creativity in ISD teams, emphasizing synergistic interactions between people, structure, task, and technology rather than isolated interventions. Practically, our findings provide insights into how IS professionals can nurture creativity by fostering empathetic leadership, aligning creative styles with organizational structures, and balancing tensions between control and drift.

Clinical analysis of decision implementation by a multidisciplinary team in cervical cancer cases in Ganzhou, China.

In this study, we evaluated the role of a multidisciplinary team (MDT) in clinical practice for cervical cancer by analyzing the development of a single-case multidisciplinary consultation for cervical cancer. Patients in MDT consultations for cervical cancer were retrospectively analyzed for clinical information, decision content of MDT discussion, implementation, and follow-up results. Of the 392 patients who met the inclusion criteria, 359 had a first episode, of which 284 were stage IA-IIA2 (79.11%) and 75 were stage IIB-IVB (20.89%). Of these 392, 33 had a recurrence (8.42%). A total of 416 cases were analyzed, and neoadjuvant chemotherapy with surgery was recommended in 43 cases, of which 40 cases were implemented, and 36 of the 40 achieved the expected outcome. Surgical treatment was recommended in 241 cases, of which 226 underwent surgery, and 215 of them achieved the expected outcome. Radiotherapy was recommended in 31 cases, of which 26 cases underwent it, and 22 of them achieved the expected efficacy. Concurrent chemoradiotherapy was recommended in 57 cases, of which 49 underwent it, and 39 of them achieved the expected efficacy. Other treatments were recommended in 44 cases, of which 23 cases were implemented, and 10 of them achieved the expected efficacy, with statistically significant differences compared with cases without implementation (P <0.05). MDT decisions were correlated with age; the younger the patients, the higher the implementation efficiency (P <0.05). The difference between MDT expectation in all implementation and partial implementation and age was statistically significant (P <0.05). No significant difference was found between age and MDT expectation in all not fully implemented decisions (P >0.05). Some decisions were not fully implemented due to economic status and fear of certain treatments of the patient. The MDT plays an important role in clinical practice such as clinical staging, treatment plan, and the complete treatment management of patients with cervical cancer, which can significantly improve the near-term treatment effect, whereas its effect on a long-term prognosis needs further clinical observation and active exploration.

Burden and patient characteristics associated with repeat consultation for unscheduled care within 30 days in primary care: a retrospective case control study with implications for aging and public health.

Repeated consultations in primary care represent a significant burden on healthcare services. Characterizing the patients who repeatedly attend ambulatory care would enhance our understanding of the healthcare needs of this population, with a view to providing appropriate services. The aim of this study was therefore to identify the factors associated with repeated consultation in unscheduled care. Our secondary aim was to explore the specific profile of patients aged >65 years. A retrospective case-control study comparing re-consultation within 30 days at a primary care facility versus non-reconsulting patients, defined as those who did not reconsult within 30 days, among patients consulting over a period of 1 year (1 January to 31 December 2019). Data was collected for a random sample of 5,059 consultations. Patients and controls were matched for age ± 5 years, and sex. The main factors associated with repeat consultation were an initial consultation late at night (midnight to 6.00 am; OR 1.31, 95%CI 1.20-1.44), and psychological disorders as the main diagnosis (OR 1.33, 95%CI 1.20-1.48). Conversely, consulting at the weekend was associated with a lower likelihood of repeat consultation (OR 0.82, 95% 0.85-0.91). 30-day reconsultations were significantly more frequent after late night consultation. This could be used as an indicator of the quality of care to assess performance of general practice teams with implications for improving overall health of an aging population.

Family caregivers in primary care: a survey of German general practitioners on procedures and problems experienced in day-to-day practice

BackgroundBy providing both assistance and support, GPs can play a central role for family caregivers. By catering to the needs of caregivers, they are capable of stabilising in-home care settings over the long term. The aim of the present study is to provide a status quo analysis of how GPs assess their options for supporting individuals providing care, as well as the focal points set by their practice, and their estimation of obstacles and challenges encountered in day-to-day practice.MethodAn online questionnaire was used to survey a total of 5112 GPs in North Rhine-Westphalia between April and November 2022 (response quota: 46%). A heterogeneous random sample was obtained (58% male, 42% female; average age: 57; 50% medium-sized town/city practice, 50% rural/small town practice). To determine significant differences between two groups, a t-test was used with independent random samples. Answers to free-form questions were analysed using a subsequent coding based on a qualitative content analysis.FindingsA total of 70% of respondents have frequent contact with family caregivers. Some 79% consider GPs to be well-suited to the role of primary contact point for caregivers and coordinating care. GP-carer support relationships typically arise as a result of caregivers approaching GPs (90%). Topics frequently addressed involve a worsening of the care situation (77%) and changes in the care needed (86%); consultations in the initial phase of the care situation are less common (44%). While respondents perceive a complex constellation of needs on the part of family caregivers, differences in priorities are observable between GPs in urban and rural environments (involvement of consultant/support network versus proactive and psychosocial assistance). GPs experience a wide range of challenges in providing assistance to caregivers, including the timely organisation of appropriate relief programmes (87%), referring caregivers to suitable help services (80%) or the early identification of informal caregivers (60%).DiscussionIn order to strengthen the GP role, the practice team should talk to caregivers as early as possible, and refer them to suitable help and support programmes. To achieve effective support for successful care, it is important to cater equally to the needs of the persons giving and receiving care as part of the caregiver-care receiver-GP triad.

Occupational Therapist-Led Mindfulness Training Program for Older Adults Living with Early Cognitive Decline in Primary Care: A Pilot Randomized Controlled Trial.

Community-dwelling older adults with early cognitive deficits experience less efficiency in performing everyday life tasks, resulting in decreased satisfaction and other adverse psychological outcomes. Mindfulness training has been linked to cognitive and psychological improvements and, most recently, has been identified as a potential intervention supporting performance of everyday life activities. This study aimed to evaluate whether mindfulness practice can improve perceived performance and satisfaction with everyday life activity and secondary psychological outcomes. This study is a pilot randomized controlled trial (RCT) in an interprofessional primary care team practice in Toronto, Ontario, Canada. The participants were 27 older adults aged 60 years of age or older living with early cognitive deficits. Participants were randomized into an 8-Week mindfulness training program (n = 14) group or a Wait-List Control (WLC; n = 13) group compared at baseline, post-intervention and 4-weeks follow-up. MANOVAs with post-hoc independent t-tests were used to compare between groups at different time points. There was a significant improvement in anxiety for the intervention group compared to the WLC group at post-intervention; Time-2 (mean difference = 3.90; CI = 0.04-7.75; p = 0.04) with large effect size (d = 0.80). Mindfulness training significantly improved anxiety scores for patients with early cognitive deficits post-intervention. Further work is required to test the sustainability of reduced anxiety over time, but this study demonstrated that MBSR is a promising primary care intervention for those living with early cognitive deficits. This study warrants the pursuit of a future study in exploring how long the reduced anxiety effects would be sustained.

Creating Global High-performing Innovation Teams - Insights and Guidelines

This study proposes a model, process and guidelines supporting the creation of global high-performing innovation teams. As global innovation work by teams has become more common, global companies conducting or aiming to conduct global innovation work would benefit from using the suggested proposals. Through a two-pronged research approach, data were collected through a systematic literature review to identify key factors enabling global innovation work from the innovation team perspective and its context, which were validated through interviews and questionnaires with senior management, management, and team members involved in innovation teams spanning six countries. The analysis enabled the proposition of an original model describing a global high-performing innovation team and its context and perspectives alongside a process and guidelines to create such teams in practice, adding knowledge to previous literature, particularly the research field of Innovation Management. Limitations and further research are discussed.

When a woman replaces a man: evaluating coach dismissal in professional tennis

ABSTRACT Purpose Previous research indicates gender discrimination in leadership positions. However, performance and not gender should be the key indicator when evaluating a leader. We examine the performance effect of changing from a female to a male coach and vice versa. Methodology We analyze 1,093 Billie Jean King Cup singles matches from 2006 to 2016, with the match result as the dependent variable. First, we examine the very short-term effects arising from the change of a coach with a regression discontinuity design. Second, we evaluate the short-, medium-, and long-term performances. Findings The results show that the gender of the new coach has no significant effect on performance. However, when a female coach succeeds another female coach, performance improves. This provides an argument in favor of female leadership. Practical Implications Team managers should primarily focus on the quality of the coach instead of gender. The results also suggest that a continuum of female leadership is likely advantageous. Research Contribution This paper contributes to the debate regarding the misrepresentation of women as head coaches and offers an avenue for further research.

Strategy on precision medicine multidisciplinary team in clinical practice

AbstractBackgroundThe multidisciplinary team (MDT) of precision medicine refers to an expert group composed of experts from multiple disciplines, which uses the concept of precision medicine to regularly discuss related diseases, in order to solve difficult clinical problems and put forward feasible personalized treatment schemes for patients.Methods and resultsThe composition and function of precision medicine MDT is defined based on our clinical practice. MDT consists of core fixed members, extended members, auxiliary personnel and secretary. The overall workflow of MDT includes patient selection, organization, discussion and follow‐up. Under this workflow, our MDT team handled many cases, and some of them have been reported.ConclusionWe focused on the strategy analysis on multidisciplinary team of precision medicine including composition, function, management, and criteria, hoping to provide a novel and standardized treatment mode for patients.

Navigating cultural competence in district nursing.

Cultural diversity is an evolving feature of modern-day society. It is recognised that many factors contribute to culturally competent care and evidence suggests there are still inequalities in care provision to some populations. District nurses (DN) deliver care to individuals', families and communities across varying demographics, and aim to provide high quality evidencebased, person-centred care. The scope of the DN and the community nursing team's practice is far reaching and extends across generations and an array of chronic complex health conditions. Therefore, it is imperative that DNs are aware of aspects surrounding cultural diversity, to ensure they can holistically assess and manage patients on their caseloads and support teams to practice culturally competent care. This article aims to provide an outline of key areas for exploration in cultural competence. It will highlight communication, pain, end of life, nutrition and health disparities to consider barriers and challenges for district nursing practice.