Journal of Interprofessional Care最新文献

Bedside interdisciplinary rounds (IDR) improve teamwork, communication, and collaborative culture in inpatient settings. Implementation of bedside IDR in academic settings depends on engagement from resident physicians; however, little is known about their knowledge and preferences related to bedside IDR. The goal of this program was to identify medical resident perceptions about bedside IDR and to engage resident physicians in the design, implementation, and assessment of bedside IDR in an academic setting. This is a pre-post mixed methods survey assessing resident physicians' perceptions surrounding a stakeholder-informed bedside IDR quality improvement project. Resident physicians in the University of Colorado Internal Medicine Residency Program (n = 77 pre-implementation survey responses from 179 eligible participants - response rate 43%) were recruited via e-mail to participate in surveys assessing perceptions surrounding the inclusion of interprofessional team members, timing, and preferred structure of bedside IDR. A bedside IDR structure was created based on input from resident and attending physicians, patients, nurses, care coordinators, pharmacists, social workers, and rehabilitation specialists. This rounding structure was implemented on acute care wards in June 2019 at a large academic regional VA hospital in Aurora, CO. Resident physicians were surveyed post implementation (n = 58 post-implementation responses from 141 eligible participants - response rate 41%) about interprofessional input, timing, and satisfaction with bedside IDR. The pre-implementation survey revealed several important resident needs during bedside IDR. Post-implementation survey results revealed high overall satisfaction with bedside IDR among residents, improved perceived efficiency of rounds, preserved quality of education, and value added by interprofessional input. Results also suggested areas for future improvement including timeliness of rounds and enhanced systems-based teaching. This project successfully engaged residents as stakeholders in system-level interprofessional change by incorporating their values and preferences into a bedside IDR framework.

Community health worker (CHW) models have been shown to improve health behaviors and health outcomes and reduce cost, particularly among low-income underserved populations. Consequently, health systems are increasingly employing CHWs to provide health services in clinical environments. A growing body of the literature suggests that effective integration of CHWs within the healthcare system is important to achieve the desired outcomes, but the question of how to achieve effective integration is less clear. This study seeks to explore the integration of CHWs within a large state university health system to identify factors critical to the effective integration of CHWs into the clinical care environment. We conducted a qualitative descriptive multiple embedded case study of the University of Illinois at Chicago's Hospital and Health Science System (UI Health). The embedded subunits of analysis were teams within the UI Health System that currently employ CHWs to assist with the provision of clinical care or services to patients. Data were collected via semi-structured interviews and document review. In total, six sub-units were enrolled, and 17 interviews were conducted with CHWs (n = 9), and administrators or healthcare providers (n = 8). Fourteen factors related to effective CHW integration were identified and organized in four categories: individual, team, organization, and community. Findings suggest that in addition to commonly recognized elements of effective CHW models including training, supervision, and the presence of a champion, programs must consider the organizational context in which the program is positioned as well as the ways in which both CHWs and the organization engage with communities served. This research can serve as a roadmap for health systems that seek to integrate CHWs within healthcare services and can be used to promote best practice in CHW integration.

The Program of Education through Work for Health (PET-Health), with a focus on interprofessionality, is one of the actions of the Plan for the Strengthening of Interprofessional Education in Brazil. This research aimed to systematically analyze the characteristics of the proposals submitted to the public notice of the PET-Health Interprofessionality specifically in relation to the theoretical-conceptual and methodological alignment of interprofessional education (IPE). The study is a qualitative document content analysis. We analyzed one hundred and twenty projects submitted to the selection process from institutions participating in the PET-Health Interprofessionality. Content analysis followed three steps: pre-analysis, exploration of the material, and treatment and interpretation of results. Seven categories were identified: a) alignment with the theoretical-conceptual frameworks of IPE, b) curriculum changes, c) faculty development with a focus on IPE, d) articulation among objectives, actions, and results expected related to IPE, e) strategies for monitoring and evaluation, f) involvement of users/families and community, and g) development of collaborative competencies. We conclude that while some advancements have been made, there remains a need for more in-depth discussion in Brazil to ensure the development of competencies capable of assuring more integral, resolute, and safer healthcare services, with capacity to (re)signify user-centered care in the planning and delivery of healthcare.

In healthcare, effective communication and teamwork are pivotal in reducing medical errors. Integrating team training into health professions education is crucial. Accurate measurement of team performance during training requires reliable assessment tools. The TeamSTEPPS® Team Performance Observation Tool (TPOT), recently updated by the Agency for Healthcare Research and Quality, serves this purpose. However, it had not been translated and validated for use in Thailand. We aimed to translate and assess the psychometric properties of the Thai version of TPOT. Employing a back-translation process, TPOT was adapted to the Thai context. The resulting Thai TPOT instrument was administered to 518 healthcare professionals who had undergone TeamSTEPPS® training. Participants were asked to evaluate two prerecorded, 7-minute simulated team emergency scenarios using the Thai TPOT instrument. Results exhibited high internal consistency (Cronbach's alpha = .96) and inter-rater reliability (ICC = .98). Confirmatory factor analysis affirmed the construct validity of the Thai TPOT. These findings establish the Thai TPOT as useful for evaluating teamwork within healthcare teams.

This integrative review aimed to synthesize the evidence regarding interprofessional education (IPE) in undergraduate health courses in Brazil. This article included original articles published between 2005 and 2020 addressing IPE in undergraduate health courses in Brazilian higher education institutions. Our search captured 333 articles in Medline, PubMed, Cochrane Library, Embase (Elsevier), Web Of Science (Main Collection), Scopus (Elsevier), Science Direct (Elsevier), ERIC, and LILACS via BVS. After applying the exclusion and inclusion criteria, the study corpus covered 34 original manuscripts. It was identified that a network is developed at the national level, and with international support, supports discussions and research on IPE. However, there is a concentration of partnerships between researchers from the Northeast, Southeast and South regions, with the need to expand studies on the country's experiences in the North and Midwest regions. There is also consistent publication of experiences concerning the implementation of IPE in undergraduate healthcare courses in Brazil. However, the uniprofessional characteristics and the lack of uniformity in the curricula are still significant, which represent essential obstacles to further IPE strengthening in Brazil. In the Brazilian literature, there is a dearth of longitudinal studies and mixed methods that assess changes in organizational practices. There remains a need for IPE studies with more rigorous designs to generate more impactful evidence.