Fiction Fix 12

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A systematic review of team-building interventions in non-acute healthcare settings

Background: Healthcare is increasingly delivered in a team-based format emphasizing interdisciplinary coordination. While recent reviews have investigated team-building interventions primarily in acute healthcare settings (e.g. emergency or surgery departments), we aimed to systematically review the evidence base for team-building interventions in non-acute settings (e.g. primary care or rehabilitation clinics). Methods: We conducted a systematic review in PubMed and Embase to identify team-building interventions, and conducted follow-up literature searches to identify articles describing empirical studies of those interventions. This process identified 14 team-building interventions for non-acute healthcare settings, and 25 manuscripts describing empirical studies of these interventions. We evaluated outcomes in four domains: trainee evaluations, teamwork attitudes/knowledge, team functioning, and patient impact. Results: Trainee evaluations for team-building interventions were generally positive, but only one study associated team-building with statistically significant improvement in teamwork attitudes/knowledge. Similarly mixed results emerged for team functioning and patient impact. Conclusions: The evidence base for healthcare team-building interventions in non-acute healthcare settings is much less developed than the parallel literature for short-term team function in acute care settings. Only one intervention we identified has been tested in multiple non-acute settings by distinct research teams. Positive findings regarding the utility of team-building interventions are tempered by a lack of control conditions, inconsistency in outcome measures, and high probability of bias. Considering these results alongside the well-recognized costs of poor healthcare teamwork suggests that additional research is sorely needed to develop the evidence base for team-building in non-acute settings

Differential patterns of opioid misuse between younger and older adults – a retrospective observational study using data from South Carolina’s prescription drug monitoring program

Background: Most research on opioid misuse focuses on younger adults, yet opioid-related mortality has risen fastest among older Americans over age 55. Objectives: To assess whether there are differential patterns of opioid misuse over time between younger and older adults and whether South Carolina’s mandatory Prescription Drug Monitoring Program (PDMP) affected opioid misuse differentially between the two groups. Methods: We used South Carolina’s Reporting and Identification Prescription Tracking System from 2010 to 2018 to calculate an opioid misuse score for 193,073 patients (sex unknown) using days’ supply, morphine milligram equivalents (MME), and the numbers of unique prescribers and dispensaries. Multivariable regression was used to assess differential opioid misuse patterns by age group over time and in response to implementation of South Carolina’s mandatory PDMP in 2017. Results: We found that between 2011 and 2018, older adults received 57% (p p p p p p  Conclusion: Older adults may misuse opioids differently compared to younger adults. Assessment of policies to reduce opioid misuse should take into account subgroup differences that may be masked at the population level.</p

sj-docx-1-dhj-10.1177_20552076221129729 - Supplemental material for Text messaging to increase patient engagement in a large health care for the homeless clinic: Results of a randomized pilot study

Supplemental material, sj-docx-1-dhj-10.1177_20552076221129729 for Text messaging to increase patient engagement in a large health care for the homeless clinic: Results of a randomized pilot study by Karyn Kershaw, Lisa Martelly, Cassidy Stevens, D. Keith McInnes, Allie Silverman, Thomas Byrne, Diana Aycinena, Lora L. Sabin, Lynn A. Garvin, Varsha G. Vimalananda and Robert Hass in Digital Health</p