Designing for Effective and Safe Multidisciplinary Primary Care Teamwork: Using the Time of COVID-19 as a Case Study

Effective medical teamwork can improve the effectiveness and experience of care for staff and patients, including safety. Healthcare organizations, and especially primary care clinics, have sought to improve medical teamwork through improved layout and design, moving staff into shared multidisciplinary team rooms. While co-locating staff has been shown to increase communi-cation, successful designs balance four teamwork needs: face-to-face communications; situational awareness; heads-down work; perception of teamness. However, precautions for COVID-19 make it more difficult to conduct face-to-face communications. In this paper we describe a model for un-derstanding how layout affects these four teamwork needs and describe how the perception of teamwork by staff changed after COVID-19 precautions were put in place. Observations, interviews and two standard surveys were conducted in two primary care clinics before COVID-19 and again in 2021 after a year of precautions. In general, staff felt more isolated and found it more difficult to conduct brief consults, though these perceptions varied by role. RNs, who spent more time on the phone, found it convenient to work part time-from home, while medical assistants found it more difficult to find providers in the distanced clinics. These cases suggest some important considera-tions for future clinic designs, including greater physical transparency that also allow for physical separation and more spaces for informal communication that are distanced from workstations

Exploring the Concept of Healing Spaces

DOI:10.1177/193758671668056

Extensive Genomic Variation within Clonal Complexes of Neisseria meningitidis

Meningococcal disease is a widely distributed complex disease affecting all age categories. It can cause severe meningitis and septicemia, especially in unvaccinated infants and young children. The causative agent, Neisseria meningitidis (Nm), can be phenotypically and genetically differentiated into serogroups and sequence types (STs) and has a highly dynamic population structure. To obtain a deeper understanding of the epidemiology of Nm, we sequenced seven Nm genomes. Large-scale genomic analysis was conducted with these 7 Nm genomes, 27 additional Nm genomes from GenBank, and 4 other Neisseria genomes. We observed extensive homologous recombination in all gene functional categories among different Nm genomes. Homologous recombination is so frequent that it has resulted in numerous chimeric open reading frames, including genes in the capsule biosynthesis cluster and loci targeted by commercial vaccines. Our results reveal that, despite widespread use, evolutionary relationships inferred from the standard seven-gene multilocus sequence typing (MLST) method could not predict virulence gene content or strain phenotype. In fact, up to 28% of the virulence-associated genes could differ between strains of identical STs. Consistent with previous studies, we found that allelic recombination is also associated with alterations in antibiotic susceptibility. Overall, these findings emphasize the extensive genomic plasticity of Nm and the limitations of standard molecular methods to quantify this genotypic and phenotypic diversity

Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

Behavior Mapping to Understand Collaboration

Presented on October 22, 2015 from 11:00 am to 12:00 noon in the Georgia Tech Architecture LibraryJennifer R. DuBose is a research associate with the College of Architecture at the Georgia Institute of Technology where she is responsible for project development and management. Her research focuses on evidence-based design for healthcare facilities projects including the development of a business case for evidence-based design, collaboration on the exhaustive 2008 literature review on the subject and investigating the role of innovation in improving design for healthcare systems.Runtime: 45:44 minute

Lighting the patient room of the future: Evaluating different lighting conditions from the patient perspective

This study explores whether “future” lighting systems that provide greater control and opportunity for circadian synchronization are acceptable to participants in the role of patients.Tunable, dimmable light emitting diode(LED)systems provide multiple potential benefits for healthcare. They can provide significant energy savings, support circadian synchronization by varying the spectrum and intensity of light over the course of the day, address nighttime navigation needs, and provide user-friendly control. There is an emerging understanding of the important visual and non-visual effects of light,however, important questions remain about the experience and acceptability of this “future” lighting if we are to adopt it broadly.U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy, Solid-State Lighting progra

The Effect of Light on Sleep and Sleep-Related Physiological Factors Among Patients in Healthcare Facilities: A Systematic Review

DOI:10.1177/1937586716680567Lighting is one of the environmental factors which can improve patient sleep in healthcare environments. Many research studies have been published on this topic, but due to the high degree of variation in study designs and results, the implications have been difficult to interpret. This review aims to consolidate studies on the impact of bright light exposure on sleep in order to present the most effective lighting conditions and characteristics that can be further applied and researched in future healthcare environments

Health Systems: The Next Generation - Rapid Fire Research Presentations 2018

Presented on November 9, 2018, at 1:15 p.m. in the Roger A. and Helen B. Krone Engineered Biosystems Building (EBB Krone), Children's Healthcare of Atlanta (CHOA) Seminar Room, Georgia Tech, Atlanta, GA.2018 Health Systems: The Next Generation Forum - Rapid Fire Research PresentationsJennifer R. DuBose is the associate director of the SimTigrate Design Lab and principal research associate in the College of Design at the Georgia Institute of Technology. She is responsible for the operations of the Lab as well project development and research. Her research focuses on evidence-based design for healthcare facilities projects including the development of a business case for evidence-based design, collaboration on the exhaustive 2008 literature review on the subject and investigating the role of innovation in improving design for healthcare systems. She has worked on projects for the Robert Wood Johnson Foundation, the Military Health System and the Louisiana State University Hospital creating materials to support transformation of new hospitals based on emerging evidence. She has authored numerous peer-reviewed journal articles, several book chapters, and has been an invited speaker at national and international meetings.PRESENTATION TITLE: "Health Economics & Analytics Lab (HEAL)". Dr. Danny Hughes is a Professor in the School of Economics and Director of Georgia Tech’s Health Economics and Analytics Lab (HEAL). He also serves as Executive Director of the Harvey L. Neiman Health Policy Institute. His research focuses on the roles of technology, innovation, and incentives in the delivery and usage of health care services – with a specific focus on the economics of diagnostic imaging. His externally funded research has focused on exploiting large scale data to explore contemporary health policy issues. He has published over 80 articles in leading journals across economics, health services research, and operations research.PRESENTATION TITLE: "Physiological Sensing & Modulation For Human Health & Performance" Omer T. Inan is an Associate Professor of Electrical and Computer Engineering and Adjunct Associate Professor of Biomedical Engineering at Georgia Tech. He received his BS, MS, and PhD in Electrical Engineering from Stanford in 2004, 2005, and 2009, respectively. From 2009-2013, he was the Chief Engineer at Countryman Associates, Inc., a professional audio manufacturer of miniature microphones and high-end audio products for Broadway theaters, theme parks, and broadcast networks. He has received several major awards for his research including the NSF CAREER award, the ONR Young Investigator award, and the IEEE Sensors Council Early Career award. While at Stanford as an undergraduate, he was the school record holder and a three-time NCAA All-American in the discus throw.PRESENTATION TITLE: "HIV Prevention Modeling at the Centers for Disease Control and Prevention". Dr. Li is a Prevention Effectiveness Fellow at the Division of HIV/AIDS Prevention of CDC. His work focus on developing and improving HIV models, including an agent-based simulation model Progression and Transmission of HIV (PATH), a compartmental model HIV Optimization and Prevention Economics (HOPE) and a resource allocation model (RAMP). Dr. Li earned his PhD and MS degrees in Operations Research at Georgia Institute of Technology, and his dissertation applied mathematical and computer algorithms to the problem of allocating limited resources to people with preferences. He works with Georgia Tech professors and students to estimate the value of vaccine inventory and identify risk factors related to unplanned extubation.PRESENTATION TITLE: "Low-Cost, Equipment-Free, Low-Volume, Quantitative Diagnostic Blood Tests". Dr. Styczynski’s research focuses on the experimental and computational study of the dynamics and regulation of metabolism, with ultimate applications in metabolic engineering, biotechnology, and biosensors/diagnostics. Metabolism, which is the process of cells taking in nutrients and turning them into energy and the building blocks for more cells, is at the core of many biotechnological processes, as well as numerous diseases. The Styczynski lab studies the network of reactions that constitutes metabolism via “metabolomics”: measurement of the concentrations of the biochemical intermediates in that network — sugars, amino acids, etc. — that are direct, real-time readouts of cellular state. Tracking these intermediates over time reveals details about the cell’s metabolic dynamics that may then be used for modeling and analysis of metabolism. The group works with a variety of systems, including cancer cells, stem cells, yeast, and E. coli. The ultimate aim is to use an increased understanding of metabolic dynamics in order to exert control over the cells, whether by keeping cancer cells from proliferating or by metabolic engineering of yeast to overproduce valuable chemical feedstocks. The group also has significant efforts in synthetic biology, including its use in the context of metabolic engineering. They are currently developing the underlying technology for diagnostics that use bacteria as biosensors that generate pigments as a visible readout. This application requires significant metabolic engineering of the cells to precisely control their pigment production, in terms of both time and pathway utilization.Runtime: 55:26 minutesThis event will focus on improving health systems, with a focus on promoting wellness in addition to treating disease, and how data and technology might enable and support a transformation. Through panel discussion, we will explore the theme of "Moving from Sick-care to Healthcare" and further dive into the topic of "Proactive Innovations Moving Healthcare Forward.” Rapid fire presentations and the poster sessions will showcase ideas for the future, allowing for dialogue and networking between presenters and participants.Georgia Institute of Technology. Center for Health and Humanitarian SystemsGeorgia Institute of Technology. School of Industrial and Systems EngineeringGeorgia Institute of Technology. Institute for People and Technolog