The effect of team and task familiarity on outcomes over time

Measuring work performance has long been considered one of the most important and well researched topics within the field of Industrial/Organizational Psychology. Since the fruition of team research, however, it is often disputed as to how performance should be measured within the team setting. This debate is a classic example of the criterion problem in which performance has been defined as either behaviors or outcomes. The more important issue about this debate for the present study is the inference that since performance could be either behaviors or outcomes there must be a relationship between them, but there has been limited experimental evidence which demonstrated that changes in behaviors are related to changes in outcomes. In addition to the problems of measuring performance, there is a lack of research on a number of inputs factors which effect performance specifically team and task familiarity. The goal of the present experiment was to overcome these limitations, using a 2 X 3 split plots factorial experimental design to assess the effects of team and task familiarity on behavioral changes and subsequent outcomes. In the between effects condition, participants were randomly assigned to one of two conditions in which team familiarity was changed or kept constant. In the repeated measures condition, all participants performed similar tasks (a measure of task familiarity) over three time periods. A total of eighteen three-member groups made up the study sample and three dependent measures were obtained across the three time periods: (1) subjective team behavioral ratings provided by each member of the group, (2) subjective behavioral ratings provided by trained assessors, and (3) an objective group outcome measure. The results did not support the study hypotheses that behaviors and subsequent outcomes would change as a result of team familiarity and task familiarity. In an attempt to explain the findings, the main thrust of the discussion section was a reanalysis of the data to explore the suggestion that team works and performance did not change because task works did not change over time

The impact of a palliative care unit on mortality rate and length of stay for medical intensive care unit patients.

OBJECTIVE: This study evaluates the impact of a 10-bed inpatient palliative care unit (PCU) on medical intensive care unit (MICU) mortality and length of stay (LOS) for terminally ill patients following the opening of an inpatient PCU. We hypothesized that MICU mortality and LOS would be reduced through the creation of a more appropriate location of care for critically ill MICU patients who were dying. METHOD: We performed a retrospective electronic database review of all MICU discharges from January 1, 2006 through December 31, 2009 (5,035 cases). Data collected included MICU mortality, MICU LOS, and mean age. The PCU opened on January 1, 2008. We compared location of death for MICU patients during the 2-year period before and the 2-year period after the opening of the PCU. RESULTS: Our data showed that the mean MICU mortality and MICU LOS both significantly decreased following the opening of the PCU, from 21 to 15.8% (p = 0.003), and from 4.6 to 4.0 days (p = 0.014), respectively. SIGNIFICANCE OF RESULTS: The creation of an inpatient PCU resulted in a statistically significant reduction in both MICU mortality rate and MICU LOS, as terminally ill patients were transitioned out of the MICU to the PCU for end-of-life care. Our data support the hypothesis that a dedicated inpatient PCU, capable of providing care to patients requiring mechanical ventilation or vasoactive agents, can protect terminally ill patients from an ICU death, while providing more appropriate care to dying patients and their loved ones

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients.

OBJECTIVE: The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization. METHOD: A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study. RESULTS: Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test, p \u3c 0.01). Time from MICU admission until death was also reduced (log-rank test, p \u3c 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2 test, p \u3c 0.0001). SIGNIFICANCE OF RESULTS: Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group

Association of HLA antigens with differential responsiveness to Mycobacterium w vaccine in multibacillary leprosy patients

Leprosy patients undergoing phase II trials in two hospitals of New Delhi, India, were HLA typed to see the association of HLA with differential responsiveness to Mycobacterium w vaccine. The vaccine comprises an atypical, nonpathogenic mycobacterium, Mycobacterium w, which has cross-reactive antigens with M. leprae. Multibacillary patients who are lepromin negative are vaccinated at an interval of 3 months. Considerable improvement is evident in the patients in terms of a decline in bacterial indices and histopathological and immunological upgrading. But all the patients do not respond to the vaccine in the same manner; some are slow responders, while others are good responders. HLA-A28 and DQw3 (DQw8+9) were found to be associated with slow responsiveness, while DQw1 and DQw7 were found to be associated with a more rapid responsiveness to the M. w vaccine. However, these associations were not significant after P correction for the number of antigens tested for each locus except for HLA-DQw3 (DQw8 and DQw9) and DQw7. DQw7, a new defined split of HLA-DQw3, seems to be associated with the responsiveness to M. w vaccine