Using a sociogram to characterize communication during an interprofessional team huddle

Purpose: The complexity of modern medicine requires high-performance teamwork to ensure quality care. Teams rely on communication patterns that are replicable and efficient. The purpose of this observational study was to characterize communication dynamics among interprofessional team members during a team huddle. The study aimed to (a) characterize communication within structured huddles on an inpatient medicine unit by evaluating who talked and to whom and what types of communication took place during each interaction and (b) explore participants\u27 perceptions of the huddles. Materials and Methods: We used a sociogram to diagram direct observations of the structure and patterns of group interaction. Through the sociogram, we documented the flow and frequency of team members information exchange, questions, and requests. We conducted two follow-up focus groups-one with residents and one with nurses. Results: The most frequent type of interaction observed was information exchange: nurse to resident (28.3%) and resident to nurse (47%). Both residents and nurses asked questions: nurse to resident (7.4%) and resident to nurse (14.2%). Nurses made more requests of residents (2.8%) than vice versa (0.3%). Four themes emerged from focus group analysis, including the huddle promotes (1) a better-informed team, (2) relationship building, (3) communication process efficiencies, and (4) logistical challenges. Conclusion: Sociograms can serve as a novel tool to characterize what actually happens during information exchange at the point of care and identify the nature of communication among team members. Daily huddles among team members involved in the frontline of patient care provides an opportunity to share information, requests, and questions and update shared mental models to meet team objectives

Using cognitive work analysis to design a continuous quality improvement monitoring system for medical school accreditation

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] The purpose of this study is to apply phases of Cognitive Work Analysis (CWA) to identify human and information constraints in how a medical school tracks and monitors the Liaison Committee of Medical Education (LCME) accreditation elements and use the identified constraints to guide design decisions for development of a Continuous Quality Improvement (CQI) Tracker system that will be used to facilitate the LCME Oversight Committee meetings. The researcher answered the following questions: What do the phases of CWA reveal about system constraints of a LCME CQI monitoring system at a medical school? More specifically, what are the design implications for a system that supports an oversight committee in the continuous monitoring of accreditation elements at a medical school? Direct observations, document review, and interviews with 17 members of the LCME Oversight Committee were conducted. Findings from qualitative analysis of interview transcripts were mapped to three phases of CWA. Findings were then used to create models that allowed the researcher to gain a deep understanding of the human and information constraints to consider when designing an LCME CQI tracking system

idiosyncraticman_appendix – Supplemental material for Listening to Patients’ Voices: Workarounds Patients Use to Construct Pain Intensity Ratings

<p>Supplemental material, idiosyncraticman_appendix for Listening to Patients’ Voices: Workarounds Patients Use to Construct Pain Intensity Ratings by Erin A. Dannecker, Melissa D. Warne-Griggs, Lisa A. Royse, and Kimberly G. Hoffman in Qualitative Health Research</p

Role competency scale on shared decision-making nurses: Development and psychometric properties

Objectives: This study aimed to develop a scale that can measure the role competency of oncology nurses during shared decision-making process. Methods: A total of 226 oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest completed the online or mail survey. Exploratory factor analysis and parallel analysis showed the multidimensionality of the role competency scale on shared decision-making nurses. Results: The role competency scale on shared decision-making nurses revealed four dimensions: knowledge, attitudes, communication, and adaptability. The 22 items have excellent internal consistency with a Cronbach’s alpha of 0.91. The four subscales also have adequate reliability with Cronbach’s alpha \u3e0.70 as well as greater than 0.70 Spearman–Brown’s correlation coefficients in split-half reliability testing for each subscale. Conclusion: The new scale has the potential to be used as a clinical tool to assess the need for shared decision-making education and training in oncology nurses

Barriers and Promoters to Participation in the Era of Shared Treatment Decision-Making

This study aimed to identify the barriers and promoters for participationin cancer treatment decision in the era of shared decision-making (SDM)process. A qualitative design was utilized. Nineteen nurses and 11 nursepractitioners from oncology inpatient and outpatient settings participatedin semi-structured interviews. Data were analyzed using directed contentanalysis. The findings include practice barrier, patient barrier, institutionalpolicy barrier, professional barrier, scope of practice barrier, insurancecoverage barrier, and administrative barrier. Multidisciplinary team approach,having a nursing voice during SDM, high level of knowledge of the diseaseand treatment, and personal valuation of SDM participation were perceivedas promoters. Oncology nurses and nurse practitioners face many barriersto their participation during SDM. Organizational support and system-wideculture of SDM are essential to achieve better cancer treatment decisionsoutcome. Additional studies are needed to determine the factors that canpromote more participation among nurses and nurse practitioners

Oncology Nursing and Shared Decision Making for Cancer Treatment

This study aimed to describe the contemporary role of the oncology nurse throughoutthe entire cancer shared decision-making (SDM) process. Study participants consistedof 30 nurses and nurse practitioners who are actively involved in direct careof patients with cancer in the inpatient or outpatient setting. The major themes thatemerged from the content analysis are: oncology nurses have various roles at differenttime points and settings of cancer SDM processes; patient education, advocacy, andtreatment side effects management are among the top nursing roles; oncology nursesvalue their participation in the cancer SDM process; oncology nurses believe they havea voice, but with various degrees of influence in actual treatment decisions; nurses’level of disease knowledge influences the degree of participation in cancer SDM;and the nursing role during cancer SDM can be complicated and requires flexibility