Institutionalizing an interprofessional simulation education program: an organizational case study using a model of strategic change

Initiatives to implement interprofessional simulation education programs (ISEP) often fail due to lack of support, resources from management or proper integration into the organization system. This paper aims to identify factors that ensure the successful implementation of an ISEP. Further, the study explores the potential effects an ISEP can have on organizational processes and culture. The case study describes the implementation process of an ISEP in a non-academic community hospital using interviews, participative observations and archival data over six years. A thematic approach has been used to analyze the data guided by Kotter's 8-step model for organizational change. Strategies for a successful implementation of an ISEP include: 1) make a case for interprofessional simulation-based education (SBE), 2) search for healthcare champions, 3) define where the ISEP will lead the organization, 4) spread the word about interprofessional SBE, 5) ensure that structures, skills and supervisors align with the change effort, 6) win over smaller entities, 7) enable peer feedback and create more change, 8) institutionalize the ISEP. Indicators of how the ISEP impacted hospital culture are presented and discussed. ISEPs - if implemented effectively - provide powerful opportunities to span boundaries between professional groups, foster interprofessional collaboration, and eventually improve patient care

Do team processes really have an effect on clinical performance? A systematic literature review

There is a growing literature on the relationship between team processes and clinical performance. The purpose of this review is to summarize these articles and examine the impact of team process behaviours on clinical performance. We conducted a literature search in five major databases. Inclusion criteria were: English peer-reviewed papers published between January 2001 and May 2012, which showed or tried to show (i) a statistical relationship of a team process variable and clinical performance or (ii) an improvement of a performance variable through a team process intervention. Study quality was assessed using predefined quality indicators. For every study, we calculated the relevant effect sizes. We included 28 studies in the review, seven of which were intervention studies. Every study reported at least one significant relationship between team processes or an intervention and performance. Also, some non-significant effects were reported. Most of the reported effect sizes were large or medium. The study quality ranged from medium to high. The studies are highly diverse regarding the specific team process behaviours investigated and also regarding the methods used. However, they suggest that team process behaviours do influence clinical performance and that training results in increased performance. Future research should rely on existing theoretical frameworks, valid, and reliable methods to assess processes such as teamwork or coordination and focus on the development of adequate tools to assess process performance, linking them with outcomes in the clinical setting

Legionnaires' disease on the rise in Switzerland: a denominator-based analysis of national diagnostic data, 2007-2016

The risk of falling ill with Legionnaires’ disease (LD) is suggested to increase, but the global burden of disease is unknown due to a lack of appropriate diagnosis and surveillance systems. In Switzerland, the number of LD cases, captured by the National Notification System for Infectious Diseases, has more than doubled since 2008. This study aims to investigate this increase, contextualizing disease surveillance data with denominator data, which is not routinely available, i.e., the number of tests performed for Legionella spp. We collected the testing data for Legionella spp. of 14 Swiss diagnostic laboratories and calculated the positivity, defined as the proportion of the number of positive tests to the number of tests performed. The number of positive tests increased proportionally to the number of tests performed; hence, the positivity remained stable. However, the cause of the increase in test volume is unclear and has a large impact on the interpretation of the positivity curve. Further, the test outcome was found to be dependent on regional determinants, and the diagnostic method applied. The lack of understanding if and at which stage LD is considered in current case management of pneumonia patients limits the interpretation of observed heterogeneities in incidence or underestimation of LD in Switzerland. The absence of (or non-adherence to) existing guidelines and the heterogeneity in diagnostic testing hampers the comparison of data in the Swiss public health context. Therefore, diagnostic procedures should be harmonised across Switzerland and adherence to national LD management guidelines supported

A Simple, Quick, and Precise Procedure for the Determination of Water in Organic Solvents

A procedure for the UV/VIS-spectroscopic determination of water by the use of a solvatochromic pyridiniumphenolate betaine is given. The water content of organic solvents is calculated by a two parameter equation from λmax of the dye. A typical, detection limit is of the order of 1 mg in 1 ml solvent for routine spectrometers. The parameters for the determination of water are given for a number of commonly used solvents

Exceeding the Ordinary: A Framework for Examining Teams Across the Extremeness Continuum and Its Impact on Future Research

Work teams increasingly face unprecedented challenges in volatile, uncertain, complex, and often ambiguous environments. In response, team researchers have begun to focus more on teams whose work revolves around mitigating risks in these dynamic environments. Some highly insightful contributions to team research and organizational studies have originated from investigating teams that face unconventional or extreme events. Despite this increased attention to extreme teams, however, a comprehensive theoretical framework is missing. We introduce such a framework that envisions team extremeness as a continuous, multidimensional variable consisting of environmental extremeness (i.e., external team context) and task extremeness (i.e., internal team context). The proposed framework allows every team to be placed on the team extremeness continuum, bridging the gap between literature on extreme and more traditional teams. Furthermore, we present six propositions addressing how team extremeness may interact with team processes, emergent states, and outcomes using core variables for team effectiveness and the well-established input-mediator-output-input model to structure our theorizing. Finally, we outline some potential directions for future research by elaborating on temporal considerations (i.e., patterns and trajectories), measurement approaches, and consideration of multilevel relationships involving team extremeness. We hope that our theoretical framework and theorizing can create a path forward, stimulating future research within the organizational team literature to further examine the impact of team extremeness on team dynamics and effectiveness

How Team Familiarity Mitigates Negative Consequences of Team Composition Disruptions: An Analysis of Premier League Teams

In today’s dynamic work environment, teams are increasingly confronted with disruptions. While there are different types of disruptions that teams face, we contend that team composition disruptions that occur during the completion of a team’s task can be especially challenging. We also argue that it is important to consider different types of team composition changes as they create different demands for team adaptation. Specifically, we assess the effects of loss of a team member and change in team membership resulting from injury substitution. We examine how these two types of team composition disruptions impact coordination and team outcomes (i.e., goals scored) by leveraging data from 2,280 soccer games in the English Premier League. We found that team member loss impaired both team coordination and outcomes while team member substitution only impacted team coordination. Moreover, we build upon and extend existing research that has examined team familiarity by distinguishing between familiarity that is built amongst members on the current team (i.e., current team familiarity) and familiarity that has developed as a result of members working together in prior teams (i.e., prior team familiarity). This distinction appears important as we did not find evidence of a main effect of prior team familiarity on coordination but found evidence of a reversing curvilinear effect of current team familiarity on coordination. Finally, the indirect effect of team member loss on team outcomes through team coordination was more pronounced when teams had low (compared to high) prior team familiarity