Evaluation of Attending Medical Teams and Their Impact on the DRG Components of Cholecystectomy

Objective:This study assessed the role of the attending medical team in the cost control of the cholecystectomy DRG components.Methods:The association between team structure,workflow,and treatment outcomes was analyzed using a mixed-methods approach combining quantitative data and qualitative interviews from 628 patients.Results:Inter-professional teamwork significantly affected length of stay,treatment costs,and recurrence rates,with experienced teams performing better in terms of emergency response and collaborative efficiency.Patient satisfaction was generally high,indicating that good teamwork enhances treatment outcomes.Significance:The study highlights the importance of optimizing team configuration to improve the quality,efficiency,and cost control of healthcare.

A qualitative study of nurse practitioner promotion of interprofessional care across institutional settings:Perspectives from different healthcare professionals

Objective:Interprofessional care,an aim of institutional healthcare settings globally,promotes safe,cost-effective,quality care.How professionals act to enable interprofessional care has not been described.The nurse practitioner role,with its expertise in both medicine and nursing,is known to enhance collaboration and promote interprofessional care delivery.The objective of this study was to identify,from the healthcare professionals'perspective,nurse practitioner strategies used to enhance interprofessional care.Method:A hermeneutic phenomenology design was employed.Healthcare professionals from acute care hospitals and associated long-term care residences(n=6)in one Canadian province were invited to participate.Individual interviews were held with healthcare professionals(n=52)who regularly work with a nurse practitioner.The participants were asked to share experiences that held significance or value in promoting interprofessional care.Results:Four valued role attributes were identified;consistent role presence,time to focus on the patient,effective communication,and respectful centrality.Identified strategies extending from the attributes included knowledge sharing,respectful negotiation,identifying patient issues,being open and transparent,listening to opinions,bridging professions,and working as the hub of the group.Multiple types of interprofessional relationships were perceived,with the hierarchical type as the most common.Conclusions:Nurse practitioners in acute care hospital and long-term care settings have valued attributes that can promote interprofessional care.Effective strategies to promote interprofessional care emerge from these role attributes.However,the interprofessional relationship type perceived could enhance or impede the contribution of the strategies to interprofessional care promotion.

Perceptions of Collaboration and Satisfaction with Collaboration Regarding Care Decision-Making in Intensive Care Units in Japan: A National Survey

Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously ill, and their families may be at risk depending on the patient’s situation. Considering these characteristics of patients and families, there is a strong need for multi-professional collaboration within ICUs. The purpose of this descriptive study was to examine recognition and other factors related to collaboration and satisfaction involving care decisions in Japanese ICUs. A mail survey about collaboration of activities and systems was sent to physicians, clinical engineers, and nurses working in ICUs in Japan, 387 consented to participate in this study. Results showed that satisfaction scores were generally high among the three aforementioned professions, but collaboration scores on deciding care for patients showed significant differences (p < 0.05). The total collaboration score was the highest among physicians (36.7 ± 6.7 points), followed by nurses (32.8 ± 7.4 points), and CEs (32.8 ± 7.4 points). The factors that commonly affected collaboration scores were the satisfaction score and the ability to collaborate with other professionals and set team medical care as a goal. Moreover, it is worth noting that the degree of difficulty in collaboration negatively affected this factor. On the other hand, other factors differed among the three professions, suggesting that the purpose and need for collaboration differ depending on the profession.

Attitudes of Undergraduate Public Health and Health Science Students towards Interprofessional Education (IPE) at a California University

Introduction: The study revealed that many healthcare professional students begin their academic studies with positive and high expectations towards interprofessional collaborative studies. Unfortunately, students lose interest if their initial expectations are not met with consistent opportunities to enhance their communication skills and better understand the different healthcare professions. The study aimed to explore health science and public health students’ attitudes toward IPE. The participants’ backgrounds and demographics were used as the variations for the study. Methods: A pre-post semi-quantitative anonymous survey was designed to assess health science and public health undergraduate students’ attitudes toward IPE. The reason for this design was to capture the participants’ attitudes toward IPE at the start of a semester when they had no academic exposure to IPE. Qualtrics was used to collect the research data. A valid and reliable scale was used to measure attitudes toward IPE. A post-survey was included to measure the participants’ change in attitude toward IPE during the semester. The goal was to measure the IPE curriculum effectiveness. There were 21 survey questions. The questions were divided into four validated subscales. The first seven questions (Questions 1 - 7) pertained to the participants’ demographics s, such as gender, age, race, ethnicity, major field of study, and prior education. Questions 8, 9, 16, & 20 were designed to determine how the participants perceived their roles and responsibilities in their future healthcare careers. Each IPE attitude question’s central tendency and demographic variations were measured. The correlation between demographics and IPE attitudes was measured. Results: The pre-survey had 192 participants, and the post-survey had 97 participants. The pre-survey had 87% of participants in the age group 17 - 25 years, while the post-survey had 82.5% in the same age group. Only 5.7% of the participants were 36 years or older in the pre-survey and 9.3% in the post-survey. The participants were 80.70% female in the pre-survey and 85.6% in the post-survey. The largest healthcare career field concentration was nursing, with 42.7% and 45.4% in the pre- and post-surveys. The other three larger career fields were healthcare administration, community health education, and physician assistant. The participants’ attitudes toward learning with different healthcare career students and becoming more effective members of a healthcare team increased from 4.36 (SD = 0.13) to 4.40 (SD = 0.17). Two negative IPE attitude questions showed an increased value: 1) The function of nursing therapists is mainly to provide support for doctors (3.51, SD = 0.19 to 3.12, SD = 0.24, p-value ≤ 0.004) and 2) Clinical and healthcare problem-solving skills could only be learned with students from the same career field (3.73, SD = 0.13 to 3.31, SD = 0.24, p-value ≤ 0.001). Conclusion: Interprofessional Education in an academic setting is essential to help healthcare students prepare and succeed in their future healthcare careers. The study results show that health science and public health students understand IPE and value academic exposure to the IPE process during their studies. Academic healthcare programs should continue integrating the IPE learning model and content throughout the student’s academic journey. The variations in IPE attitude do not significantly vary based on demographics and healthcare career fields. This study only represents a sample size of the many healthcare careers. Interprofessional communication and collaboration are essential to the future healthcare delivery challenges we face. For this reason, IPE should be integrated into healthcare education for all health science and public health students. It is recommended that more research should be done on creative curriculum design to get students more engaged in various healthcare IPE learning activities.

Assessing the implementation of the family care team in the district health system of health region 2,Thailand

Background:The family care team(FCT)was established to improve the quality of care.This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT.Methods:Forty in-depth interviews were conducted.The interviewees consisted of five pri-mary care managers in the provincial medical health office,five directors of community hospitals,five administrators in district health offices,ten subdistrict health-promoting hospital directors,rep-resentatives from ten local organizations,and five heads of village health volunteers.Data were col-lected in accordance with semistructured interview guidelines and analyzed by thematic analysis.Results:Participants’expressed their opinions through five themes:(1)the role and scope of practice,(2)the communication in collaboration of the FCT,(3)the management of the FCT,(4)the impact of the FCT on the team members’feelings and primary care performance,and(5)the main challenges,including the insufficiency of a teamwork culture and a biomedical approach.Conclusion:The information suggests the importance of issues such as the clarification of the team members’roles and managers’roles,communication within and across FCTs,and the prepara-tion for training of interprofessionals to enhance collaborative management to achieve the optimal care for people in the district health system.