Interprofessional huddling

BACKGROUND: Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings...

BACKGROUND AND OBJECTIVE: Shared decision-making (SDM) aligns patient preferences with health care team treatment goals. This quality improvement initiative implemented a standardized SDM bundle within a neurocritical care unit (NCCU), where unique demands make existing, provider-driven SDM practices challenging. METHODS: An interprofessional team defined key issues, identified barriers, and created change ideas to drive implementation of an SDM bundle using the Institute for Healthcare Improvement Model for Improvement framework incorporating Plan-Do-Study-Act cycles...

At our institution, we observed inconsistency in the application of structural facilitators for interprofessional teamwork such as handoffs and communication of contingency planning, complete formation and engagement of teams on interprofessional rounds, regular situation monitoring, interprofessional huddles, use of "check back" during code situations, and standard debriefings after codes and procedures (TeamSTEPPS® ). To enhance team performance, we piloted TeamSTEPPS® training and reinforcement for all healthcare team members in the medical intensive care unit (MICU), inclusive of trainees, advanced practice providers (APPs), nurses, and respiratory therapists rotating through the unit...

BACKGROUND: Deprescribing initiatives in the long-term care (LTC) setting are often unsuccessful or not sustained. Prior research has considered how physicians and pharmacists feel about deprescribing, yet little is known about the perspectives of frontline nursing staff and residents. Our aim was to elicit perspectives from LTC nursing staff, patients, and proxies regarding their experiences and preferences for deprescribing in order to inform future deprescribing efforts in LTC. METHODS: This study was a qualitative analysis of interviews with nurses, nurse aides, a nurse practitioner, residents, and proxies (family member and/or responsible party) from three LTC facilities...

INTRODUCTION: Recognizing a patient requiring urgent or emergent care and initiating evaluation and management must include elements that support teams working and thinking together. Although team communication strategies exist, a standardized approach for communicating about patients with urgent or emergent conditions is lacking. This simulation was designed to provide first-semester medical students with the opportunity to deliberately practice the foundational teamwork skills required to think as a team while caring for a patient with critical hypoglycemia...

BACKGROUND: There is significant variability in how residency programs prepare the primary care workforce in behavioral health competencies. One approach that warrants further exploration is to have integrated behavioral health consultants (BHCs) capitalize on in vivo clinical teaching opportunities in the context of team-based care. This article presents preliminary results from the implementation of a pilot program wherein BHCs use warm handoffs and other clinical interactions to provide brief, targeted education to medical residents...

Interprofessional practice and education (IPE) is incorporated into pre-licensure healthcare programs to prepare students for collaboration in clinical practice and to improve patient outcomes. The use of interprofessional simulation as a teaching strategy is increasing, but most literature involves medical and nursing students, and outcomes measure students' knowledge, perceptions, or attitudes. The purpose of this study was to compare allied health students' self-assessment of their team's interprofessional collaborative care (IPCC) skills and behaviors with an independent observer's perception during an interprofessional simulation discharge planning event with standardized patients...

Engaging residents with nurses in interprofessional performance improvement teams can improve learning and care. Residents at the University of Chicago Medicine were identified by nurses, and endorsed by program directors, to serve alongside nurses in Improving GME Nursing Interprofessional Team Experiences (IGNITE) teams. Teams met monthly with improvement coaches to implement institutionally aligned improvement plans. Institutional data was used to monitor progress. The Interprofessional Collaborative Competencies Attainment Survey (ICCAS) assessed interprofessional collaboration competency...

At a time when the older adult population is increasing exponentially and health care agencies are fraught with crisis-level short-handedness and burnout, addressing the Quadruple Aim of enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers is more crucial than ever. A multi-step education model was designed to advance competencies in geriatrics and Interprofessional Collaborative Practice (IPCP) for health profession students focused on each element of the Quadruple Aim...

The current article provides an overview of an interprofessional service-learning course that became virtual in the setting of the coronavirus disease 2019 pandemic. Telehealth video technologies were used to build an intergenerational, virtual classroom and increase engagement of older adults with interdisciplinary health professional students. The virtual classroom involved group health education sessions, individualized Medicare wellness visits, and a clinical huddle. The course addressed the public health need for reliable health information during the early days of the pandemic, social connection, and meeting the educational goals for health care students and older adults in a novel virtual setting...

BACKGROUND: Preadmission discussions in the study institution's pediatric intensive care unit are not standardized and admission plans were thought to be disjointed, leading to a perceived lack of organization and preparation for the arrival of a critically ill child. OBJECTIVE: To evaluate the impact of a new, formalized preadmission pediatric intensive care unit interdisciplinary huddle on clinician perceptions of interprofessional communication. The hypothesis was that preadmission huddles would improve unit clinicians' perceptions of interprofessional communication...

This paper describes the (Sin Exclusión) Transdisciplinary Autism Assessment and Resources ([S]TAAR) model and presents early metrics tracking efficiency and equity in access to high-quality comprehensive autism evaluations for young children. Retrospective chart reviews over one year (08/2018-08/2019) with n = 173 children were reviewed. Through care coordination with community providers, the model was developed to meet local needs by increasing throughput of children (< 4 years old) evaluated by a transdisciplinary team...

Primary care (PC) settings increasingly use team-based care activities with embedded behavioral health providers (BHPs) to enhance patient care via group medical visits, conjoint appointments, team huddles, and warm handoffs. Aim 1 was to describe the variation of team-based care activities within integrated PC clinics. Aim 2 was to explore whether factors associated with the BHP (e.g., gender, training, and experience) and the PC setting (e.g., perceived teamwork) predict engagement in team-based activities...

BACKGROUND: This study investigated checklist compliance to highlight where assumptions about the Surgical Safety Checklist might not be met in practice. METHODS: We used ethnographic methods to investigate the practice of the Surgical Safety Checklist in one hospital. Fifty-one observation days, eight semi-structured interviews, and two surveys of operating room staff over two years were conducted. Data were collected and analyzed iteratively. RESULTS: Despite the near 100% compliance rates reported to the Ministry of Health, practice of the Surgical Safety Checklist varied widely: 82% of Briefings, 76% of Time-Outs, and 22% of Debriefings included some sort of team huddle...

BACKGROUND: Interprofessional teamwork is crucial for fostering healthcare performance and for minimizing adverse events. The daily huddle is an important arena for interprofessional interaction and communication between nurses and physicians in hospitals. Although prevalence strongly rooted in clinical practice, the huddle does not seem to be a prioritized area in nursing education programs. Taking part in a huddle is traditionally something nursing students learn in their clinical studies...

Emergency departments (EDs) are the point of entry for infectious diseases, making it necessary to reevaluate current practices and make adjustments to decrease transmission when presented with a novel viral infection. This article discusses strategies implemented in the ED to prevent transmission of coronavirus disease-2019 (COVID-19) while identifying areas of needed change in creating a safe environment for patients, health care workers, and ancillary staff. A team approach is ultimately necessary for success; therefore, development of interprofessional teams was formed to mitigate any obstacles...

Even with the expansion of primary care teams to include behavioral health and other providers from a range of disciplines, providers are regularly challenged to deliver care that adequately addresses the complex array of biopsychosocial factors underlying the patient's presenting concern. The limits of expertise, the ever-changing shifts in evidence-based practices, and the difficulties of interprofessional teamwork contribute to the challenge. In this article, we discuss the opportunity to leverage the interprofessional team-based care activities within integrated primary care settings as interactive educational opportunities to build competencies in biopsychosocial care among primary care team members...

OBJECTIVES: To use improved situation awareness to decrease cardiopulmonary resuscitation events by 25% over 18 months and demonstrate process and outcome sustainability. DESIGN: Structured quality improvement initiative. SETTING: Single-center, 35-bed quaternary-care PICU. PATIENTS: All patients admitted to the PICU from February 1, 2017, to December 31, 2020. INTERVENTIONS: Interventions targeted situation awareness and included bid safety huddles, bedside mitigation signs and huddles, smaller pod-based huddles, and an automated clinical decision support tool to identify high-risk patients...

Early provision of interprofessional education (IPE) is imperative to ensure effective communication between healthcare professionals. However, there are several barriers to offering adequate IPE, including space restrictions and lack of human resources, prompting exploration of alternative modalities. In 2019, an IPE activity was offered in person with 213 pharmacy and 45 physician assistant (PA) students participating in one-on-one team huddles focusing on managing an acutely ill patient. In 2020, the same IPE activity, including 194 pharmacy and 45 PA students, was offered virtually...

BACKGROUND: COVID-19 presents unique challenges to the care of hospitalized older adults, including fractured lines of communication and uncertainty surrounding long term trajectories in cognition and function. Geriatric medicine and palliative care clinicians bring specialized training in facilitating communication in the face of uncertainty. Insurance expansion of virtual visits enabled inpatient virtual consultation, which can preserve personal protective equipment and minimize exposure to clinicians...