Researcher and partner perspectives on the relationship between engagement in research and three uses of patient-centered comparative clinical effectiveness research study findings.

Background: The uptake of research findings into clinical practice is critical to providing health care that improves health outcomes for patients. This study explored how Patient-Centered Outcomes Research Institute (PCORI) awardees perceive the relationship between engagement of patients and other partners in research and three uses, or applications, of patient-centered comparative clinical effectiveness research (CER) study findings, which may lead to uptake in clinical practice: (1) Integration into clinical practice guidelines, recognized point-of-care decision tools, or documents that may inform policy; (2) Implementation beyond the study, including at sites outside of the study setting or patient populations; and (3) Active dissemination of findings to specific audiences by parties external to the study team.

Methods: This exploratory qualitative study examined awardee and partner perceptions of what led to each use of study findings and how engaged partners contributed.

Decoding healthcare teamwork: a typology of hospital teams.

The effectiveness of healthcare depends on successful teamwork. Current understanding of teamwork in healthcare is limited due to the complexity of the context, variety of team structures, and unique demands of healthcare work. This qualitative study aimed to identify different types of healthcare teams based on their structure, membership, and function.

Improving the quality of written communication at patient discharge: triangulation of qualitative analyses and intervention co-design.

Background: Poor handovers between hospital and primary care threaten safe discharges, with elderly and frail patients most at risk of harm. Using Behavioural Science we explored influences and identified relevant behaviour change techniques (BCTs) to improve written handovers and safety during discharge.

Methods: We conducted two qualitative studies: (1) ethnographic observations (>80 h) collected by five researchers in five purposively sampled clinical areas of a London teaching hospital, investigating routine work and interactions of hospital staff involved in discharges; and (2) 12 semi-structured interviews with hospital staff involved in discharge exploring influences on preparations of written handovers.

Quirky conversations: how people with a diagnosis of schizophrenia do dialogue differently.

People with a diagnosis of schizophrenia (PSz) have difficulty engaging in social interaction, but little research has focused on dialogues involving PSz interacting with partners who are unaware of their diagnosis. Using quantitative and qualitative methods on a unique corpus of triadic dialogues of PSz first social encounters, we show that turn-taking is disrupted in dialogues involving a PSz. Specifically, there are on average longer gaps between turns in groups which contain a PSz compared to those which do not, particularly when the speaker switch occurs from one control (C) participant to the other.

Understanding complex work using an extension of the resilience CARE model: an ethnographic study.

Background: Resilient Healthcare research centres on understanding and improving quality and safety in healthcare. The Concepts for Applying Resilience Engineering (CARE) model highlights the relationships between demand, capacity, work-as-done, work-as-imagined, and outcomes, all of which are central aspects of Resilient Healthcare theory. However, detailed descriptions of the nature of misalignments and the mechanisms used to adapt to them are still unknown.

A Systematic Review of Training Interventions for Emergency Department Providers and Psychosocial Interventions delivered by Emergency Department Providers for Patients who self-harm.

Objectives: People who self-harm frequently present to the emergency department (ED) and are treated by generalist healthcare staff with no specialist mental health training. We systematically reviewed (i) training interventions for generalist ED providers and (ii) psychosocial interventions delivered predominantly by generalist ED providers for people who self-harm.

Method: Five databases were searched for studies reporting on training interventions for generalist ED staff (at least 50% of the sample needed to be generalist ED staff) or psychosocial interventions for people who self-harm delivered predominantly by generalist ED staff.

People with arthritis-disability and provider experiences with chronic opioid therapy: A qualitative inquiry.

Background: Growing concerns about opioid overprescribing, opioid use disorder (OUD), and overdose led to opioid misuse prevention practices that may impact the lives of people with disability (PWD) and chronic pain.

Objective: To investigate the experiences of providers and people with arthritis related disability with opioid prescribing and monitoring following release of the Centers for Disease Control and Prevention Guideline for prescribing opioids for chronic pain.

Methods: We conducted semi-structured interviews with 24 specialists and primary care providers and 24PWD.

Capturing challenges and trade-offs in healthcare work using the pressures diagram: An ethnographic study.

Healthcare workers must balance competing priorities to deliver high-quality patient care. Rasmussen's Dynamic Safety Model proposed three factors that organisations must balance to maintain acceptable performance, but there has been little empirical exploration of these ideas, and little is known about the risk trade-offs workers make in practice. The aim of this study was to investigate the different pressures that healthcare workers experience, what risk trade-off decisions they make in response to pressures, and to analyse the implications for quality and safety.

Bridging Knowledge Systems: A Community-Participatory Approach to EcoHealth.

Earth's life-supporting ecosystems are integral to human and planetary health. Ecosystem services connect ecosystem functions to human wellbeing. The complex, multifaceted socio-ecological challenges of ecosystem decline necessitate a transdisciplinary approach, including the active and meaningful engagement and participation of local communities.

The role of transactive memory systems, psychological safety and interpersonal conflict in hospital team performance.

Safe patient care in hospitals relies on teamwork. Transactive Memory Systems (TMS), are shared cognitive systems that have been linked to team performance in other domains, but have received limited attention in healthcare. This study investigated the role of TMS, psychological safety and interpersonal conflict in predicting team performance in hospital ward teams where team membership is dynamic and often loosely defined.

Interprofessional teamwork for managing medical deterioration in pregnancy: what contributes to good clinical performance in simulated practice?

Objectives: To identify the patterns of teamwork displayed by interprofessional teams during simulated management of medical deterioration in pregnancy and examine whether and how they are related to clinical performance in simulated practice.

Design: Exploratory observational cohort study.

Setting: Interprofessional clinical simulation training with scenarios involving the management of medical deterioration in pregnant women.

Understanding adaptive teamwork in health care: Progress and future directions.

Health care teamwork is a vital part of clinical work and patient care but is poorly understood. Despite poor teamwork being cited as a major contributory factor to adverse events, we lack vital knowledge about how teamwork can be improved. Teams in health care are diverse in structure and purpose, and most patient care depends on the ability of different professionals to coordinate their actions.

Reflections, impact and recommendations of a co-produced qualitative study with young people who have experience of mental health difficulties.

Background: There is limited evidence of genuine equal partnership where power is shared with young people with mental health difficulties throughout all research stages, particularly in data collection and analysis.

Objective: To describe how our qualitative study, exploring young peoples' perceptions on the feasibility of using technology to detect mental health deterioration, was co-produced using principles of co-production, whilst reflecting on impact, challenges and recommendations.

Methods: Young people with experience of mental health difficulties were appointed and then worked with researchers throughout all research stages.

Threats to safe transitions from hospital to home: a consensus study in North West London primary care.

Background: Transitions between healthcare settings are vulnerable points for patients.

Aim: To identify key threats to safe patient transitions from hospital to primary care settings.

Design And Setting: Three-round web-based Delphi consensus process among clinical and non-clinical staff from 39 primary care practices in North West London, England.

Young adults' perceptions of using wearables, social media and other technologies to detect worsening mental health: A qualitative study.

Background: Technological interventions may help support and improve mental health. However young peoples' perspectives on using different technologies to detect deteriorating mental health in those already diagnosed with a mental health condition is lacking. The study aim was to explore the perspectives of young patients on the feasibility and acceptability of using wearables, social media and technologies to detect mental health deterioration.

An evidence based framework for the Temporal Observational Analysis of Teamwork in healthcare settings.

Objective: Effective teamwork is critical to patient safety across multiple healthcare settings. However, current observational tools assessing teamwork performance tend to be developed for specific settings or tasks and do not capture temporal features of interaction. This study aimed to develop a valid and reliable observational teamwork behaviour framework, which is based on healthcare practice, applicable across a variety of healthcare contexts and can be used to capture temporal team dynamics.

Beyond the clinical team: evaluating the human factors-oriented training of non-clinical professionals working in healthcare contexts.

Background: As clinical simulation has evolved, it is increasingly used to educate staff who work in healthcare contexts (e.g. hospital administrators) or frequently encounter clinical populations as part of their work (e.

The physical and mental health of acute psychiatric ward staff, and its relationship to experience of physical violence.

To evaluate and describe the physical and mental health of staff on acute psychiatric wards and examine whether violence exposure is linked with health status. We undertook a cross-sectional survey with 564 nursing staff and healthcare assistants from 31 psychiatric wards in nine NHS Trusts using the SF-36, a reliable and valid measure of health status and compared summary scores with national normative data. Additional violence exposure data were collated simultaneously and also compared with health status.

MBRRACE in simulation: an evaluation of a multi-disciplinary simulation training for medical emergencies in obstetrics (MEmO).

The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO).

Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings.

Background: A central feature of clinical simulation training is human factors skills, providing staff with the social and cognitive skills to cope with demanding clinical situations. Although these skills are critical to safe patient care, assessing their learning is challenging. This study aimed to develop, pilot and evaluate a valid and reliable structured instrument to assess human factors skills, which can be used pre- and post-simulation training, and is relevant across a range of healthcare professions.

Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: A mixed methods evaluation study.

Background: In the UK, people with severe mental illness die up to 20years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness.

Objectives: To evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings.

Patient, caregiver and clinician use of comparative effectiveness research findings in care decisions: results from a national study.

Aim: To assess awareness, use and attitudes concerning comparative effectiveness research (CER) findings.

Materials & Methods: Online surveys of patients and caregivers managing rare (n = 560 patients, n = 609 caregivers) or chronic conditions (n = 762 patients, n = 776 caregivers), and practicing clinicians (n = 638).

Results: Less than half of patients and caregivers reported exposure to any type of CER findings in the past 12 months.