Background: Cleft care provision in the United Kingdom has been centralized over the past 15 years to improve outcomes for children born with cleft lip and palate. However, to date, there have been no investigations to examine how well these multidisciplinary teams are performing.
Methods: In this pilot study, a cross-sectional questionnaire surveyed members of all health care specialties working to provide cleft care in 11 services across the United Kingdom. Team members were asked to complete the Team Work Assessment (TWA) to investigate perceptions of team working in cleft services. The TWA comprises 55 items measuring seven constructs: team foundation, function, performance and skills, team climate and atmosphere, team leadership, and team identity; individual constructs were also aggregated to provide an overall TWA score. Items were measured using five-point Likert-type scales and were converted into percentage agreement for analysis.
Results: Responses were received from members of every cleft team. Ninety-nine of 138 cleft team questionnaires (71.7%) were returned and analyzed. The median (interquartile range) percentage of maximum possible score across teams was 75.5% (70.8, 88.2) for the sum of all items. Team performance and team identity were viewed most positively, with 82.0% (75.0, 88.2) and 88.4% (82.2, 91.4), respectively. Team foundation and leadership were viewed least positively with 79.0% (72.6, 84.6) and 76.6% (70.6, 85.4), respectively.
Conclusions: Cleft team members perceive that their teams work well, but there are variations in response according to construct.
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http://dx.doi.org/10.1597/13.111 | DOI Listing |
JAMA Netw Open
January 2025
Department of Public Health and Preventive Medicine, State University New York (SUNY) Upstate Medical University, Syracuse, New York.
Importance: Environmental service workers (ESWs) have a critical role within the hospital infrastructure and are at the frontline of infection prevention. ESWs are highly trained in managing all forms of regulated waste, which includes biohazardous waste, and are responsible for the overall patient experience, janitorial work, and infection prevention. Without environmental services, patients have a 6 times greater risk of being infected by pathogens from patients who previously occupied their room.
View Article and Find Full Text PDFPrehosp Emerg Care
January 2025
Prisma Health Department of Emergency Medicine, Greenville, South Carolina.
While several studies have focused on preliminary data and outcomes associated with prehospital buprenorphine administration interventions, to date there has been little discussion of the challenges experienced during the initial implementation of a prehospital buprenorphine protocol. In this case series we examine 3 separate patient encounters with different crews, patients, and receiving emergency medicine (EM) physicians, which highlight initial challenges experienced with implementing the first prehospital buprenorphine program in a rural Appalachian County within South Carolina. In 2 cases we highlight conflicts that may require collegial intervention and education of local receiving EM physicians regarding the new prehospital protocol.
View Article and Find Full Text PDFJ Gen Intern Med
January 2025
University of California, San Francisco, CA, USA.
Objectives: With the increase in illicit fentanyl use in the USA, hospitals face challenges managing opioid withdrawal and opioid use disorder (OUD). To improve opioid withdrawal and OUD treatment among hospitalized patients with daily fentanyl use, we developed a rapid methadone titration (RMT) protocol. We describe development, implementation, and outcomes during the first 12 weeks.
View Article and Find Full Text PDFInt J Legal Med
January 2025
Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FIN-00271, Finland.
In July 2023, an in-house forensic neuropathology consultation pilot was established at the Helsinki office of the Forensic Medicine Unit, Finnish Institute for Health and Welfare. This offered an alternative to the previous practice of full outsourcing to a hospital neuropathology department. This paper aims to introduce the first year experiences of the pilot.
View Article and Find Full Text PDFWorld J Urol
January 2025
Research & Analysis Services, University Hospital Basel, Steinengraben 36, Basel, 4051, Switzerland.
Background: Multidisciplinary teams (MDTs) are essential for cancer care but are resource-intensive. Decision-making processes within MDTs, while critical, contribute to increased healthcare costs due to the need for specialist time and coordination. The recent emergence of large language models (LLMs) offers the potential to improve the efficiency and accuracy of clinical decision-making processes, potentially reducing costs associated with traditional MDT models.
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