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Interdisciplinary clinical practice has become an essential objective for the management of complex cases in a large number of health facilities in Quebec and elsewhere. However, this highly desirable practice cannot be implemented on demand and requires a carefully designed approach in combination with continuous feedback between the various partners involved in the management and functioning of an interdisciplinary team. The purpose of this research was to provide teams with a tool to help them identify their strengths and weaknesses in order to ensure continuous improvement.Following a comprehensive review of the literature on microsystems ensuring interdisciplinarity in health, we identified a large number of elements considered to be important factors allowing effective interdisciplinarity. These factors were used to construct a questionnaire that was submitted to several stages of validation (qualitative and statistical) designed to enable health professionals to measure their degree of integration of the concepts allowing interdisciplinary clinical practice.This approach allowed validation of this questionnaire (Cronbach's alpha greater than 0.97). During the validation process, the number of questions of the questionnaire was reduced from 99 to 65.The various steps of validation of the questionnaire allowed the development of a relevant tool to promote continuous improvement of interdisciplinary clinical teams.

The purpose of this study was to calculate the cost savings associated with using the kaizen approach in our hospital.Originally developed in Japan, the kaizen approach, based on the idea of continuous improvement, has considerable support in North America, including in the Quebec health care system. This study assessed the first fifteen kaizen projects at the CHUS.Based on an economic evaluation, we showed that using the kaizen approach can result in substantial cost savings.The success of the kaizen approach requires compliance with specific prerequisites. The future of the approach will depend on our ability to comply with these prerequisites. More specifically, such compliance will determine whether the approach is merely a passing fad or a strategy for improving our management style to promote greater efficiency.

The main objectives of this literature review are to determine if scalp cooling is efficient and safe, if there are side effects and if the patients' quality of life improves. In terms of effectiveness, scalp cooling seems to get good performance in its aim to prevent hair loss in patients receiving chemotherapy. The weighted average results of all identified studies indicate that this technology allows for 63.5% of patients to have a good preservation of their hair. In studies with a group of control, the weighted rates of good preservation of the hair are 50.6% with scalp cooling and 16.3% without. From the standpoint of safety technology, the main risk is that of scalp metastases. However, no study has successfully demonstrated a statistically significant difference between groups of patients receiving chemotherapy with or without scalp cooling.