Search

Abstract Introduction Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation.

Abstract Structured reporting in radiology continues to hold substantial potential to improve the quality of service provided to patients and referring physicians. Despite many physicians’ preference for structured reports and various efforts by radiological societies and some vendors, structured reporting has still not been widely adopted in clinical routine. While in many countries national radiological societies have launched initiatives to further promote structured reporting, cross-institutional applications of report templates and incentives for usage of structured reporting are lacking. Various legislative measures have been taken in the USA and the European Union to promote interoperable data formats such as Fast Healthcare Interoperability Resources (FHIR) in the context of the EU Health Data Space (EHDS) which will certainly be relevant for the future of structured reporting. Lastly, recent advances in artificial intelligence and large language models may provide innovative and efficient approaches to integrate structured reporting more seamlessly into the radiologists’ workflow. The ESR will remain committed to advancing structured reporting as a key component towards more value-based radiology. Practical solutions for structured reporting need to be provided by vendors. Policy makers should incentivize the usage of structured radiological reporting, especially in cross-institutional setting. Critical relevance statement Over the past years, the benefits of structured reporting in radiology have been widely discussed and agreed upon; however, implementation in clinical routine is lacking due—policy makers should incentivize the usage of structured radiological reporting, especially in cross-institutional setting. Key points 1. Various national societies have established initiatives for structured reporting in radiology. 2. Almost no monetary or structural incentives exist that favor structured reporting. 3. A consensus on technical standards for structured reporting is still missing. 4. The application of large language models may help structuring radiological reports. 5. Policy makers should incentivize the usage of structured radiological reporting. Graphical Abstract

The aim of this discussion paper is to explore factors and contexts that influence how nurses might conceptualise and assign personhood for people with altered consciousness, cognition and behaviours. While a biomedical framing is founded upon a dichotomy between the body and self, such that the body can be subjected to a medical and objectifying gaze, relational theories of self, multiculturalism and technological advances for life‐sustaining interventions present new dilemmas which necessitate discussion about what constitutes personhood. The concept of personhood is dynamic and evolving: where historical constructs of rationality, agency, autonomy and a conscious mind once formed the basis for personhood, these ideas have been challenged to encompass embodied, relational, social and cultural paradigms of selfhood. Themes in this discussion include: the right to personhood, mind–body dualism versus the embodied self; personhood as consciousness, rationality and narratives of self; social relational contexts of personhood and cultural contexts of personhood. Patricia Benner's and Christine Tanner's clinical judgement model is then applied to consider the implications for nursing care that seeks to reflexively incorporate personhood. Nurse clinicians are able to move between conceptions of personhood and act to support the body, as well as presumed autonomy and relational, social and cultural personhood. In doing so, they use analytical, intuitive and narrative reasoning which prioritises autonomous constructions of self. They also incorporate relational and social contexts of the person receiving care within the possibilities of technological advances and constraints of contextual resources. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

Many researchers in the construction field have explored the utilization of augmented reality (AR) and its impact on the industry. Previous studies have shown potential uses for AR in the construction industry. However, a comprehensive critical review exploring the ways in which AR supports synchronized communication is still missing. This paper aims to fill this gap by examining trends identified in the literature and by analyzing both beneficial and challenging attributes. This work was performed by collecting numerous journal and conference papers, using keywords including "augmented reality", "construction", and "synchronous communication". The papers were then categorized based on the reported attributes that were indicated to be challenges or benefits. Throughout the analysis, several benefits were consistently reported, including training, visualization, instantly sharing information, decision making, and intuitive interaction. Similarly, several challenges were consistently reported, such as difficulty in manipulation, unfriendly interface, device discomfort, and sun brightness. Regarding other attributes, such as field of view, cost, safety hazards, and hands-free mode, researchers provided divergent reports regarding whether they were beneficial or detrimental to AR communication. These findings provide valuable guidance for future researchers and practitioners, enabling them to leverage AR for synchronized communication in ways that consistently offer value. [ABSTRACT FROM AUTHOR]

The data paper is an emerging academic genre that focuses on the description of research data objects. However, there is a lack of empirical knowledge about this rising genre in quantitative science studies, particularly from the perspective of its linguistic features. To fill this gap, this research aims to offer a first quantitative examination of which rhetorical moves—rhetorical units performing a coherent narrative function—are used in data paper abstracts, as well as how these moves are used. To this end, we developed a new classification scheme for rhetorical moves in data paper abstracts by expanding a well‐received system that focuses on English‐language research article abstracts. We used this expanded scheme to classify and analyze rhetorical moves used in two flagship data journals, Scientific Data and Data in Brief. We found that data papers exhibit a combination of introduction, method, results, and discussion‐ and data‐oriented moves and that the usage differences between the journals can be largely explained by journal policies concerning abstract and paper structure. This research offers a novel examination of how the data paper, a data‐oriented knowledge representation, is composed, which greatly contributes to a deeper understanding of research data and its publication in the scholarly communication system. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder is one of the most burdensome severe mental disorders, characterized by high levels of personal and social disability. Patients often need an integrated pharmacological and non-pharmacological approach. Lithium is one of the most effective treatments available not only in psychiatry, but in the whole medicine, and its clinical efficacy is superior to that of other mood stabilizers. However, a declining trend on lithium prescriptions has been observed worldwide in the last 20 years, supporting the notion that lithium is a 'forgotten drug' and highlighting that the majority of patients with bipolar disorder are missing out the best available pharmacological option. Based on such premises, a narrative review has been carried out on the most common "misconceptions" and "stereotypes" associated with lithium treatment; we also provide a list of "good reasons" for using lithium in ordinary clinical practice to overcome those false myths. Main text: A narrative search of the available literature has been performed entering the following keywords: "bipolar disorder", "lithium", "myth", "mythology", "pharmacological treatment", and "misunderstanding". The most common false myths have been critically revised and the following statements have been proposed: (1) Lithium should represent the first choice for the treatment of patients with bipolar disorder; (2) lithium treatment is effective in different patients' groups suffering from bipolar disorder; (3) Drug–drug interaction risk can be easily managed during lithium treatment; (4) The optimal management of lithium treatment includes periodical laboratory tests; (5) Slow-release lithium formulation has advantages compared to immediate release formulation; (6) Lithium treatment has antisuicidal properties; (7) Lithium can be carefully managed during pregnancy. Conclusions: In recent years, a discrepancy between evidence-based recommendations and clinical practice in using lithium treatment for patients with bipolar disorder has been highlighted. It is time to disseminate clear and unbiased information on the clinical efficacy, effectiveness, tolerability and easiness to use of lithium treatment in patients with bipolar disorder. It is necessary to reinvigorate the clinical and academic discussion about the efficacy of lithium, to counteract the decreasing prescription trend of one of the most effective drugs available in the whole medicine. [ABSTRACT FROM AUTHOR]

In the eighteenth century, during the context of imperial rivalries, the circulation of information became a crucial element for success in warfare and politics. This article argues that the adaptability of postal communication systems played an essential role in military and political decision-making in a Caribbean space characterized by its dynamism and connectivity. [ABSTRACT FROM AUTHOR]

The article presents the discussion on claims about the nutritional and health benefits of foods and drinks Position Paper emphasises the learnings gaining through the implementation of the European Food Safety Authority evidence‐based process for assessment of proposed claims; and main audience for the Academy's work is the nutrition science community/profession and its stakeholders.

The Internet convulsed journalism and created new press models based on budgets radically different from those that traditionally shaped the performance of the profession. Although at first the newspapers created different work structures for paper and web media, the final decision of the journalistic companies was to create a single newsroom for paper and web media. This article investigates if from the theory of Communication, and especially from the works of McLuhan, this decision is or is not justified in a correct way. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore organisation‐wide experiences of person‐centred care and risk assessment practices using existing healthcare organisation documentation. Background: There is increasing emphasis on multidimensional risk assessments during hospital admission. However, little is known about how nurses use multidimensional assessment documentation in clinical practice to address preventable harms and optimise person‐centred care. Design: A qualitative descriptive study reported according to COREQ. Methods: Metropolitan tertiary hospital and rehabilitation hospital servicing a population of 550,000. A sample of 111 participants (12 patients, 4 family members/carers, 94 nurses and 1 allied health professional) from a range of wards/clinical locations. Semi‐structured interviews and focus groups were conducted at two time points. The audio recording was transcribed, and an inductive thematic analysis was used to provide insight from multiple perspectives. Results: Three main themes emerged: (1) 'What works well in practice' included: efficiency in the structure of the documentation; the Introduction, Situation, Background Assessment, Recommendation (ISBAR) framework and prompting for clinical decision‐making were valued by nurses; and direct patient care is always prioritised. (2) 'What does not work well in practice': obtaining the patient's signature on daily care plans; multidisciplinary (MDT) involvement; duplication of paperwork and person‐centred goals are not well‐captured in care plan documentation. (3) 'Experience of care'; satisfaction of person‐centred care; communication in the MDT was important, but sometimes insufficient; patients had variable involvement in their daily care plan; and inadequate integration of care between MDT team which negatively impacted patients. Conclusions: Efficient and streamlined documentation systems should herald feedback from nurses to address their clinical workflow needs and can support, and capture, their decision‐making that enables partnership with patients to improve the individualisation of care provision. Relevance to clinical practice: The integration of effective MDT involvement in clinical documentation was problematic and resulted in unmet supportive care from the patient's perspective. [ABSTRACT FROM AUTHOR]

Background: Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. Aims: To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. Methods: Use of Neale's (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. Results: DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. Conclusions: DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people's perceptions of adult services as supportive, empowering and available. DC can be used for frequent 'check-ins' and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting. [ABSTRACT FROM AUTHOR]

Person‐centred care, with its central focus on the patient in partnership with healthcare practitioners, is considered to be the contemporary gold standard of care. This type of care implies effective communication from and by both the patient and the healthcare practitioner. This is often problematic in the case of the paediatric population, because of the many communicative challenges that may arise due to the child's developmental level, illness and distress, linguistic competency and disabilities. The principle of universal design put forth in conventions and legislation means that the design of products and services should be usable by all people, to the greatest extent possible. Augmentative and alternative communication encompasses strategies, for example pictures and apps, that are typically used with people with communication disability. In this position paper, we argue for the universal use of augmentative and alternative communication to support person‐centred communication and care for children, regardless of age or potential disability. Clinical examples are shared from three different paediatric care settings where pictorial supports were applied universally. Interviews were conducted with children and adolescents (with and without disabilities), parents and healthcare practitioners, and the principles of universal design were used as a framework to demonstrate how person‐centred communication is supported in paediatric care. [ABSTRACT FROM AUTHOR]

The paper studies reading in the digital age and grounds characteristic reading features on paper and the screen. We studied various scientific points on the uniqueness of reading activities in various formats, effectiveness, and perception of readers about printed and electronic texts. The study concludes that screen-reading practices keep evolving. Digital reading dynamically changes the communication environment, speeding up and simplifying access to information. The new reading format has many opportunities and advantages, and it transforms the reading skills and habits of society. Although it revives social reading, it intensifies the digital divide, leading to a secondary mental cognitive digital divide, and modifies the personal reading experience of contemporaries. [ABSTRACT FROM AUTHOR]

Objectives: A national electronic health record is being procured for Health Service Executive hospitals in Ireland. A number of hospitals have implemented an electronic document management system. This study aimed to investigate the efficiency and safety of the electronic document management system in our centre. Methods: A retrospective audit was performed of patients operated on at Galway University Hospital. The availability and location of patients' admission data on the electronic document management system were recorded. These data were analysed using Microsoft Excel software, version 16.45. Results: The records of 100 patients were analysed. The main findings were: 5 per cent of operation notes were missing, 80 per cent were in the incorrect section, while 15 per cent were in the correct 'procedure' section on the electronic document management system. Conclusion: This study shows there is potential for error with 'paper-light' solutions, whereby delayed scanning, misfiling of scanned records and missing records may lead to significant delays in treatment and potential patient safety issues. [ABSTRACT FROM AUTHOR]

This study focused on how adopted adults who have reunited with at least one birth family member experienced identity shifts related to their original birth certificates (OBCs). Framed by the Communication Theory of Identity (CTI), 50 adopted adults discussed their experiences related to their OBCs and how their identities are connected to this symbol through three of the layers of CTI, the personal, enacted, and relational layers. Participants discussed the presence of an ambiguous and unsolvable identity that interpenetrated with their other identity layers. Findings extend CTI to include an additional layer for adoptees – phantom identity – which can explain the life adoptees would have lived had they not been adopted. This identity was salient for participants as it manifested in ways such as expressing frustration with obstacles in gaining access to their OBC and refocusing their professional life to support other adopted adults. Moreover, findings offer implications for the examination into current adoption record practices in the United States, additional state mutual consent registries, and increased access to adoption-competent counselors for adoptees. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to verify the use of organisational culture and strategic management in the public sector, specifically in school management. To do this, a systematic literature was used. As a result, we presented a survey of the papers on the state of the art of the subject and analysed the heterogeneity of the returned papers. In addition, we analysed 348 papers presenting the search strings on the Web of Science and Scopus, the increase in the theme in recent years, the number of authors, the countries of the researchers, the research approaches, and the word cloud of returned themes. We also made a preliminary bibliometric analysis. We concluded the importance of a systematic review to point out a research gap and provided a systematic review protocol for the area and related research. [ABSTRACT FROM AUTHOR]

In its mission to optimise the quality of patient care and the level of clinician training within the fields of biotherapy, the BioTherapeutics, Education and Research (BTER) Foundation and its Maggot Therapy Competency Committee identified qualities and achievements assessed to be the minimum standards that health care professionals should attain in order to be deemed competent in maggot therapy. The set of six standards were selected to reflect the same high degree of professionalism that is used by the Accreditation Council of Graduate Medical Education for assessing other medical specialists, but with an emphasis on the principles and practice of maggot therapy. For each domain in which competency is expected, the rationale has been explained, specific competencies have been articulated, and methods for demonstrating or evaluating those competencies have been suggested. Applicable to any clinician applying maggot dressings professionally, these recommendations should assist those who wish to identify, assess, or achieve competency in maggot therapy. Specifically, these six competencies include: (1) knowledge about wound care in general and maggot therapy in particular; (2) skill in general patient care, to a level commensurate with their professional role; (3) ability to communicate effectively with colleagues, patients, and the general public; (4) professional and ethical behaviour; (5) ability to deliver systems‐based health care; (6) incorporation of continuing education and quality improvement into their practice. [ABSTRACT FROM AUTHOR]