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In the context of the COVID-19 pandemic, the authors conduct three online studies to examine effects of health messages that use descriptive norms to bring attention to pervasive social distancing violations and vaccine resistance. The studies provide empirical evidence that when social messages show examples of widespread noncompliant behaviors, they may unintentionally increase resistance to social distancing guidelines and vaccinations. Backfire effects are more pronounced when audiences highly identify with noncompliant actors or pay more attention to others' behaviors. We also show that injunctive norms should be included to alleviate backfire effects. The studies suggest that governments and authorities can more effectively encourage compliance with health guidelines by focusing on the majority of compliant individuals rather than broadcasting images of noncompliant individuals. [ABSTRACT FROM AUTHOR]

Objective: To characterize the motivations of stakeholders from diverse sectors who engaged in cross-sector collaboration with an academic medical center.Data Source: Primary qualitative data (2014-2015) were collected from 22 organizations involved in a cross-sector diabetes intervention on the South Side of Chicago.Study Design: In-depth, semistructured interviews; participants included leaders from all stakeholder organization types (e.g., businesses, community development, faith-based) involved in the intervention.Data Collection Methods: Data were transcribed verbatim from audio and video recordings. Analysis was conducted using the constant comparison method, derived from grounded theory.Principal Findings: All stakeholders described collaboration as an opportunity to promote community health in vulnerable populations. Among diverse motivations across organization types, stakeholders described collaboration as an opportunity for: financial support, brand enhancement, access to specialized skills or knowledge, professional networking, and health care system involvement in community-based efforts. Based on our findings, we propose a framework for implementing a working knowledge of stakeholder motivations to facilitate effective cross-sector collaboration.Conclusions: We identified several factors that motivated collaboration across diverse sectors with health care systems to promote health in a high-poverty, urban setting. Understanding these motivations will be foundational to optimizing meaningful cross-sector collaboration and improving diabetes outcomes in the nation's most vulnerable communities. [ABSTRACT FROM AUTHOR]

Background: Reduction in door-to-needle (DTN) times in patients with acute ischemic stroke treated with tissue-type plasminogen activator is associated with improved outcomes. We hypothesized that a learning collaborative would rapidly reduce DTN times at Chicago's primary stroke centers.Methods and Results: We analyzed data from all adult patients with out-of-hospital ischemic stroke hospitalized between January 1, 2010 and March 31, 2015 and who received tissue-type plasminogen activator in the emergency department at 15 primary stroke centers in Chicago and 15 primary stroke centers in St. Louis. We implemented a structured learning collaborative in Chicago in quarter 1 of 2013 that included (1) a quality improvement leader, (2) stroke content expert, (3) multidisciplinary teams from each site, (4) a targeted goal for the program (DTN time <60 minutes in >50% of patients treated with tissue-type plasminogen activator), and (5) face-to-face meetings with on-site visits. We used interrupted time-series analysis to compare the impact of the learning collaborative on DTN times in Chicago pre- and post implementation and also concurrently versus St. Louis. We prespecified adjustment for mode of arrival, emergency medical services prenotification, and onset-to-arrival times. P values less than 0.05 were considered significant. In adjusted analysis, the reduction in DTN time within 1 quarter of implementation was 15.5 minutes (P=0.046) at Chicago sites versus 1.17 minutes at St. Louis sites (P=0.601).Conclusions: Using a learning collaborative model at Chicago's 15 primary stroke centers, we observed major reductions in DTN times within 1 quarter of implementation. Regional collaboration and best practices sharing should be a model for rapid and sustainable system-wide quality improvement. [ABSTRACT FROM AUTHOR]

Background: Effective collaboration and teamwork is essential in providing safe and effective hospital care. Prior research reveals deficiencies in collaboration on medical teaching units.Objective: The aim of this study was to assess the impact of an intervention, structured inter-disciplinary rounds (SIDR), on hospital care providers' ratings of collaboration and teamwork.Methods: The study was a controlled trial comparing an intervention medical teaching unit with a similar control unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We surveyed providers on each unit and asked them to rate the quality of communication and collaboration they had experienced with other disciplines using a five-point ordinal scale. We also assessed the teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost.Results: One hundred forty-seven of 159 (92%) eligible providers completed the survey. Although resident physicians on each unit rated the quality of communication and collaboration with nurses similarly, a greater percentage of nurses gave high ratings to the quality of collaboration with resident physicians on the intervention unit as compared to the control unit (74% vs. 44%; p = 0.02). Providers on the intervention unit rated the teamwork climate significantly higher as compared to the control unit (82.4 +/- 11.7 vs. 77.3 +/- 12.3; p = 0.01). The difference was explained by higher teamwork climate ratings on the part of nurses on the intervention unit (83.5 +/- 14.7 vs. 74.2 +/- 14.1; p = 0.005). Ratings of the safety climate were not significantly different between units. Adjusted LOS and hospital costs were not significantly different between units.Conclusions: SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a medical teaching unit. Further study is required to assess the impact of SIDR on patient safety measures. [ABSTRACT FROM AUTHOR]

The article reports on the cancellation on the plan of merger between University of Chicago and Northwestern University in Illinois. In a statement signed by the presidents and the presidents of the board of trustees of both universities, the committee decided that after a thorough study, it is best to lay aside the plan and to dissolve the committee. They also agreed that the presidents of the universities continue a close cooperation to yield best results for higher education.