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Introduction: Optimizing the performance of emergency department (ED) teams impacts patient care, but the utility of current, team-based performance assessment tools to comprehensively measure this impact is underexplored. In this study we aimed to 1) evaluate ED team performance using current team-based assessment tools during an interprofessional in situ simulation and 2) identify characteristics of effective ED teams.Methods: This mixed-methods study employed case study methodology based on a constructivist paradigm. Sixty-three eligible nurses, technicians, pharmacists, and postgraduate year 2–4 emergency medicine residents at a tertiary academic ED participated in a 10-minute in situ simulation of a critically ill patient. Participants self-rated performance using the Team Performance Observation Tool (TPOT) 2.0 and completed a brief demographic form. Two raters independently reviewed simulation videos and rated performance using the TPOT 2.0, Team Emergency Assessment Measure (TEAM), and Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). Following simulations, we conducted semi-structured interviews and focus groups with in situ participants. Transcripts were analyzed using thematic analysis.Results: Eighteen team-based simulations took place between January–April 2021. Raters’ scores were on the upper end of the tools for the TPOT 2.0 (R1 4.90, SD 0.17; R2 4.53, SD 0.27, IRR [inter-rater reliability] 0.47), TEAM (R1 3.89, SD 0.19; R2 3.58, SD 0.39, IRR 0.73), and Ottawa GRS (R1 6.6, SD 0.56; R2 6.2, SD 0.54, IRR 0.68). We identified six themes from our interview data: team member entrustment; interdependent energy; leadership tone; optimal communication; strategic staffing; and simulation empowering team performance.Conclusion: Current team performance assessment tools insufficiently discriminate among high performing teams in the ED. Emergency department-specific assessments that capture features of entrustability, interdependent energy, and leadership tone may offer a more comprehensive way to assess an individual’s contribution to a team’s performance.

Interprofessional co-treatment occurs when practitioners from different professions engage in collaborative practice during the same session with the same patient or client. While interprofessional co-treatment is common practice in many settings, there are no known studies that have synthesized the available literature across professions on this interprofessional intervention. A scoping review was conducted to explore the nature and volume of the literature on interprofessional co-treatment involving six allied health professions. A search strategy was implemented, and articles were reviewed by two independent reviewers. Thirty-three articles were included in the study. The professions commonly represented in co-treatment studies were as follows: occupational therapy, physical therapy, speech-language pathology, music therapy, and classroom teaching. Studies discussed co-treatment in direct patient or client care, as a student learning experience, or in the exploration of professional practice issues. Studies discussed co-treatment in a range of clinical contexts. The most common co-treatment collaborations were between occupational therapy and physical therapy; physical therapy and speech-language pathology; speech-language pathology and music therapy; and speech-language pathology and classroom teaching. Co-treatment occurs with a range of professions in both health and non-health contexts, which may be reflected in student IPE experiences. Given the paucity of empirical studies on co-treatment, more work is required by practitioners and researchers to advance the evidence base. [ABSTRACT FROM AUTHOR]

Protocols instituted for behavioral treatment and skills training programs for the management of autism spectrum disorder (ASD) suffer from lack of collaborative approaches. The tenets of interprofessional collaborative practice (IPCP) focus on preparing a panel of health care professionals (HCPs) from different professions who can work together to enable the common goal of ensuring that children with ASD can participate in society. This study was designed to pilot this approach through an IPCP training module on ASD for care providers from multiple professions. An interventional study with pre-post analysis began with formation of the interprofessional (IP) team, who developed an IPCP module, addressing the knowledge and skills needed for the collaborative management of neurodevelopmental issues of children with ASD. This module was delivered through an online training workshop using various teaching learning methods to the participants from seven different health professions after obtaining informed consent. Perceptions of interprofessional collaboration and competencies of IPCP were assessed using standard IP tools and reflective summaries and analyzed through a mixed-methods approach. A total of 42 HCPs from seven professions, including speech and hearing, occupational therapy, clinical psychology, physiotherapy, pediatrics, nursing, and pedodontics, participated in the study. Pre-post analysis of PINCOM-Q and Dow-IPEC data and thematic analysis revealed a significant difference in the perceptions of interprofessional collaboration and competencies' levels of IPCP. This study suggests that use of IPCP principles in the training of professionals working with ASD is a promising and feasible option to develop more competent health professionals. The training enhanced the abilities of professionals to work in field of ASD as conveyed by the participants. They also expressed confidence in the knowledge of IP core competencies after the completion of the module. [ABSTRACT FROM AUTHOR]

This paper uses a neo-institutional perspective to examine possibilities and obstacles for participation in coordinated individual planning (CIP) for people with intellectual disabilities. CIP is a tool for interprofessional and interorganizational coordination with the objective of creating a joint plan for a person needing cohesive care. Participation by the service-user is considered important for effective coordination but involving someone with an intellectual disability may require special adaptations. A thematic analysis of interviews with 17 professionals from different organizations in Sweden reveals that service user participation is considered an important goal by professionals, but also that it is difficult to put into practice. The results indicate that CIP is characterized by tensions and policy-practice decoupling that limit the service-users' possibilities for participation. Points of interest: Different organisations and professionals sometimes give support to one individual. They need to coordinate this support. It is necessary for service-users to be involved in coordinated planning of the support and care they need. The study analyses how professionals experience participation in coordinated planning when the service-user has an intellectual disability. The study found that coordinated planning can be difficult to adapt for service-user participation. The study found a gap between ideals and practice caused by the organizations' rules, norms, and structures. The findings reveal a risk of focusing on changing the service-user's behaviour or situation rather than addressing problems within the organizations. [ABSTRACT FROM AUTHOR]

Blended Intensive Programmes (BIP's) represent a valuable tool for gathering knowledge and summarising the latest trends in medicine and dentistry. Blended education has been found, even before the COVID-19 pandemic, to increase the level of education and stimulate effective learning for postgraduate healthcare professionals. Interprofessional education is critical for preparing students to enter the health workforce, where teamwork and collaboration are important competencies. This article outlines the key points of the Blended Intensive Programme's implementation in dental education organised by Wroclaw Medical University in Poland. BIP involved professors from 12 universities or research institutions from Europe and South America and 28 participants from 8 countries. The course was taught remotely and in person. In addition, it included a visit to the university and practical classes with artificial simulation and practice in dentistry. A structured questionnaire enabled measuring the evaluation of students' perception of the COVID-19 education before and after the pandemic. The European Region Action Scheme for the Mobility of University Students (ERASMUS) was fundamental to carrying out the BIP with the participation of several countries, allowing the exchange of knowledge, assessing the impact of the pandemic on dental universities, and strengthening international collaborations and the future project of research, education and clinical assistance. We conclude that hybrid teaching programmes broaden the learning spectrum in dental studies by allowing transnational and interdisciplinary approaches that make students aware of the importance of their work within the framework of the general health approach, as this differs from country to country. [ABSTRACT FROM AUTHOR]

Clinical reasoning is considered one of the most important competencies but is not included in most healthcare curricula. The number and diversity of patient encounters are the decisive factors in the development of clinical reasoning competence. Physical real patient encounters are considered optimal, but virtual patient cases also promote clinical reasoning. A high-volume, low-fidelity virtual patient library thus can support clinical reasoning training in a safe environment and can be tailored to the needs of learners from different health care professions. It may also stimulate interprofessional understanding and team shared decisions. Implementation will be challenged by tradition, the lack of educator competence and prior experience as well as the high-density curricula at medical and veterinary schools and will need explicit address from curriculum managers and education leads. [ABSTRACT FROM AUTHOR]

Purpose: In simulation-based education (SBE), educators integrate their professional experiences to prepare learners for real world practice and may embed unproductive stereotypical biases. Although learning culture influences educational practices, the interactions between professional culture and SBE remain less clear. This study explores how professional learning culture informs simulation practices in healthcare, law, teacher training and paramedicine. Methods: Using constructivist grounded theory, we interviewed 19 educators about their experiences in designing and delivering simulation-based communication training. Data collection and analysis occurred iteratively via constant comparison, memo-writing and reflexive analytical discussions to identify themes and explore their relationships. Results: Varied conceptualizations and enactments of SBE contributed to distinct professional learning cultures. We identified a unique 'simulation culture' in each profession, which reflected a hyper-real representation of professional practice shaped by three interrelated elements: purpose and rationale for SBE, professional values and beliefs, and educational customs and techniques. Dynamic simulation cultures created tensions that may help or hinder learning for later interprofessional practice. Conclusion: The concept of simulation culture enhances our understanding of SBE. Simulation educators must be mindful of their uni-professional learning culture and its impacts. Sharing knowledge about simulation practices across professional boundaries may enhance interprofessional education and learners' professional practice. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsMedical students seek early patient contact but their curriculum starts with scientific knowledge. We integrated the Healthcare Assistant (HCA) course into semester one for early patient-facing clinical contact. This study compares students’ aspirations for this learning with the realities of employed work as HCAs.This sequential mixed-methods study used pre-post-scored questionnaire data, followed by post-course focus groups, and interviews a year later. The quantitative data were analysed using SPSS and the qualitative data using thematic analysis.The learning was highly valued with early perceptions challenged. The learning both accelerated and advanced their medical skills. Their naivety of nurses’ work within team-based practice quickly eroded; they symbiotically linked their clinical and non-clinical learning; they acclimatised to the hospital environment while future gazing in preparation for clinical learning. Early anxieties for starting employment were overcome, building resilience.HCA training offers a practical patient-facing set of competencies on which to build medical capability. Student text-book scientific knowledge was validated through their experiences with recognition of the importance of empathetic patient-centred care. They quickly learnt and absorbed ward function; experienced good and poor teamworking; highly valued the nursing role; and experienced the every-day stresses of being a front-line practitioner. [ABSTRACT FROM AUTHOR]

Research into metacognitive processes within interprofessional clinical simulation has been largely overlooked in the literature. This study explores how interprofessional simulation may influence cognitive and metacognitive processes across several professional programmes; medicine, nursing, pharmacy, and occupational therapy. This study focused on changes in performance pre- and post-simulation, with undergraduate students from each profession answering a set of questions related to the simulation case, requiring specialized knowledge from each profession. Question scores, item confidence judgment ratings, and calibration values were collected and analyzed. The data revealed a pattern of convergence in post-simulation assessments, where professions initially with lower performance in the pre-simulation phase improved, and those initially performing well demonstrating a decline in performance. Calibration values indicated that medical students developed metacognitive errors from their interactions in the simulation, which were not present pre-simulation, and that occupational therapy students suffered a loss of confidence and calibration in questions within their own field resulting from their experience (being more accurate pre-simulation). The authors anticipate that the phenomenon of convergence may have longer-term consequences, potentially fostering distrust among professions for those with declining performance. The authors propose that expanding awareness of convergence phenomena and conducting repeated simulations (thus facilitating further team development) could mitigate this issue. [ABSTRACT FROM AUTHOR]

Background: As our global population ages, malnutrition and sarcopenia are increasingly prevalent. Given the multifactorial nature of these conditions, effective management of (risk of) malnutrition and sarcopenia necessitates interprofessional collaboration (IPC). This study aimed to understand primary and social care professionals' barriers, facilitators, preferences, and needs regarding interprofessional management of (risk of) malnutrition and sarcopenia in community-dwelling older adults. Methods: We conducted a qualitative, Straussian, grounded theory study. We collected data using online semi-structured focus group interviews. A grounded theory data analysis was performed using open, axial, and selective coding, followed by developing a conceptual model. Results: We conducted five online focus groups with 28 professionals from the primary and social care setting. We identified five selective codes: 1) Information exchange between professionals must be smooth, 2) Regular consultation on the tasks, responsibilities, and extent of IPC is needed; 3) Thorough involvement of older adults in IPC is preferred; 4) Coordination of interprofessional care around the older adult is needed; and 5) IPC must move beyond healthcare systems. Our conceptual model illustrates three interconnected dimensions in interprofessional collaboration: professionals, infrastructure, and older adults. Conclusion: Based on insights from professionals, interprofessional collaboration requires synergy between professionals, infrastructure, and older adults. Professionals need both infrastructure elements and the engagement of older adults for successful interprofessional collaboration. [ABSTRACT FROM AUTHOR]

Background/objectives: International guidelines recommend cardiopulmonary resuscitation [CPR] training every sixth month. However, research indicates that more training is needed to maintain CPR competence. The objectives of this pilot study were (a) to assess health personnel's self-reported competence and need for more training in CPR before and after interprofessional in situ CPR simulation and (b) to assess time since the last CPR course and respondent's reported need for more training. Also, we wanted a pilot to assess areas of improvement in a future, larger study. Methods: A questionnaire was administered to healthcare personnel in hospital wards receiving CPR training using a purposeful sampling strategy. Results: In total, 311 respondents answered the pre-intervention and 45 respondents answered the post-intervention survey. The respondents believed they had good knowledge, skills, and training in CPR, and about 2/3 of the respondents reported a need for more knowledge, skills, and training. There was a weak positive correlation between the time since the last CPR course and the perceived need for more training [p < 0.05]. There were no significant differences in self-reported competence or perceived need for more training pre- and post-intervention. The pilot detected several limitations that need improvement in a future study. Conclusions: The authors suggest that regular training is important for maintaining competence in CPR. Also, in a future study, comparisons at an individual level, as well as assessments by experts and of non-technical skills, should be included. [ABSTRACT FROM AUTHOR]

Abstract Background Interprofessional simulation-based team training (ISBTT) is commonly used to optimize interprofessional teamwork in healthcare. The literature documents the benefits of ISBTT, yet effective interprofessional collaboration continues to be challenged by complex hierarchies and power dynamics. Explicitly addressing these issues during ISBTT may help participants acquire skills to navigate such challenges, but guidelines on how to do this are limited. Methods We applied an educational design research approach to develop and pilot structured facilitator guidelines that explicitly address power and hierarchy with interprofessional teams. We conducted this work in a previously established ISBTT program at our institution, between September 2020 and December 2021. We first reviewed the literature to identify relevant educational theories and developed design principles. We subsequently designed, revised, and tested guidelines. We used qualitative thematic and content analysis of facilitator interviews and video-recording of IBSTT sessions to evaluate the effects of the guidelines on the pre- and debriefs. Results Qualitative content analysis showed that structured guidelines shifted debriefing participation and content. Debriefings changed from physician-led discussions with a strong focus on medical content to conversations with more equal participation by nurses and physicians and more emphasis on teamwork and communication. The thematic analysis further showed how the conversation during debriefing changed and how interprofessional learning improved after the implementation of the guidelines. While power and hierarchy were more frequently discussed, for many facilitators these topics remained challenging to address. Conclusion We successfully created and implemented guidelines for ISBTT facilitators to explicitly address hierarchy and power. Future work will explore how this approach to ISBTT impacts interprofessional collaboration in clinical practice.

In competency-based education, entrustable professional activities (EPAs) play a defining role in developing the competence of students by providing contextual relevance. EPAs aid in the assessment of both cognitive and noncognitive (namely teamwork, leadership, communication skills, professionalism, etc.) attributes of the student. In fact, the inclusion of EPAs targeting interprofessional education (IPE) in the curriculum strengthens collaborative learning. The process of integration of EPAs related to IPE in the medical curriculum requires systematic planning and implementation to encourage collaborative learning and prepare students for medical practice. Assessment of IPE-related competencies using EPAs can be carried out with the help of different methods. In conclusion, EPAs can significantly strengthen the delivery of IPE by promoting collaboration and teamwork. There is an immense need to integrate IPE-related EPAs into the medical curriculum to improve the quality of care and patient-related outcomes.

Abstract Background Early- to mid-career academics (EMCAs) represent a core component of the Australian higher education workforce. These academics experience major challenges to their wellbeing, driving a strong desire to leave academia. Objectives Determine (1) EMCA awareness of, and engagement with, previous University- and Faculty-level diversity and inclusion events/initiatives and (2) opportunities and solutions to address previously reported diversity and inclusion issues experienced in the workplace. Methods 114 EMCAs in medicine, dentistry and health sciences completed an electronic cross-sectional survey. The survey contained a list of University- and Faculty-provided diversity and inclusion initiatives and sought respondent ratings of interest, awareness (knowing/hearing about) and engagement (attending/applying/participating). Two in-person focus groups comprising participants who opted in during the survey or who responded to broader advertising were conducted. Both groups explored opportunities and solutions to address diversity and inclusion issues reported in an earlier organisation-wide survey. Results Whilst early- and mid-career academics reported high interest in diversity and inclusion events, they also reported limited awareness and engagement with these events, feeling unsupported to engage or perceiving consequences for workload. Focus groups identified five themes related to opportunities and solutions to address diversity and inclusion issues experienced in the workplace (1) enhanced relational support for career progression, (2) clear and transparent processes for efficient working, (3) reducing structural barriers to create opportunity, (4) improved financial renumeration, and (5) improved transitions and pathways. Conclusion Early- and mid-career academics often felt unable to engage with activities outside of their immediate work responsibilities, such as events about diversity and inclusion, due to feelings of high workload. A systems approach to deploying targeted strategies to address these wellbeing challenges is recommended to sustain and retain this critical workforce.

Abstract Background In Canada, primary care reforms led to the implementation of various team-based care models to improve access and provide more comprehensive care for patients. Despite these advances, ongoing challenges remain. The aim of this scoping review is to explore current understanding of the functioning of these care models as well as the contexts in which they have emerged and their impact on the population, providers and healthcare costs. Methods The Medline and CINAHL databases were consulted. To be included, team-based care models had to be co-located, involve a family physician, specify the other professionals included, and provide information about their organization, their relevance and their impact within a primary care context. Models based on inter-professional intervention programs were excluded. The organization and coordination of services, the emerging contexts and the impact on the population, providers and healthcare costs were analysed. Results A total of 5952 studies were screened after removing duplicates; 15 articles were selected for final analysis. There was considerable variation in the information available as well as the terms used to describe the models. They are operationalized in various ways, generally consistent with the Patient’s Medical Home vision. Except for nurses, the inclusion of other types of professionals is variable and tends to be associated with the specific nature of the services offered. The models primarily focus on individuals with mental health conditions and chronic diseases. They appear to generally satisfy the expectations of the overarching framework of a high-performing team-based primary care model at patient and provider levels. However, economic factors are seldom integrated in their evaluations. Conclusions The studies rarely provide an overarching view that permits an understanding of the specific contexts, service organization, their impacts, and the broader context of implementation, making it difficult to establish universal guidelines for the operationalization of effective models. Negotiating the inherent complexity associated with implementing models requires a collaborative approach between various stakeholders, including patients, to tailor the models to the specific needs and characteristics of populations in given areas, and reflection about the professionals to be included in delivering these services.

This qualitative study explores how communication practice affects Swedish home care nurses' psychosocial work environment. Data consisted of interviews and field observations, analyzed from the perspective of Media Synchronicity Theory and the Job-Demand-Control-Support model. Individual home care nurses were found to manage an interorganizational communication web. The results indicated that this web could have a protective function for the nurses. Synchronous communication was found important to control the work situation. Nevertheless, asynchronous communication was enforced when communicating with other health care organizations. This reduced the level of control for the nurses. However, when possible, the nurses also arranged their communication practice to gain control. Thus, local optimization for one group could result in suboptimization for others. We conclude that communication practice should be designed holistically and promote synchronous communication to foster well-functioning interprofessional teamwork and to create a healthy psychosocial work environment for both home care nurses and their collaborators. [ABSTRACT FROM AUTHOR]

Background: Early- to mid-career academics (EMCAs) represent a core component of the Australian higher education workforce. These academics experience major challenges to their wellbeing, driving a strong desire to leave academia. Objectives: Determine (1) EMCA awareness of, and engagement with, previous University- and Faculty-level diversity and inclusion events/initiatives and (2) opportunities and solutions to address previously reported diversity and inclusion issues experienced in the workplace. Methods: 114 EMCAs in medicine, dentistry and health sciences completed an electronic cross-sectional survey. The survey contained a list of University- and Faculty-provided diversity and inclusion initiatives and sought respondent ratings of interest, awareness (knowing/hearing about) and engagement (attending/applying/participating). Two in-person focus groups comprising participants who opted in during the survey or who responded to broader advertising were conducted. Both groups explored opportunities and solutions to address diversity and inclusion issues reported in an earlier organisation-wide survey. Results: Whilst early- and mid-career academics reported high interest in diversity and inclusion events, they also reported limited awareness and engagement with these events, feeling unsupported to engage or perceiving consequences for workload. Focus groups identified five themes related to opportunities and solutions to address diversity and inclusion issues experienced in the workplace (1) enhanced relational support for career progression, (2) clear and transparent processes for efficient working, (3) reducing structural barriers to create opportunity, (4) improved financial renumeration, and (5) improved transitions and pathways. Conclusion: Early- and mid-career academics often felt unable to engage with activities outside of their immediate work responsibilities, such as events about diversity and inclusion, due to feelings of high workload. A systems approach to deploying targeted strategies to address these wellbeing challenges is recommended to sustain and retain this critical workforce. [ABSTRACT FROM AUTHOR]

Interprofessional education aims to foster healthcare students’ ability to collaborate in interprofessional teams with the patients at the center of care as active participants. However, little is known about how patients experience this collaboration. Therefore, this study aimed to explore patients’ experiences of being involved in the interprofessional team of healthcare students at a clinical training ward in Sweden. A descriptive design with a qualitative approach was used. Data were collected through semi-structured individual interviews with 22 patients. Braun and Clarke’s reflexive thematic analysis was used. The main finding was that patients were only included as passive participants. Although most patients wanted to be involved, they were hindered due to their health condition or excluded from care planning and decision-making. The patients needed family members’ support to be involved. However, this need was not recognised by the interprofessional team of healthcare students. Patient involvement must be highlighted as an important component of interprofessional education initiatives. Further research is needed to explore family members’ perspectives on involvement in interprofessional training ward settings. [ABSTRACT FROM AUTHOR]

Early discharge is a focus for many hospitals to improve patient flow. In a large acute care hospital, an interprofessional workgroup implemented a best practice initiative that increased the percentage of discharges by 11:00 a.m. for adult med- ical-surgical patients. [ABSTRACT FROM AUTHOR]

A nurse-driven mobility program using BMAT 2.0 was implemented to increase patient mobilization and reduce inpatient falls. The program was supported through use of an interprofessional team, program champions, and hands-on practice to increase safe staff use of patient handling devices. [ABSTRACT FROM AUTHOR]

Background/Objectives: Early interventions for infants at high risk of cerebral palsy (CP) are recommended, but limited evidence exists. Our objective was, therefore, to evaluate the effects of the family-centered and interprofessional Small Step early intervention program on motor development in infants at high risk of CP (ClinicalTrials.gov: NCT03264339). Methods: A single-subject research design was employed to investigate participant characteristics (motor dysfunction severity measured using the Hammersmith Infant Neurological Examination (HINE) and Alberta Infant Motor Scale (AIMS) at three months of corrected age (3mCA) related to intervention response. The repeated measures Peabody Developmental Motor Scales-2 fine and gross motor composite (PDMS2-FMC and -GMC) and Hand Assessment for Infants (HAI) were analyzed visually by cumulative line graphs, while the Gross Motor Function Measure-66 (GMFM-66) was plotted against reference percentiles for various Gross Motor Function Classification System (GMFCS) levels. Results: All infants (n = 12) received the Small Step program, and eight completed all five training steps. At two years of corrected age (2yCA), nine children were diagnosed with CP. The children with the lowest HINE < 25 and/or AIMS ≤ 6 at 3mCA (n = 4) showed minor improvements during the program and were classified at GMFCS V 2yCA. Children with HINE = 25–40 (n = 5) improved their fine motor skills during the program, and four children had larger GMFM-66 improvements than expected according to the reference curves but that did not always happen during the mobility training steps. Three children with HINE = 41–50 and AIMS > 7 showed the largest improvements and were not diagnosed with CP 2yCA. Conclusions: Our results indicate that the Small Step program contributed to the children's motor development, with better results for those with an initial higher HINE (>25). The specificity of training could not be confirmed. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) clinicians who care for seriously ill patients frequently report that they do not feel confident nor adequately prepared to manage patients' palliative care (PC) needs. With the goal, therefore, of increasing PC knowledge and skills amongst interprofessional clinicians providing CVD care, the ACC's PC Workgroup designed, developed, and implemented a comprehensive PC online educational activity. This paper describes the process and 13-month performance of this free, online activity for clinicians across disciplines and levels of training, "Palliative Care for the Cardiovascular Clinician" (PCCVC). A key component of PCCVC is that it is tailored to the lifelong learner; users can choose and receive credit for the activities that meet their individual learning needs. This webinar series was well-subscribed, and upon completion of the modules, learners reported better self-perceived abilities related to palliative care competencies. We propose PCCVC as a model for primary PC education for clinicians caring for individuals with other serious or life-shortening illnesses. [ABSTRACT FROM AUTHOR]

This dental student-led study aimed to explore the extent to which an interprofessional intervention can be incorporated within the management of Parkinson’s Disease (PD) to address the oral health needs of those living with the condition. Existing integrated or interprofessional (IP) care models lack the inclusion of oral health to improve clinical outcomes. We conducted key informant interviews with five neurologists and four dentists to ascertain their willingness, and the process needed, to facilitate collaborative referral management for patients with PD. We conducted a focus group composed of eight patients living with PD to understand their oral health needs and perspective on an integrated oral health management care team. Both neurologists and dentists were receptive IP the idea of integrating oral health into the overall management of patients, with the expectation of improved communication and collaboration. Patients commonly expressed a need for their oral health to be addressed by both neurologists and dentists. These results reveal an opportunity for an IP care model that includes oral health management in the care for patients with PD. It also provides clues on how to incorporate care for PD into a dental education curriculum. [ABSTRACT FROM AUTHOR]

The Indiana University School of Dentistry TMJ Institute is a multidisciplinary clinic designed to support the management of patients with challenging temporomandibular disorders. Professionals across dentistry, medicine, physical therapy, and social work collaborate to create a customised, interprofessional consensus to patient care. Compared with traditional, siloed healthcare models, are patients diagnosed with TMJ dysfunction satisfied with the quality of care received from an interprofessional approach? The objective of this study is to determine the level of patient satisfaction at the Institute using a 5-Point Likert scale patient questionnaire. A total of 93 questionnaires were distributed and 84 were collected. A total of 43% of patients travelled over 50 miles to be seen at the Institute. 'Strongly agree' was the most selected response for each prompt. The exception was whether patients preferred to meet with each clinician individually, to which 'strongly disagree' or 'disagree' was the most popular response, indicating that an interprofessional approach was preferred. The results and comments provided by patients revealed that most patients diagnosed with TMJ dysfunction were highly satisfied with the interprofessional approach used at the TMJ Institute. Our study suggests that positive patient satisfaction is an important factor in assessing the quality and efficacy of interprofessional, patient-centred clinic models. [ABSTRACT FROM AUTHOR]

Objective: Diabetes-related care makes up approximately 24% of outpatient clinic visits. Therefore, confidence and understanding of diabetes management is necessary for family medicine residents. Methods: We developed a combined lecture and simulation lab curriculum utilizing a registered nurse and pharmacist to deliver education to 20 family medicine learners. Pre and post surveys of the educational material were completed in 2 sections including one gauging medical knowledge and a second part gauging level of comfort. Results: Of the learners who participated, fourteen completed the pre-post surveys. Most (53%) respondents improved their scores, while 20% scored the same 27% scored worse. The overall average score increased 57% to 70% and improvement was statistically significant (P <.05). All learners improved confidence by at least 1 point. Conclusion: An interprofessional team utilizing a lecture curriculum focusing on providing education on effective prescribing, medication safety profiles, and resource availability, showed improvement in confidence but mixed knowledge benefit. Further modifications to the curriculum may yield further educational gains. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed unprecedented challenges with its impact on patient safety culture and staff well-being. This study was to identify potential changes in safety culture among health care workers from before to during the COVID-19 pandemic, and to determine the differences across occupational groups. The Safety Attitudes Questionnaire (SAQ) was administered electronically in both English and Malay languages using the Google Forms platform in 2018 and was repeated in 2021, during the COVID-19 pandemic. Comparisons were made between 2018 and 2021 to determine changes in patient safety culture for the overall staff population and by occupational groups. A total of 3175 health care workers completed the questionnaire in 2021. Overall, a comparable percentage agreement was found for all SAQ domains in 2018 and 2021 with visible improvements for doctors and support staff. Safety Attitudes Questionnaire domain scores differed in teamwork, safety climate, perception of hospital management, and working condition domains across occupational groups. Self-isolation and COVID-19 were associated with poorer SAQ domain scores, while redeployment was associated with improvements in SAQ domain scores. Interventions targeting areas of weakness as well as utilizing positive experiences such as redeployment should be explored to enhance patient safety in hospitals settings postpandemic. [ABSTRACT FROM AUTHOR]

Primary care provider and staff burnout is high, although less research exists comparing burnout by role. The objectives of this study were to characterize primary care provider and staff wellness and burnout and provide suggestions to improve wellness in a large network. Survey items included demographics, the Perceived Stress Reactivity Subscale, abbreviated Maslach Burnout Inventory, Mini-Z burnout survey, self-reported wellness, and one open-ended question asking what would improve their work-related wellness. Surveys were disseminated in February 2021, October 2021, and June 2022. Responses were analyzed by demographic categories. Open-ended responses were coded. In total 1015 responses were recorded (29.5% response rate). Burnout varied by role and campus. The 677 open-ended comments had six main themes for improving wellness: Staffing, Health System, Practice, Training, Incentives, and Miscellaneous. Primary care providers/staff reported varying, consistent levels of burnout. They suggested practice and system-level changes including increased staffing, schedule changes and improved communication. [ABSTRACT FROM AUTHOR]

Global health issues, including population health disparities, government policy, and pandemics, impact care delivery at all levels. Healthcare is interconnected in ways never seen before, and interprofessional collaboration is imperative for individual and population health and wellness. Nursing and health professions programs have a noticeable gap in global health coverage across the curriculum. Purposeful global health competency integration in healthcare programs can address this gap and prepare healthcare providers with the knowledge needed to address health disparities on a global level. This paper highlights the process developed by a nursing program to embed interprofessional global health competencies in undergraduate and graduate nursing curricula, data dashboard development to streamline competency tracking, and digital badging to showcase competency attainment. [ABSTRACT FROM AUTHOR]

Aims Design Methods Results Conclusion Implications for the Profession Impact (Addressing) Patient or Public Contribution 1. To explore the perceptions of physicians, registered nurses (RN) and allied health professionals (AHP) towards the role of ward‐based advanced practice nurse (APN). 2. To examine healthcare professionals' perception of APN role expansion in inpatient care.Cross‐sectional study.A 43‐item survey comprising of five domains was conducted on healthcare professionals' perceptions towards ward‐based APNs in five medical wards of a tertiary hospital from November 2022 to February 2023. The participants were recruited using convenience sampling via email and cross‐platform messaging service.A total of 181 completed respondents including 26 physicians, 102 nurses and 45 AHPs. Statistical analysis was performed with IBM SPSS Version 28.0. APNs were perceived to be spending a great extent of time across all five domains, namely, ‘direct comprehensive care’, ‘support of systems’, ‘research’, ‘education’ and ‘publication and professional leadership’. Significant differences were noted in perceptions based on prior experience with APNs and between different healthcare professions. The majority recognized APNs' positive impact on patient safety, efficiency and patient‐centeredness.This study offers valuable insights into ward‐based APNs' practice patterns, roles and impact, revealing a positive shift in their acceptance and expanding roles within inpatient general wards. It also highlights the valuable roles and impact of ward‐based APNs in direct patient care, system support, research, education and leadership, despite ongoing challenges in role clarity, particularly in treatment planning and ward rounds.APNs are highly regarded as competent and a consistent personnel in the wards. However, there are divided views on clinical activities that APNs undertake. What problem did the study address? ○Role ambiguity for ward‐based APNs. ○Healthcare professionals' readiness and acceptance of APNs. What were the main findings? ○APNs are perceived to have a strong involvement in direct patient care, support of system, research, education and leadership. ○APNs are recognized for their significant impact on patient safety, efficiency and patient‐centredness, but there were varied perceptions on the extent of time they spend in different practice domains. ○The critical roles of APNs participating in daily ward rounds and initiating discharge plans were highlighted, emphasizing their importance in timeliness and continuity of care. Where and on whom will the research have an impact? ○It will affect healthcare professionals including physicians, nurses, allied health professionals and healthcare administrators by providing insights into the roles and contributions of ward‐based APNs. ○The findings will guide policymakers and nurse leaders in making informed decisions about the implementation and development of APN roles, ultimately improving patient care and outcomes. What problem did the study address? ○Role ambiguity for ward‐based APNs. ○Healthcare professionals' readiness and acceptance of APNs. Role ambiguity for ward‐based APNs.Healthcare professionals' readiness and acceptance of APNs.What were the main findings? ○APNs are perceived to have a strong involvement in direct patient care, support of system, research, education and leadership. ○APNs are recognized for their significant impact on patient safety, efficiency and patient‐centredness, but there were varied perceptions on the extent of time they spend in different practice domains. ○The critical roles of APNs participating in daily ward rounds and initiating discharge plans were highlighted, emphasizing their importance in timeliness and continuity of care. APNs are perceived to have a strong involvement in direct patient care, support of system, research, education and leadership.APNs are recognized for their significant impact on patient safety, efficiency and patient‐centredness, but there were varied perceptions on the extent of time they spend in different practice domains.The critical roles of APNs participating in daily ward rounds and initiating discharge plans were highlighted, emphasizing their importance in timeliness and continuity of care.Where and on whom will the research have an impact? ○It will affect healthcare professionals including physicians, nurses, allied health professionals and healthcare administrators by providing insights into the roles and contributions of ward‐based APNs. ○The findings will guide policymakers and nurse leaders in making informed decisions about the implementation and development of APN roles, ultimately improving patient care and outcomes. It will affect healthcare professionals including physicians, nurses, allied health professionals and healthcare administrators by providing insights into the roles and contributions of ward‐based APNs.The findings will guide policymakers and nurse leaders in making informed decisions about the implementation and development of APN roles, ultimately improving patient care and outcomes.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: In Canada, primary care reforms led to the implementation of various team-based care models to improve access and provide more comprehensive care for patients. Despite these advances, ongoing challenges remain. The aim of this scoping review is to explore current understanding of the functioning of these care models as well as the contexts in which they have emerged and their impact on the population, providers and healthcare costs. Methods: The Medline and CINAHL databases were consulted. To be included, team-based care models had to be co-located, involve a family physician, specify the other professionals included, and provide information about their organization, their relevance and their impact within a primary care context. Models based on inter-professional intervention programs were excluded. The organization and coordination of services, the emerging contexts and the impact on the population, providers and healthcare costs were analysed. Results: A total of 5952 studies were screened after removing duplicates; 15 articles were selected for final analysis. There was considerable variation in the information available as well as the terms used to describe the models. They are operationalized in various ways, generally consistent with the Patient's Medical Home vision. Except for nurses, the inclusion of other types of professionals is variable and tends to be associated with the specific nature of the services offered. The models primarily focus on individuals with mental health conditions and chronic diseases. They appear to generally satisfy the expectations of the overarching framework of a high-performing team-based primary care model at patient and provider levels. However, economic factors are seldom integrated in their evaluations. Conclusions: The studies rarely provide an overarching view that permits an understanding of the specific contexts, service organization, their impacts, and the broader context of implementation, making it difficult to establish universal guidelines for the operationalization of effective models. Negotiating the inherent complexity associated with implementing models requires a collaborative approach between various stakeholders, including patients, to tailor the models to the specific needs and characteristics of populations in given areas, and reflection about the professionals to be included in delivering these services. [ABSTRACT FROM AUTHOR]

Participation is widely recognized as an important health determinant for older adults. Exploring interventions to promote active participation of community-dwelling older adults is an important step in translating current knowledge into practice. Few studies have examined community-level interventions to support older adults' participation. The study purpose was to examine the significance of the lived experiences of community-dwelling older adults who participated in an interprofessional healthy aging promotion program. The specific aims were to uncover the narrative significance of the lived experiences and how they evolved and intertwined with the life histories of the older adults 2 years after the intervention ended. A narrative inquiry design was used. Four key informants participated in two semi-structured interviews and a member-checking process. The data were analyzed from a three-dimensional inquiry space of time and continuity, place and context, and social interactions. The findings affirmed three core threads that wove the participants' lived experiences within the program together with their life histories after the intervention. These were enjoyment, learning, and sharing. Four themes revealed the essential elements of the lived experience, and three others exposed participants' growth and life enrichment, all being fundamental to participation. The 3-year community-level intervention was valued and a novel opportunity for facilitating participation and successful aging. It allowed the participants to acquire an evolved vision of self, have meaningful interactions, develop the means to engage in future community activities, implement new self-care strategies, and establish memories and friendships significant for life participation. [ABSTRACT FROM AUTHOR]

Background: A growing number of older adults live in senior affordable housing, many with limited support systems and representing underserved or disadvantaged populations. Staff in these buildings are in a unique position to identify and address the healthcare and biopsychosocial needs of their residents and link them to services and supports. Methods: Staff in four affordable housing sites received training on the 4Ms approach to caring for older adults and conducting resident health assessments. They learned to collect comprehensive health information using a 4Ms Resident Health Risk Assessment (4Ms‐RHRA) and results are entered into a customized electronic database. Embedded flags identify potential risk factors and initiate a follow‐up process for documenting interventions and tracking referrals to healthcare and supportive services. Results: Eighty‐one percent of the 221 4Ms‐RHRAs completed with residents (63% female, mean age 71.1 years, 73% live alone) were flagged for at least one concern (Mean = 2.2 flags). Items addressing What Matters were most frequently flagged: resident's "most important health issue" (55%) and Advance Care Planning (ACP: 48%). In response, staff provided Advance Directive forms and Five Wishes pamphlets to interested residents and reminded residents to review ACP documents annually. Conclusion: Training affordable housing staff, precepting faculty, and students to conduct health assessments based on the 4Ms framework and longitudinally track interventions related to resident‐centered needs and manage long‐term service and supports is a first step in creating an interprofessional workforce capable of addressing the complex needs of older individuals in affordable housing. [ABSTRACT FROM AUTHOR]

Background: The Updated 2022 Centers for Disease Control (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain highlights the importance of shared decision making and provider-patient relationships. Interprofessional teams may be helpful in supporting providers and patients. A large, multi-site primary care department created an interprofessional primary care opioid stewardship team to target high-risk opioid prescribing and improve practice alignment with CDC recommendations through dashboard reporting and education. Objective: The primary objective was to assess reduction in morphine milligram equivalents (MME) from baseline to 6 months in patients on opioid doses ≥90 MME daily. The secondary objective assessed change in number of naloxone prescriptions from baseline to 6 months after education. Methods: The study was conducted across 30 primary care sites of one health system within Michigan from 2021 to 2022. The opioid stewardship team included 2 physicians, 3 pharmacists, a project operations manager, and IT support. Interventions included creation of a dashboard, provider education, dissemination of policy, and chart audits. Using the electronic health record (EHR) dashboard, patients on chronic opioid doses ≥90 MME daily or missing an active naloxone prescription were identified. Primary care providers (PCP) were provided with an individual list of patients for whom to consider intervention. Support was provided for prescribers, but the team did not interact with patients directly. Results: Baseline analysis identified 290 patients on doses ≥ 90 MME daily. There was reduction in median daily MME from baseline to 6 months in the overall study population (140 [105 240] vs 120 [90 240], P <.001). At 6 months 181 (62.4%) of patients had been given a prescription for naloxone versus 108 (37.2%) who had one at baseline, P <.001. Conclusion: The initiatives implemented by the opioid stewardship team resulted in statistically significant reductions in MME and an increase in naloxone prescribing from baseline to 6 months post-education. [ABSTRACT FROM AUTHOR]

Student-athlete well-being is a key objective for individuals working with or for university athletic departments. This paper will describe how a university athletic department used a team approach to enhancing student-athlete health and well-being. The Interprofessional Education Collaborative (IPEC) Core Competencies of (1) Values and Ethics; (2) Roles and Responsibilities; (3) Communication; and (4) Teams and Teamwork provide a guiding framework for interprofessional collaboration. (IPC; Interprofessional Education Collaborative, 2023). However, significant barriers exist in implementing IPC in university athletic departments and little research exists on how to overcome these barriers in university athletic departments to enhance student-athlete wellness. To address this gap, this paper will first provide a review of the literature on athlete well-being, followed by an applied section that describes the experience of an interprofessional wellness team (IWT) consisting of a clinical sports psychology doctoral student, a licensed mental health professional, an athletic trainer, and a sports dietitian. A case vignette is used to demonstrate how IPEC core competencies are operationalized by the team to address athlete health and well-being through IPC. Recommendations on the further implementation of IPC centered around student-athlete well-being will be provided. [ABSTRACT FROM AUTHOR]

Clinicians are increasingly required to work and learn interprofessionally, yet few studies explore the nature of being interprofessional. The purpose of this study was to explore the lived experience of clinicians who identify as interprofessional or have an interprofessional identity. Interpretive phenomenological analysis (IPA) was applied as a qualitative research approach and analytical method. Fifteen key informants from a range of professions, settings, and roles were recruited via purposive sampling. Data was collected via semi-structured interviews, observation of participants’ day-to-day practice, and review of organizational documents, and analyzed using IPA. Six interdependent Group Experiential Themes were developed: (i) The power of person-centered holistic care, (ii) Learning and growth through curiosity, reflection, and willingness to be vulnerable, (iii) Welcomes, values, and empowers all others, (iv) Trust and mutual respect through belonging and connection, (v) The contribution of background and previous experiences, and (vi) The influence of workplace context. Each Group Experiential Theme had between two and nine sub-themes. Results support the value of understanding and making explicit the concepts that comprise clinician interprofessional identity. The findings can be used to support clinicians, educators, leaders, and policy makers to develop and sustain interprofessional identity, and subsequently cultivate a culture of interprofessional collaborative practice. Future research is needed to further explore the themes, investigate their inter-relationships, and present the concepts that comprise clinician interprofessional identity in a way that is accessible to healthcare professionals and facilitates their integration into practice. [ABSTRACT FROM AUTHOR]

Mental health and substance use are growing nationwide public health concerns being exacerbated by the COVID-19 pandemic. At the same time, there is a dire shortage in the public health workforce. This paper shares the design and mixed-method outcome evaluation of a Behavioral Health Workforce Education and Training (BHWET)-funded rural, interprofessional, behavioral health training program (RIBHS) delivered during COVID-19 at one southeastern US public university. Twenty-six advanced year MSW students completed the RIBHS program. Data were collected from trainees via pre/post surveys and two focus groups. Trainees' self-reported statistically significant increases in teamwork, behavioral health, and rural practice competencies. Trainees also described how COVID-19 shaped their experience in the RIBHS program. The RIBHS program prepared trainees with the competencies needed to address the growing behavioral health crisis in the US and can serve as a training model for other social work and related public health workforce initiatives. [ABSTRACT FROM AUTHOR]

In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions. [ABSTRACT FROM AUTHOR]

Military unit cohesion has been associated with team performance, combat motivation, and positive mental health outcomes. Scholarship of military cohesion has been dominated by the Standard Model of Cohesion and the Task Cohesion Approach. Recent shifts in the character of conflict alongside a range of sociopolitical changes require these models to be reevaluated. This article aims to empirically compare these models using a deductive exploratory approach to assess their utility for present-day military formations. Seven construct variables were operationalized as deductive themes, coded against 26 focus groups with personnel from three military formations. Thematic analysis was supplemented by graph modeling, allowing to visualize interactions of constructs. Findings show that military formations develop cohesion in different ways. Teams low in occupational similarity emphasized leadership and shared experiences, while those with high levels emphasized professional competence. This novel approach provided a powerful tool to analyze, visualize, and model qualitative data about cohesion. [ABSTRACT FROM AUTHOR]

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Learning and working together towards better health outcomes today have become more complex requiring an investigation on how interprofessional education (IPE) and interprofessional collaboration (IPC) practices could be sustained and further developed. Through a sociomaterial perspective, we can better understand IPE and IPC practices by foregrounding the material aspect of learning and working together and examining its relationship with humans and their interactions. This article aimed to examine existing literature that discusses the application of sociomaterial perspectives in IPE and IPC. A scoping review was conducted following Arksey and O'Malley's framework to explore the extent within the current body of knowledge that discuss how sociomaterial perspective is applied in IPE and IPC practices. A systematic database search was performed in September 2021 to retrieve literature published from 2007 onwards, with forty-three papers meeting the inclusion criteria. These papers included research articles, book chapters, conference papers and commentaries, with the majority originating from Europe. The thematic analysis revealed the following themes: (1) power as a sociomaterial entity shaping IPE and IPC; (2) inclusion of non-health professionals in reimagining IPE and IPC practices, and (3) the critical understanding of sociomateriality. The findings suggest that a sociomaterial perspective can allow for the reimagination of the contemporary and future practices of interprofessionalism. [ABSTRACT FROM AUTHOR]

Objectives: To systematically map the entry-level competencies of rehabilitation professions to the World Health Organization's Rehabilitation Competency Framework (RCF) to identify overlapping commonalities and gaps across available rehabilitation frameworks. Design: The competence frameworks of audiology, occupational therapy, physical and rehabilitation medicine, psychology, physiotherapy, prosthetics and orthotics, rehabilitation nursing, and speech and language therapy were researched online. In cases where international standards or competencies were unavailable online, expert colleagues in the related field were consulted to confirm the absence of an international document. A nationally recognized and freely available document was selected to represent the profession if no international document was found. The frameworks were then mapped to the RCF domains. Setting: Desk-based research. Participants: Not applicable. Interventions: Not applicable. Main Outcome Measures: Not applicable. Results: The professional documents demonstrated a stronger alignment with the competencies outlined in the RCF activities. The practice and professionalism domains showed the greatest congruence with profession-specific competencies, whereas the learning and development, management and leadership, and research domains had varying levels of alignment. This consistency in mapping may be attributed to the profession-specific competencies’ focus on the fundamental entry-level knowledge, skills, values, and abilities essential for delivering safe and effective patient care. Conclusions: The mapping exercise revealed that competencies in the profession-specific frameworks primarily focused on individual-level skills for effective patient care rather than societal-level impact, such as acting as rehabilitation advocates. The study provides valuable insights into the alignment between profession-specific competencies among the rehabilitation professions. Identifying commonalities and gaps can facilitate the development of shared educational resources for foundational support across diverse rehabilitation disciplines. This effort can contribute to building a robust and unified rehabilitation workforce capable of meeting the emerging health needs of diverse populations worldwide.

Reflective practice is an important cornerstone of continuing professional development for healthcare practitioners in primary care. Following workshops on communication, conflict resolution, teamwork, and leadership, this study analyzed written reflections that used Gibbs Reflective Cycle from 501 healthcare practitioners. We first analyzed the level of these reflections using Bradley’s 3 levels of reflection, then conducted content-thematic analysis of reflections on the four workshops topics. Key findings highlighted that most reflections were at level 2, followed by level 3 and the least were at level 1. Moreover, the highest number of reflections was on communication, when three themes were identified: communication issues with a team member, language barriers with patient/family, and problematic verbal communication from patient/family. Teamwork was the second in terms of number of reflections and it also revealed three themes: effective teamwork to accomplish an institutional mission, teamwork in the workshop itself and hierarchy. Less reflections were on leadership and conflict resolution. We argue that reflective writing enables health professionals and leadership to identify challenges and facilitators for effective communication, teamwork, leadership, and conflict resolutions.

Objective: Palliative care communication skills help tailor care to patients' goals. With a palliative care physician shortage, non-physicians must gain these serious illness communication skills. Historically, trainings have targeted physician-only groups; our goal was to train interprofessional teams. Methods: Workshops were conducted to teach palliative care communication skills and interprofessional communication. Participants completed surveys which included questions from the Interpersonal Reactivity Index, the Ekman Faces tool, the Consultation and Relational Empathy measure, open-ended questions about empathy, and measures of effective interprofessional practice. Results: Participants felt the workshop improved their ability to listen (p

Objective: To assess the effectiveness and costs of intensive stroke rehabilitation and improvements in patient pathway in the city of Lahti and in Päijät-Häme region compared with other parts in Finland. Design: Retrospective benchmarking controlled trial. Patients: Three cohorts of Finnish community-dwelling patients (n = 94,749, n = 4,184, and n = 105,458) with ischaemic stroke between 2001 and 2019. Methods: This study is based on the PERFECT 2001–2019 database of ischaemic stroke patients. PERFECT indicators describe how the stroke patients recover. The difference-in-difference method was used in the main analysis. Results: Improved stroke rehabilitation in Lahti increased the share of patients discharged home (p = 0.005) and decreased the length of first institutional episode (–4 days, p = 0.006), the share of patients institutionalized (–5.1%, p = 0.001), and the costs of first institutional episode (€–2,085, p