Hemodynamic team decision making in the cardiac surgical intensive care context

Purpose
The purpose of this study was to explore the extent and sources of variability of critical care nurses’ hemodynamic decision making as a function of contextual factors in the immediate 2-hour period after cardiac surgery.

Methods
A qualitative exploratory design with observation and interview was used. Eight critical care nurses were observed on different occasions in clinical practice for a 2-hour period. A brief interview immediately followed each observation to clarify observation data.

Findings
Analysis of the data revealed that patient management decisions were made both by individual nurses and by a team of nurses and health professionals. Team decision making (TDM) is described in this study as integrated or non-integrated and refers to an intra-professional nursing team. During displays of integrated TDM, the primary nurse, who was assigned to care for the patient, made most hemodynamic decisions and nurses who assisted the primary nurse deferred decisions. During displays of non-integrated TDM, nurses assisting the primary nurse assumed responsibilities for most patient-related decisions. Non-integrated TDM occurred more frequently when inexperienced cardiac surgical intensive care nurses were in the role of primary nurse, whereas integrated TDM was more common among experienced cardiac surgical intensive care nurses.

Conclusions
This observed variability can occur in multiple ways and in hemodynamic decision making has implications for patient outcomes as behaviors of non-integrated TDM led to nurses sensing a loss of control of patient management.

The trials and tribulations of team-nursing

Aim: The aim of this study was to review the team-nursing approach to care adopted by two general medical wards in a large private hospital. The delivery model of care was reviewed to determine the factors that enhance and/or hinder the timely delivery, continuity and communication of care.
Method: All nursing and ancillary staff who worked on two medical wards at a private teaching hospital were invited to participate in the study. Thirty eight participants from the two wards took part in focus group discussions, individual interviews and completed the Staff Continuity of Care Questionnaire. Findings: Findings indicated that achieving functionally sound teamwork is a complex task that is affected by the interplay of a number of organisational, patient and staff factors. Its smooth application is further affected by the uncertain and changing conditions on the wards, which are difficult to control and impact on the smooth delivery of patient care. The findings revealed strengths and weaknesses in teamwork, communication of care, documentation and discharge planning. The results also highlighted factors that enhance and hinder the smooth delivery of care. This paper details the factors that influence the delivery of care from the perspectives of nursing staff and makes recommendations to enhance the delivery of patient care using a team-nursing approach.

Development of a model of the antecedents and consequences of an inclusivie team climate

Exclusion due to the tendency of people to form subgroups based on perceived interpersonal similarities and dissimilarities still prevents many individuals and teams from reaching their full potential. Using research from the social psychology and organisational behaviour literature we examine the relationship between perceived dissimilarity, subgroup formation and team climate and individual team member's responses to the team and propose a model of the antecedents and consequences of individual team members propensity to perceive dissimilarity and an inclusive team climate.

Team teaching in teacher education: towards an interdisciplinary approach

‘Team teaching’ across disciplines at Australian universities is rare. Academics are rigorous in developing specific disciplinary expertise that often prevents collaboration outside of their disciplinary area. In pre-service primary education courses, academics often teach in traditional and exclusive disciplinary approaches. This separation is at odds however with the impetus for a pedagogical move forward towards an interdisciplinary approach in primary schools. The authors contend that primary
teacher educators must model effective interdisciplinary practice to their student teachers and unpack the processes of how to make meaningful connections together. This paper presents the work of two teacher educators who are involved in a broader, innovative, team teaching, field based collaboration with schools and non-school settings for the Bachelor of Teaching (Postgraduate) at Deakin University. In this paper, the authors firstly discuss their rationale for adopting a team teaching approach and describe how they are working towards an interdisciplinary model, bringing together the two areas; music and literacy and providing examples from their team teaching experience. The paper concludes with reflections and recommendations for future team teaching at the tertiary level.

Leveraging the Commonwealth Games in Melbourne for community engagement: an examination of Equal First and the Adopt-a-Second-Team program

Event leverage provides information about what outcomes occur as a result of an event. Unlike event impact studies, event leverage analysis identifies why particular outcomes occurred, and the processes that can be used to optimise desired event outcomes. While research has been directed towards understanding how events can be leveraged to provide optimal economic outcomes for host communities, there is little research that examines social leverage within the context of events. The research presented in this paper is part of a larger study that investigated social leverage within the context of the 2006 Commonwealth Games, held in Melbourne, Australia. This paper presents preliminary results relating to two Victorian regions with regard to one the over-arching social policy, Equal First, and a subsidiary program called, Adopt-a-Second-Team. Participant observations and stakeholder interviews were employed to explore the development, operationalisation, implementation and outcomes of Equal First and Adopt-a-Second-Team. The results suggest that although each region achieved outcomes that were consistent with the directions of Equal First, each implemented the Adopt-a-Second-Team differently. The two case studies presented in this paper highlight that the model of implementation developed by the City of Port Phillip may provide a benchmark in social leverage of events. Implications for leveraging social impacts and managing social legacies of events through an approach that includes consideration of policy development and operationalisation from the event organising body and program implementation from the perspective of local community event organisers are discussed.

Tapping global human resources in an MBA teaching team : insights with implications for management education worldwide

It is found that geographic diversity, respect for differing beliefs, encouraging feedback, active participation and interaction with the students, and techniques such as active listening, contribute an architecture and atmosphere to student learning, teacher effectiveness and program excellence in virtual education. One functioning teaching team in University of Maryland University College’s online MBA program provides the action research foundation underpinning the findings. A widely dispersed team of academics and assistants have documented the ways they enhance educational information for students in the program. Assessment activities, supplementary communications and biographical information contribute to student perception of the quality of management education in the program. Mechanisms for effectively tapping a global faculty team are discussed and are informative for administrators and academics alike.

Investigating the influences on attendance and intention to rejoin with inaugural members of a new football team

This study investigated the effects of factors like member satisfaction and social rituals on desirable outcomes such as attendance, intention to rejoin and merchandise sales. This study focuses on the inaugural members of a new team in Australia’s A-League to gain insight into how loyalty develops amongst fans of new sporting organisations. The results show the importance to sports marketers of satisfying members and building ritual behaviour, as both are correlated with all of the positive outcomes investigated here.

Video reflection and the formation of teacher identity in a team of pre-service and experienced teachers

This paper discusses a project in which a team of pre-service and experienced teachers, following a teaching development model devised by the authors, reflected on videos of the pre-service teachers teaching literacy. Using a discourse analytic approach, the paper focuses on how teachers' joint reflection contributes to student teacher identity formation. Analysis suggests that reflection, at least in the talk of this team, is a language practice with a distinctive generic structure. Using this structure, participants jointly construct professional teacher identities for themselves and others through the key devices of representation, categorization, evaluation, individualization and inclusion.

Team-based strategy at Varian Australia : a case study

This article discusses the use of work teams at Varian Australia, a manufacturing organisation based in Melbourne, Australia. The company manufactures high-technology instruments that are largely exported to the USA and Europe. The paper describes the experiences of the company with continuous improvement process teams (CIP) and corrective action team (CATs) over a decade, from 1990 to 2000. The article discusses the reasons for the slow down of the process improvement program and the appropriate changes that were made to relaunch the continuous improvement strategy at Varian Australia. Based on the qualitative analysis in this article, a number of interesting lessons can be learned. The main lesson is that voluntary, cross-functional teams are more effective than compulsory membership, as team members are motivated to work towards their goals and better understand the processes. Team members found that by working together the result of their combined effort was much greater than the combined results of their individual efforts. This approach reduced the product development cycle on Varian projects by up to 50%.

Bushfire incident management team decision making

Large scale bushfire (or wildfire) suppression activities are conducted under the control of an Incident Management Team (IMT) comprising four major functions: Command, Operations, Planning, and Logistics. Four methodologies were used to investigate processes determining the effectiveness of IMT decision making activities: (a) laboratory experiments using the Networked Fire Chief computer simulation program; (b) analyses of reports of significant fires; (c) structured interviews with experienced IMT staff; and, (d) cognitive ethnographic studies of IMTs. Three classes of team processes were found to be important determinants of IMT effectiveness: information sharing and management; matching of the four component function goals to overall IMT goals; and monitoring of the overall IMT situation to detect and correct task disruptive processes. Several non-rational processes with the potential for hindering IMT effectiveness were noted. Team metacognition emerged as a key process for understanding effective IMT decision making.

Exploring the cultural and social impacts on the requirements engineering processes-highlighting some problems challenging virtual team relationships with clients

Abstract:

Requirements engineering is a crucial phase in software development. Software development in a virtual domain adds another dimension to the process of requirements engineering. There has been growing interest in virtual teams, and more specifically in virtual software development. While structured software development methods are the obvious first choice for project managers to ensure a virtual software development team remains on track, the social and cultural aspects of requirements engineering cannot be ignored. These social aspects are especially important across different cultures, and have been shown to affect the success of an information system. The discussion in this paper is centred around the requirements engineering processes of a virtual team in a Thai Software House. This paper explains the issues and challenges of requirements engineering in a virtual domain from a social and cultural perspective. Project managers need to encourage a balance between structured methods and social aspects in requirements engineering for virtual team members. Cultural and social aspects influence the relationship between the virtual team and the client.