Améliorer la prise en charge de l'hypertension arterielle en favorisant la collaboration avec les pharmaciens et les infirmières [Team-based care involving pharmacists and nurses to improve the management of hypertension].

Only half of hypertensive patients has controlled blood pressure. Chronic kidney disease (CKD) is also associated with low blood pressure control, 25-30% of CKD patients achieving adequate blood pressure. The Community Preventive Services Task Force has recently recommended team-based care to improve blood pressure control. Team-based care of hypertension involves facilitating coordination of care among physician, pharmacist and nurse and requires sharing clinical data, laboratory results, and medications, e.g., electronically or by fax. Based on recent studies, development and evaluation of team-based care of hypertensive patients should be done in the Swiss healthcare system.

Blood pressure monitoring through pharmacies and team-based care of hypertension.

In the last issue of Blood Pressure Monitoring, (James K, Dolan E, O'Brien E. Making ambulatory blood pressure monitoring accessible in pharmacies. Blood Press Monit 2014;19:134-139) elegantly reported for the first time the characteristics of patients attending pharmacies for ambulatory blood pressure measurement (ABPM) and showed that they were similar to those undergoing ABPM through primary care practices. The authors concluded that pharmacies could be a valuable resource to perform ABPM. In the continuity of this study, we would like to emphasize the results of recent studies as well as recommenda-tions of pharmacist involvement in the management of hypertension, more specifically in a team approach.

Modified Team-based Learning (TBL) as a tool in Problem-based learning (PBL); Observations and Lessons from Year One

Both TBL and PBL attempt to maximally engage the learner and both are designed to encourage interactive teaching / learning. PBL is student centered. TBL, in contrast, is typically instructor centered. The PBL Executive Committee of the UTHSC-Houston Medical School, in an attempt to capture the pedagogical advantages of PBL and of TBL, implemented a unique PBL experience into the ICE/PBL course during the final block of PBL instruction in year 2. PBL cases provided the content knowledge for focused learning. The subsequent, related TBL exercises fostered integration / critical thinking about each of these cases. [See PDF for complete abstract]

Creating a Web-accessible, point-of-care, team-based information system (PoinTIS): the librarian as publisher*

The Internet has created new opportunities for librarians to develop information systems that are readily accessible at the point of care. This paper describes the multiyear process used to justify, fund, design, develop, promote, and evaluate a rehabilitation prototype of a point-of-care, team-based information system (PoinTIS) and train health care providers to use this prototype for their spinal cord injury and traumatic brain injury patient care and education activities. PoinTIS is a successful model for librarians in the twenty-first century to serve as publishers of information created or used by their parent organizations and to respond to the opportunities for information dissemination provided by recent technological advances.

Finding common ground in team-based qualitative research using the convergent interviewing method

Research councils, agencies, and researchers recognize the benefits of team-based health research. However, researchers involved in large-scale team-based research projects face multiple challenges as they seek to identify epistemological and ontological common ground. Typically, these challenges occur between quantitative and qualitative researchers but can occur between qualitative researchers, particularly when the project involves multiple disciplinary perspectives. The authors use the convergent interviewing technique in their multidisciplinary research project to overcome these challenges. This technique assists them in developing common epistemological and ontological ground while enabling swift and detailed data collection and analysis. Although convergent interviewing is a relatively new method described primarily in marketing research, it compares and contrasts well with grounded theory and other techniques. The authors argue that this process provides a rigorous method to structure and refine research projects and requires researchers to identify and be accountable for developing a common epistemological and ontological position.

Building team-based working:a practical guide to organizational transformation

Building Team-based Working is designed for use by managers and consultants who are introducing team-based working into organizations. The book synthesizes knowledge about how to build team-based organizations, focusing particularly on the psychological and social processes that can facilitate or obstruct successful teamwork. Rather than advise managers on how to build effective teams, as most books in this area tend to do, this book instead focuses on how to build organizations structured around teams. The text is divided into six sections describing the six main stages of developing team-based working in an organization. The chapters follow a common structure. Each one opens with a summary of the aims and activities relevant to that stage and concludes with a selection of appropriate support materials and tools. These materials can also be downloaded from the CD accompanying the text. The advice given is based on evidence gathered by the authors over 20 years of practical management experience, research work in organizations, and consultancy across the public, manufacturing and service sectors.

Do stressful times call for team-based working? A study of psychiatric nurses in UK mental healthcase

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Team-based working and employee well being:a cross-cultural comparison of United Kingdom and Hong Kong health services

This study examined the impact of team-based working, team structure, and job design on employee well-being (in term of job satisfaction and work stress) in staff working in healthcare organizations in Hong Kong. Cross-cultural differences in the impact of job design, team structure, and employee well-being outcomes between United Kingdom and Hong Kong were also investigated. A group of 197 staff from two Hong Kong hospitals were compared to a sample of 270 UK staff working in National Health Service organizations in the UK. Results showed that team structure and job design were significantly associated with greater employee satisfaction and lower stress for Hong Kong healthcare staff. Culture was also found to moderate the impact of team structure and job design on employee well-being. The findings suggest that although team structure and job design contribute to employee well-being, they have differential impacts across cultures. This provides insights to policy planning on building team-based organizations in the healthcare sector involving multinational collaboration.