Getting Interdisciplinary Teams into the Field: Institutional Review Board Preapproval and Multi-Institution Authorization Agreements for Rapid Response Disaster Research.
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ABSTRACT:
SUBMITTER: Peek L
PROVIDER: S-EPMC8360063 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Effective climate mitigation requires international cooperation, and these global efforts need broad public support to be sustainable over the long run. We provide estimates of public support for different types of climate agreements in France, Germany, the United Kingdom, and the United States. Using data from a large-scale experimental survey, we explore how three key dimensions of global climate cooperation--costs and distribution, participation, and enforcement--affect individuals' willingness to support these international efforts. We find that design features have significant effects on public support. Specifically, our results indicate that support is higher for global climate agreements that involve lower costs, distribute costs according to prominent fairness principles, encompass more countries, and include a small sanction if a country fails to meet its emissions reduction targets. In contrast to well-documented baseline differences in public support for climate mitigation efforts, opinion responds similarly to changes in climate policy design in all four countries. We also find that the effects of institutional design features can bring about decisive changes in the level of public support for a global climate agreement. Moreover, the results appear consistent with the view that the sensitivity of public support to design features reflects underlying norms of reciprocity and individuals' beliefs about the potential effectiveness of specific agreements.
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Project description:BackgroundAlthough interdisciplinary hospital quality improvement (QI) teams are both prevalent and associated with success of (QI) efforts, little is known about the behaviors of successful interdisciplinary QI teams.ObjectiveWe examined the specific behaviors of interdisciplinary QI teams in hospitals that successfully redesigned care for patients with ST-elevation myocardial infarction (STEMI) and reduced door-to-balloon times.DesignQualitative study.ParticipantsResearchers interviewed 122 administrators, providers, and staff in 11 hospitals with substantial improvements in door-to-balloon times.MeasurementsUsing data from the in-depth qualitative interviews, the authors identified themes that described the behaviors of interdisciplinary QI teams in successful hospitals.ResultsTeams focused on 5 behaviors: (1) motivating involved hospital staff toward a shared goal, (2) creating opportunities for learning and problem-solving, (3) addressing the impact of changes to care processes on staff, (4) protecting the integrity of the new care processes, and (5) representing each involved clinical discipline effectively.ConclusionsThe behaviors observed may enhance a QI team's ability to motivate the various disciplines involved, understand the care process they must change, be responsive to front-line concerns while maintaining control over the improvement process, and share information across all levels of the hospital hierarchy. Teams in successful hospitals did not avoid interdisciplinary conflict, but rather allowed each discipline to contribute to the team from its own perspective. Successful QI teams addressed the concerns of each involved discipline, modified protocols guided by clinical outcomes, and became conduits of information on changes to care processes to both executive managers and front-line staff.
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Project description:BackgroundInstitutional Review Boards (IRBs) have been criticized for inconsistency, delay, and bias, suggesting an opportunity for quality improvement. To aid such quality improvement, this study aimed at determining IRB members' and investigators' priorities regarding IRB review at 10 Veterans Affairs (VA) IRBs.Methods680 anonymous internet surveys were sent to 252 IRB members and staff, and 428 principal investigators and project coordinators at 9 VA Medical Centers and the VA Central IRB. Surveys included 27 statements adapted from Koocher and Kieth-Spiegel's IRB-RAT describing IRB activities or functions (e.g., "An IRB that is open to reversing its earlier decisions"). Respondents indicated how each statement described both their "ideal" and "actual" IRBs. The difference between the ratings of the actual and ideal IRBs was calculated for each item along with estimated 95% confidence intervals. Ratings outside those intervals indicated activities or functions with relatively good or poor performance compared to the ideal IRB.Results390 (57.4%) responses from 165 IRB members and staff (65.5%) and 225 investigators and project coordinators (52.6%) demonstrated that these IRBs were closest to the ideal when protecting human subjects, treating investigators with respect, and taking appropriate action for alleged scientific misconduct. The IRBs were furthest from the ideal regarding duplicative forms, timeliness of review, and provision of complete rationales for decisions. Although IRB members reported near-ideal willingness to reverse earlier decisions, investigators rated this capacity far from ideal. Investigators rated IRB members' knowledge about procedures and policy as nearly ideal, but IRB members themselves rated this aspect far from ideal. Noteworthy site-level differences in the ratings of IRB functions and activities were also identified.ConclusionsAlthough these VA IRBs perform well in some areas, these data support the need for ongoing quality improvement. The described method of administering and analyzing the IRB-RAT may help identify and monitor site- and activity- specific initiatives for quality improvement.
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Project description:Scientific teams are increasingly diverse in discipline, international scope and demographics. Diversity has been found to be a driver of innovation but also can be a source of interpersonal friction. Drawing on a mixed-method study of 22 scientific working groups, this paper presents evidence that team diversity has a positive impact on scientific output (i.e., the number of journal papers and citations) through the mediation of the interdisciplinarity of the collaborative process, as evidenced by publishing in and citing more diverse sources. Ironically these factors also seem to be related to lower team member satisfaction and perceived effectiveness, countered by the gender balance of the team. Qualitative data suggests additional factors that facilitate collaboration, such as trust and leadership. Our findings have implications for team design and management, as team diversity seems beneficial, but the process of integration can be difficult and needs management to lead to a productive and innovative process.
| S-EPMC9707800 | biostudies-literature
Project description:OBJECTIVE:To examine how expertise redundancy and transactive memory (TM) in interdisciplinary care teams (ICTs) are related to team performance. DATA SOURCES/STUDY SETTING:Survey and administrative data were collected from 26 interdisciplinary mental health teams. STUDY DESIGN:The study used a longitudinal, observational design. Independent variables were measured at baseline, 6, and 12 months: expertise redundancy (the extent to which team members possess highly overlapping knowledge), TM accuracy (the extent to which team members accurately recognize experts in relevant knowledge domains), and TM consensus (the extent to which team members agree on who is expert in which knowledge domain). Team performance was measured as risk-adjusted average number of client hospitalization for the 6 months following each survey. DATA COLLECTION METHODS:Survey data were collected by the authors. Administrative data were collected by the state's administrative agency. PRINCIPAL FINDINGS:Expertise redundancy had a negative effect on performance. TM accuracy had a positive effect on performance, and such effect was stronger when expertise redundancy was higher. No significant effect was found on TM consensus. CONCLUSIONS:Transactive memory could serve as a cognitive coordination mechanism for mitigating the negative effect of complex knowledge structure in ICTs.
| S-EPMC6232407 | biostudies-literature
Project description:IntroductionIncentivizing the development of interdisciplinary scientific teams to address significant societal challenges usually takes the form of pilot funding. However, while pilot funding is likely necessary, it is not sufficient for successful collaborations. Interdisciplinary collaborations are enhanced when team members acquire competencies that support team success.MethodsWe evaluated the impact of a multifaceted team development intervention that included an eight-session workshop spanning two half-days. The workshop employed multiple methods for team development, including lectures on empirically supported best practices, skills-based modules, role plays, hands-on planning sessions, and social interaction within and across teams. We evaluated the impact of the intervention by (1) asking participants to assess each of the workshop sessions and (2) by completing a pre/postquestionnaire that included variables such as readiness to collaborate, goal clarity, process clarity, role ambiguity, and behavioral trust.ResultsThe content of the team development intervention was very well received, particularly the workshop session focused on psychological safety. Comparison of survey scores before and after the team development intervention indicated that scores on readiness to collaborate and behavioral trust were significantly higher among participants who attended the workshop. Goal clarity, process clarity, and role ambiguity did not differ among those who attended versus those who did not.ConclusionsMulticomponent team development interventions that focus on key competencies required for interdisciplinary teams can support attitudes and cognitions that the literature on the science of team science indicate are predictive of success. We offer recommendations for the design of future interventions.
| S-EPMC8532188 | biostudies-literature
Project description:The aim of this study was to evaluate the process of accreditation resulting in improvement of the Institutional Review Board (IRB) functioning.Randomly selected projects from years 2007 (before accreditation), 2010 (after accreditation), and 2013 (after reaccreditation) were evaluated to assess parameters, namely, submission of good clinical practices (GCPs), completeness of IRB submission form, fulfillment of quorum, documentation of the declaration of conflict of interests, and submission of the status reports. Compliance to these parameters was compared over a period of 3 years.A total of seventy projects were evaluated retrospectively. Compliance of the principal investigators regarding submission of GCP certificates increased substantially from 5% to 53.1%. Completeness of IRB forms was 80% in 2007 while it became 100% in 2010 and continued even in 2013. Fulfillment of quorum increased significantly from 35% in 2007 to 100% in 2010 and 2013 after the accreditation procedures. Out of the selected twenty projects (2007), nonfinancial conflict of interest was not declared in all three applicable projects, while of 18 projects (2010), nonfinancial conflict of interest was declared in all three applicable cases. Of 32 projects (2013), nonfinancial conflict of interest was declared in seven out of eight applicable cases. Timely submission of status reports increased from 10% in 2007 to 38.9% in 2010 and 37.5% in 2013.Accreditation plays a vital role in the improvement of IRB. The policies and procedures formulated and implemented during the process of accreditation resulted in improvement of IRB performance. Continuing training of the IRB and researchers is required to maintain the accreditation.
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Project description:This study proposes a new practical approach for tracking institutional changes in research teamwork and productivity using commonly available institutional electronic databases such as eCV and grant management systems. We tested several definitions of interdisciplinary collaborations based on number of collaborations and their fields of discipline. We demonstrated that the extent of interdisciplinary collaboration varies significantly by academic unit, faculty appointment and seniority. Interdisciplinary grants constitute 24% of all grants but the trend has significantly increased over the last five years. Departments with more interdisciplinary grants receive more research funding. More research is needed to improve efficiency of interdisciplinary collaborations.
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Project description:Background: Clinical research studies often integrate precision medicine technologies and techniques, offering novel treatment opportunities for patients but also posing significant challenges for regulatory authorities and local institutional review boards (IRBs) as they attempt to protect patient safety and privacy. Methods: We review the basics of precision medicine and discuss how IRBs are addressing new challenges associated with the era of precision medicine. Results: Precision medicine trials rely on genomic testing for inclusion criteria and investigational drug therapy choices. The vast amounts of complex information that can be obtained from basic genetic sequencing tests must be stored, analyzed, and interpreted, creating challenges for clinicians, researchers, and regulatory staff who are concerned with complex ethical, security, and legal issues surrounding patients' personal genetic data in the digital age. All members of the IRB face a rapidly changing environment. The traditional areas of primary concern, such as patient privacy, terminology, and financial benefits, have been joined by issues associated with precision medicine, such as accelerated US Food and Drug Administration drug approval, multiple informed consent form modifications, increasing length and complexity of informed consent forms, and participant genetic privacy. The challenge to the IRB is to remain focused on the prior areas of significance while also adapting the evaluation process to the novel science of precision medicine. Conclusion: In this era of exponentially increasing big data and easy-to-access genetic sequencing data, IRBs will be tasked with adapting their processes and adjusting to the new technology and its corresponding complexities. Such adaptation has always been required of IRBs, but now it will need to occur rapidly as technology and data analysis capabilities accelerate.
| S-EPMC7122257 | biostudies-literature
Project description:ObjectiveWe investigated the content and quality of communication of interservice interprofessional handover between obstetric nurses and neonatal physicians for high-risk deliveries.DesignObservational study.SettingLabour and delivery unit at a tertiary care hospital.MethodWe audio-recorded handovers between obstetric and neonatal teams (n=50) and conducted clinician interviews (n=29). A handover content framework was developed and used to qualitatively code missing core and ancillary content and their potential for adverse events.Results26 (52%) handovers missed one or more clinical content elements; a third of the handovers missed at least one core clinical content element. Increase in the number of missed clinical content elements increased the odds of potential adverse events by 2.39 (95% CI1.18 to 5.37). Both residents and nurses perceived handovers to be of low quality and inconsistent and attributed it to the lack of a structured handover process.ConclusionStreamlining handover processes by instituting standardisation approaches for both information organisation and communication can improve the quality of neonatal handovers.
| S-EPMC6542453 | biostudies-literature