2024-07-15, Dubois, Hanna, Manser, Tanja, Häbel, Henrike, Härgestam, Maria, Creutzfeldt, Johan

Abstract Background In northern rural Sweden, telemedicine is used to improve access to healthcare and to provide patient-centered care. In emergency care during on-call hours, video-conference systems are used to connect the physicians to the rest of the team – creating ‘distributed teams’. Patient participation is a core competency for healthcare professionals. Knowledge about how distributed teamwork affects patient participation is missing. The aim was to investigate if and how teamwork affecting patient participation, as well as clinicians’ perceptions regarding shared decision-making differ between co-located and distributed emergency teams. Methods In an observational study with a randomized cross-over design, healthcare professionals (n = 51) participated in authentic teams (n = 17) in two scripted simulated emergency scenarios with a standardized patient: one as a co-located team and the other as a distributed team. Team performances were filmed and observed by independent raters using the PIC-ET tool to rate patient participation behavior. The participants individually filled out the Dyadic OPTION questionnaire after the respective scenarios to measure perceptions of shared decision-making. Scores in both instruments were translated to percentage of a maximum score. The observational data between the two settings were compared using linear mixed-effects regression models and the self-reported questionnaire data were compared using one-way ANOVA. Neither the participants nor the observers were blinded to the allocations. Results A significant difference in observer rated overall patient participation behavior was found, mean 51.1 (± 11.5) % for the co-located teams vs 44.7 (± 8.6) % for the distributed teams (p = 0.02). In the PIC-ET tool category ‘Sharing power’, the scores decreased from 14.4 (± 12.4) % in the co-located teams to 2 (± 4.4) % in the distributed teams (p = 0.001). Co-located teams scored in mean 60.5% (± 14.4) when self-assessing shared decision-making, vs 55.8% (± 15.1) in the distributed teams (p = 0.03). Conclusions Team behavior enabling patient participation was found decreased in distributed teams, especially regarding sharing power with the patient. This finding was also mirrored in the self-assessments of the healthcare professionals. This study highlights the risk of an increased power asymmetry between patients and distributed emergency teams and can serve as a basis for further research, education, and quality improvement.

2023-10, Wespi, Rafael, Birrenbach, Tanja, Schauber, Stefan K., Manser, Tanja, Sauter, Thomas C., Kämmer, Juliane E.

2018, Clack, Lauren, Passerini, Siomone, Sax, Hugo, Manser, Tanja

2013-02-21T00:00:00Z, Briner, Matthias, Kessler, Oliver, Pfeiffer, Yvonne, Wehner, Theo, Manser, Tanja

2024-06-19, Brogaard, Lise, Manser, Tanja

2023-05-01, Tanner, Alexandra, Urech, Andreas, Schulze, Hartmut, Manser, Tanja

Promoting the well-being of older adults in an aging society requires new solutions. One resource might be the use of social robots for group activities that promote physical and cognitive stimulation. Engaging in a robot-assisted group activity may help in the slowdown of physical and cognitive decline in older adults. Currently, our knowledge is limited on whether older adults engage in group activities with humanlike social robots and whether they experience a positive affect while doing so. Both are necessary preconditions to achieve the intended effects of a group activity. Our pilot study has 2 aims. First, we aimed to develop and pilot an observational coding scheme for robot-assisted group activities because self-report data on engagement and mood of nursing home residents are often difficult to obtain, and the existing observation instruments do have limitations. Second, we aimed to investigate older adults’ engagement and mood during robot-assisted group activities in 4 different nursing care homes in the German-speaking part of Switzerland. We developed an observation system, inspired by existing tools, for a structured observation of engagement and mood of older adults during a robot-assisted group activity. In this study, 85 older adult residents from 4 different care homes in Switzerland participated in 5 robot-assisted group activity sessions, and they were observed using our developed system. The data were collected in the form of video clips that were assessed by 2 raters regarding engagement (direction of gaze, posture as well as body expression, and activity) and mood (positive and negative affects). Both variables were rated on a 5-point rating scale. Our pilot study findings show that the engagement and mood of older adults can be assessed reliably by using the proposed observational coding scheme. Most participants actively engaged in robot-assisted group activities (mean 4.19, SD 0.47; median 4.0). The variables used to measure engagement were direction of gaze (mean 4.65, SD 0.49; median 5.0), posture and body expression (mean 4.03, SD 0.71; median 4.0), and activity (mean 3.90, SD 0.65; median 4.0). Further, we observed mainly positive affects in this group. Almost no negative affect was observed (mean 1.13, SD 0.20; median 1.0), while the positive affect (mean 3.22, SD 0.55; median 3.2) was high. The developed observational coding system can be used and further developed in future studies on robot-assisted group activities in the nursing home context and potentially in other settings. Additionally, our pilot study indicates that cognitive and physical stimulation of older adults can be promoted by social robots in a group setting. This finding encourages future technological development and improvement of social robots and points to the potential of observational research to systematically evaluate such developments.

2015, Schär, Claudia, Vollmer, Albert, Manser, Tanja, Vollmer, Albert, Dick, Michael, Wehner, Theo

2024, Brogaard, Lise, Rosvig, Lena Have, Hjorth-Hansen, Kristiane Roed, Hvidman, Lone, Hinshaw, Kim, Kierkegaard, Ole, Uldbjerg, Niels, Manser, Tanja

Introduction Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician’s technical abilities. Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions. Methods We installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams’ non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams’ clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0–59; average: 60–84; and high: 85–100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality. Results Teams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of “team interaction,” “anticipation,” “avoidance fixation,” and “focused communication.” Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71–0.88) and 0.84 for the clinical performance (95% CI: 0.74–0.90). Conclusion Although assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.

2020-10, Burtscher, Michael J., Nussbeck, Fridtjof W., Sevdalis, Nick, Gisin, Stefan, Manser, Tanja

Communication and coordination represent central processes in healthcare action teams. However, we have a limited understanding of how expertise affects these processes and to what extent these effects are shaped by interprofessional differences. The current study addresses these questions by jointly investigating the influence of different aspects of expertise – individual expertise, team familiarity, and expertise asymmetry – on coordination quality and communication openness. We tested our propositions in two hospitals: one in Switzerland (CH, Sample 1) and one in the United Kingdom (UK, Sample 2). Both samples included two-person anesthesia action teams consisting of a physician and a nurse ( NCH = 47 teams, NUK = 48 teams). We used a correlational design with two measurement points (i.e., pre- and postoperation). To consider potential interprofessional differences, we analyzed our data with actor-partner interdependence models. Moreover, we explored differences in the effects of expertise between both hospitals. Our findings suggest that nurses’ expertise is the most important predictor of coordination quality and communication openness. Overall, differences between the two hospitals were more prevalent than interprofessional differences between physicians and nurses. The current study provides a nuanced picture of the effects of expertise, and thereby extends our understanding of interprofessional teamwork.

2013-02-27T00:00:00Z, Briner, Matthias, Manser, Tanja