Background:Depictions of eye images and messages encouraging compliance with social norms have successfully motivated behavioral change in a variety of experimental and applied settings. We studied the effect of these 2 visual cues on hand hygiene adherence in a cohort of hospital-based healthcare providers participating in an electronic monitoring and feedback program.Methods:Prospective, quasi-experimental study utilizing an interrupted time-series design. Intervention placards depicting an image of eyes, a social norms message, or a control placard were placed near soap and alcohol-based hand-rub dispensers on 2 hospital units. Placards were alternated every 10 days. Hand hygiene opportunities and adherence rates were assessed electronically via the CenTrak Hand Hygiene Compliance Solution.Results:A total of 166 nurses and certified nursing assistants (74 on a medical-surgical unit and 92 on a progressive care unit) were monitored electronically over the 4-month study period. In total, 184,172 electronic observations were collected (110,903 on a medical-surgical unit and 73,269 on a progressive care unit). The median daily number of electronic observations was 1,471 (interquartile range, 1,337–1,584). The preintervention baseline hand hygiene adherence rate was 70%. No statistically significant increase in hand hygiene adherence was observed as a result of either intervention.Conclusion:Displaying eye images or a social norms message in the hospital environment did not result in measurable improvements in HH adherence in a cohort of healthcare providers participating in an electronic monitoring and feedback program.
Purpose -This paper seeks to develop a self-report instrument completed by team members, the Integral Team Effectiveness Measure (ITEM), in order to assess team strengths and weaknesses based on a review of research and models of effective teams. The ability of the instrument, based on an "integral" or holistic framework, to capture a latent factor relevant to team success is tested. Based on two studies, support for the construct and predictive validity of the ITEM measure is provided. Design/methodology/approach -Psychometric evaluation of a survey instrument is described. A quasi-experiment to see whether an objective measure of team performance can be predicted from the instrument and multi-level modelling was also incorporated. Findings -Although there are many elements necessary for good teamwork, there is nevertheless an underlying common theme. This underlying theme or construct of integral team effectiveness can be measured with a self-report instrument, which successfully predicted subsequent team performance in a sample of 45 teams. Practical implications -The Integral Team Effectiveness Measure (ITEM) is an instrument that captures an important underlying quality of teams. Organisations relying on teams may benefit from using the ITEM to diagnose weaknesses and to design corrective interventions. Originality/value -Although many previous studies have described variables which impact team performance, integral team effectiveness is an original contribution in that it describes and measures an underlying essence of teamwork. Managers and team members may find integral team effectiveness valuable for overcoming the apparent complexities and contradictions that confound sincere efforts to improve team performance.
Introduction: Mounting evidence indicates that early life trauma is highly prevalent and associated with adverse health outcomes later in life. However, primary care providers report lacking the training to effectively address trauma encountered in daily practice. There is a paucity of research describing the implementation and evaluation of trauma-informed care (TIC) curricula within Graduate Medical Education.Methods: We piloted a three-hour TIC workshop facilitated by a community-based psychologist expert to assess the feasibility and impact of TIC training on Internal Medicine (IM) residents' knowledge, attitudes and skills related to TIC. Participants were a subset of IM residents in a health-equity-focused curricular pathway in the University of Colorado IM Residency. Residents completed anonymous surveys one week before and after the workshop, and a final survey 10 weeks later. Residents who did not participate in the workshop completed a similar baseline survey (control group). Data were analyzed using matched pair Ttests.Results: Fourteen of 20 residents (70%) who participated in the pilot workshop completed the initial survey. Of these, 10 (71%) completed the first post-workshop survey, and seven (50%) completed the final survey. We observed significant improvements in residents' self-reported knowledge, attitudes and skills related to TIC. The majority of residents in the control group reported a desire for TIC training.Conclusions: TIC is an important curricular gap in IM training. A single, brief TIC workshop was feasible and was associated with improved self-reported knowledge, attitudes and skills among IM residents.
The adoption of new vehicle technologies such as electric vehicles and fuel cell electric vehicles has put more pressure on gasoline vehicles to become more efficient and eco-friendly. Many future buyers find themselves in a grey area and may be unsure what drivetrain saves them the most over the long run. In this paper, we will unveil the total cost of ownership (TCO) for several mid-size sedan cars including conventional gasoline-powered cars, and electric vehicles (xEV) with an autobody that is made from lightweight materials (steel, AHSS, aluminum, magnesium, GFRP, and CFRP). The developed TCO model in this study helps unveil the cost associated with owning lightweight vehicles with different drivetrains using unbiased analysis of the vehicle’s total life from cradle to grave and fuel lifecycle from well to wheel. From the TCO perspective, hybrid electric vehicles seem to be the most competitive drivetrain if we use the U.S. national average numbers. TCO results vary in each state depending on the source of the electricity, the social cost of carbon, and the average driven mile in that state. Comparison between different lightweight materials shows that vehicles made from AHSS can easily break even with vehicles made from conventional dual-phase steel. Saved weight will reduce energy consumption in the vehicles’ use phase and reduce amounts of GHG emissions, without a noticeable increase in maintenance and insurance costs. However, other lightweight materials seem far from being able to breakeven with conventional dual-phase steel unless we can see higher prices of gasoline and electricity.
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