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Background Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants’ views on the meeting function, including perceived benefits and barriers. Methods In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation. Results The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports. Conclusions Health professionals’ report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented. Electronic supplementary material The online version of this article (10.1186/s12913-018-2990-4) contains supplementary material, which is available to authorized users.

BACKGROUND: It is often difficult to determine when a multidisciplinary aneurysm team should be summoned based on the (often limited) pre-hospital information provided METHOD: We performed a retrospective cohort study of patients brought to our hospital between January 1st 2013 and October 1st 2014 by the emergency medical services (EMS) with a clinical suspicion of an acute AAA. Within this group we compared patients with a documented acute AAA and without an acute AAA in order to identify patient characteristics that could be used for the development of evidence based activation criteria for multidisciplinary acute aneurysm teams. RESULTS: Of the 63 patients presented by the EMS with a clinical suspicion of an acute AAA, 16 had an acute AAA. The optimal age cut-off value to discriminate patients with- from patients without an acute AAA was 70 years, whereas the optimal cut-off systolic blood pressure was 137 mmHg. "Age> 70" (LR+ 2.6 [1.8-3.8], "SBP 50%. CONCLUSION: Pre-hospital information regarding the patient's age, history (known AAA), blood pressure and general appearance (presence of diaphoresis) can be useful when EMS services announce the arrival of a patient with suspected acute AAA in order to improve appropriate triage and minimize time to definitive care.

Nurses play a key role in the ongoing treatment and management of chronic conditions such as Hepatitis C. Their skills in counseling, education, and as liaisons between patients, support services, and other healthcare providers make them crucial in the management of patients with Hepatitis C. Qualitative methods were used to explore and describe quality-of-care perspectives of patients receiving care in viral hepatitis clinics. Data were collected through focus group interviews at three hepatitis prevention and care demonstration projects located in underserved rural and small urban areas in British Columbia, Canada. Key themes were identified and used to construct a "Hepatitis C care model" and generate quality-of-care statements. These statements were then rated by another group of participants with Hepatitis C, using concept mapping. Most themes identified by the participants in focus groups (n = 21) related to care provision processes (autonomy, communication, education/information, continuity of care, professional competence, and support) rather than structure or outcomes of care. Concept-mapping participants (n = 20) rated communication as the key theme. Participants also highlighted the supportive role nurses played. Hepatitis C programming can be improved by leveraging nurses' strengths within multidisciplinary teams to address patient's concerns about process and communication issues.

Introduction: Most risk stratification scores used in surgery do not include external and non-technical factors as predictors of morbidity and mortality. Objective: The present study aimed to translate and adapt transculturally the Brazilian version of the Disruptions in Surgery Index (DiSI) questionnaire, which was developed to capture the self-perception of each member of the surgical team regarding the disruptions that may contribute to error and obstruction of safe surgical flow. Methods: A universalist approach was adopted to evaluate the conceptual equivalence of items and semantics, which included the following stages: (1) translation of the questionnaire into Portuguese; (2) back translation into English; (3) panel of experts to draft the preliminary version; and (4) pre-test for evaluation of verbal comprehension by the target population of 43 professionals working in cardiothoracic surgery. Results: The questionnaire was translated into Portuguese and its final version with 29 items obtained 89.6% approval from the panel of experts. The target population evaluated all items as easy to understand. The mean overall clarity and verbal comprehension observed in the pre-test reached 4.48 ± 0.16 out of the maximum value of 5 on the psychometric Likert scale. Conclusion: Based on the methodology used, the experts' analysis and the results of the pre-test, it is concluded that the essential stages of translation and cross-cultural adaptation of DiSI to the Portuguese language were satisfactorily fulfilled in this study.

Background: Shared learning activities aim to enhance the collaborative skills of health students and professionals in relation to both colleagues and patients. The Readiness for Interprofessional Learning Scale is used to assess such skills. The aim of this study was to validate a Danish four-subscale version of the RIPLS in a sample of 370 health-care students and 200 health professionals. Methods: The questionnaire was translated following a two-step process, including forward and backward translations, and a pilot test. A test of internal consistency and a test-retest of reliability were performed using a web-based questionnaire. Results: The questionnaire was completed by 370 health care students and 200 health professionals (test) whereas the retest was completed by 203 health professionals. A full data set of first-time responses was generated from the 570 students and professionals at baseline (test). Good internal association was found between items in Positive Professional Identity (Q13-Q16), with factor loadings between 0.61 and 0.72. The confirmatory factor analyses revealed 11 items with factor loadings above 0.50, 18 below 0.50, and no items below 0.20. Weighted kappa values were between 0.20 and 0.40, 16 items with values between 0.40 and 0.60, and six items between 0.60 and 0.80; all showing p-values below 0.001. Conclusion: Strong internal consistency was found for both populations. The Danish RIPLS proved a stable and reliable instrument for the Teamwork and Collaboration, Negative Professional Identity, and Positive Professional Identity subscales, while the Roles and Responsibility subscale showed some limitations. The reason behind these limitations is unclear.

Elder abuse and in particular material and financial exploitation involving the misappropriation of the older person's money or property is common but rarely identified or managed in clinical practice. It has a direct impact on quality of life, health and social status. Our aim is to assist clinicians by summarizing this frequently unrecognized problem. We discuss risk factors, alerting signs, clinical manifestations, and specific questions that can be used for screening purposes as well as intervention strategies preferably in the context of a multidisciplinary team.

OBJECTIVE: To assess the effect of a Crew Resource Management (CRM) intervention specifically designed to improve teamwork and communication skills in a multidisciplinary obstetrical setting. METHOD: Design--A before-and-after cross-sectional study designed to assess participants' satisfaction, learning and change in behaviour, according to Kirkpatrick's evaluation framework for training programmes. Setting--Labour and delivery units of a large university-affiliated hospital. Participants--Two hundred and thirty nine midwives, nurses, physicians and technicians from the department of anaesthesia, obstetrics and paediatrics. Intervention--All participants took part in a CRM-based training programme specifically designed to improve teamwork and communication skills. Principal measures of outcome-We assessed participants' satisfaction by means of a 10-item standardized questionnaire. A 36-item survey was administered before and after the course to assess participants' learning. Behavioural change was assessed by a 57-item safety attitude questionnaire measuring staff's change in attitude to safety over 1 year of programme implementation. RESULTS: Most participants valued the experience highly and 63-90% rated their level of satisfaction as being very high. Except for seven items, the 36-item survey testing participants' learning demonstrated a significant change (P