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Background: Multidisciplinary care is paramount in patient-specific decision making, especially as pertaining to oral cavity squamous cell cancer (OCSCC) treatment. Protracted surgery-postoperative-radiation (S-PORT) has a detrimental impact on OCSCC patients' outcomes. This study examined the impact of surgeon-radiation oncologist dyads on the treatment of OCSCC, focusing on S-PORT interval and disease specific outcomes. Methods: All OCSCC patients treated in a tertiary cancer center between 2009 to 2017 were included. Patients were categorized into "dyad" and "nondyad" groups defined as whether they were treated by a paired surgeon–radiation oncology team with joint multidisciplinary clinic or shared >30% patient volumes. Univariate and multivariate logistic regression were performed to identify factors associated with a prolonged S-PORT time interval (≥8 weeks). Overall survival and locoregional recurrence were estimated and compared. Results: A total of 444 OCSCC were eligible. Treatment by a dyad was significantly less likely associated with S-PORT ≥ 8 weeks (odds ratio [OR]unadjusted: 0.65; 95% confidence interval [CI] 0.44–0.96; p = 0.03). Obtaining pre-operative radiation oncology consultation also decreased the S-PORT interval. Advanced T-category and the need for free tissue flap reconstruction increased the likelihood of prolonged S-PORT on univariate but not multivariate analysis. No significant differences were observed in overall survival or locoregional recurrence by dyad status nor S-PORT (p > 0.05). Conclusions: Surgeon-radiation oncology dyads significantly minimized time from surgery to postoperative radiation in OCSCC. While improvement in overall survival or locoregional recurrence was not observed, these findings support close knit collaborative multidisciplinary treatment care models, including dyad-based care. [ABSTRACT FROM AUTHOR]

Granting agencies often require cross-disciplinary team composition to be competitive for funding. However, to what extent do research teams have cross-disciplinary authorships after they win an award, given that grants are not contracts? This mixed-method study examined the degree to which cross-disciplinary composition translated into cross-disciplinary authorship in grant-funded teams and the factors motivating cross-disciplinary collaboration. We found that after receiving a grant award, nearly 90% of investigators chose to collaborate across disciplines, with 80% working with researchers from fields very different from their own. Interviews uncovered facilitators and hindrances to continued collaboration. Facilitators included strong interpersonal relationships, shared goals, and openness to new ideas. Common hindrances involved funding shortages and limited face-to-face interactions. What defined success in cross-disciplinary collaboration were not only research outputs but learning opportunities, highlighting the intangible benefits of cross-disciplinary research. Researchers stressed the importance of integration and resource availability for deeper collaboration across disciplines. [ABSTRACT FROM AUTHOR]

In light of the post-pandemic situation in education, adopting a transdisciplinary and multidisciplinary approach is vital. Social pedagogy encompasses a range of strategies and practices that can compensate, support, innovate, and provide services that align with the current needs of individuals, communities and the global challenges facing humanity. Social educators have become members of support teams, whether at the school level, educational and counseling institutions or local governments. These teams require multidisciplinary, interdepartmental or transnational collaboration. This paper presents the current post-pandemic situation in Slovakia and offers an overview of the latest development in social pedagogue education. Also, it describes the current process of standardising the social pedagogue profession and the functions of multidisciplinary teams in the school and counselling system.

Health planning provides a structure for the application of epidemiological data to managed populations with the intention of maximising health and identifying targets for intervention. Whilst this is established practice in livestock health, such schemes are rarely applied to free-living wild animal populations. The health of wildlife is important for a variety of reasons including conservation, human health, and ecosystem health, and so it is recommended that a formalised health planning approach be adopted for wildlife, based upon advantages of livestock health schemes identified here. Six key strengths of livestock herd health plans are identified in that these plans are: (1) Outcome driven, (2) Structured and repeatable, (3) They can incorporate both health and welfare considerations and in doing so, establish multidisciplinary management teams, (4) Evidence-based allowing for the prioritisation of key risk factors, (5) Encompassing of both population and individual metrics, and (6) Offer the opportunity for accreditation schemes. The benefits highlighted have implications for both wildlife management and research agendas where the structured format of the health plans will highlight knowledge gaps. Challenges are acknowledged, and it is recognised that livestock health planning cannot simply be copied across to a wildlife context. However, the strengths identified are great enough that it is recommended that wildlife population health planning is developed for active management of individual populations, learning lessons from existing plans. [ABSTRACT FROM AUTHOR]

This paper investigates the synergy between Levin's theories on technology transfer as a socio-technical learning and developmental process (TLD process), and what we learnt about socio-technical systems (STS) theories in a case study developing human robot solutions for the construction sector. Levin's extensive work highlights the significance of technology transfer as a means for organizational development. His TLD process emphasizes the intricate interplay between technology, organizational change, and learning and highlights the importance of incorporating cultural knowledge and skills into the technological transfer process. Contemporary STS views developed through our own work are introduced to complement and extend Levin's theories by providing a systemic lens to understand the broader socio-technical context in which technology transfer occurs. To illustrate the synergies and potential challenges from Levin's theories of technology transfer with contemporary STS concepts, we use a qualitative study of a unique case about the design and development of human-robot teams (HRTs) for construction tasks. Our findings reveal that while Levin's theories provide a valuable foundation for understanding technology transfer and organizational change, contemporary socio-technical systems face unique challenges in the context of AI-driven human-robot teams, where intelligent robots also contribute to the socio-technical learning process. Moreover, the rapidly evolving nature of technology and innovations could exponentially impact on multidisciplinary design teams, stakeholder participation and inter-organizational dynamics. The discussions suggest an extension of co-generative learning to incorporate 'collaborative intelligence' between human-robot teams enabled by artificial intelligence (AI). Consequently, we suggest that Levin's theories of technology transfer, developed before the rapid application of AI, may not have fully considered further social challenges caused by the introduction of autonomous systems such as AI-driven HRT systems. We extend Levin's important work by suggesting that addressing such challenges requires ongoing dialogue and collaboration among researchers, practitioners, and policymakers with different disciplinary backgrounds to develop robust and reliable socio-technical systems frameworks to navigate the complexities of robotics and AI in today's rapidly evolving technological landscape. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware that orofacial clefts are the most common facial congenital abnormalities in humans • To read a case study presenting an overview of the care provided for an infant born with a cleft palate • To recognise the vital role of children’s nurses in supporting family-centred care. Orofacial clefts are the most common facial congenital abnormalities in humans. Their management is complex due to a range of immediate and ongoing challenges. These include breathing, feeding, speech, hearing and dental issues. This article uses a case study approach to outline these challenges for a patient who was born with a cleft palate. The case is followed by a discussion of contemporary evidence-based care. The article focuses on family-centred care and multidisciplinary teamwork, and the author also details the central role of the children’s nurse. [ABSTRACT FROM AUTHOR]

Long covid (persistent COVID‐19) is a new disease with contested aetiology and variable prognosis. We report a 2‐year ethnography of UK long covid clinics. Using a preformative lens, we show that multidisciplinary teams (MDTs) built working knowledge based on shared practices, mutual trust, distributed cognition (e.g. emails, record entries), relational knowledge of what was at stake for the patient, and harnessing uncertainty to open new discursive spaces. Most long covid MDTs performed the working knowledge of 'rehabilitation', a linked set of practices oriented to ensuring that the patient understood and strove to 'correct' maladaptive physiological responses (e.g. through breathing exercises) and pursued recovery goals, supported by physiotherapists, psychologists and generalist clinicians. Some MDTs with a higher proportion of doctors (e.g. cardiologists, neurologists, immunologists) enacted the working knowledge of 'microscopic damage', seeking to elucidate and rectify long covid's underlying molecular and cellular pathology. They justified non‐standard investigations and medication in selected patients by co‐constructing an evidentiary narrative based on biological mechanisms. Working knowledge was ontologically concordant within MDTs but sometimes discordant between MDTs. Overt ontological conflict occurred mostly when patients attending 'rehabilitation' clinics invoked the working knowledge of microscopic damage that had been generated and circulated in online support communities. [ABSTRACT FROM AUTHOR]

The term 'chronic pain' itself is often multifaceted, and for many patients with this condition it exacts a toll on physical and psychological well-being. Yet most conventional pain management methods do not take into account the massive role mental health plays in pain sensation and healing. The current paper promotes for a specially trained pain psychologist and psychiatrist role in the pain clinic, concentrating mainly on emotional, cognitive and behavioral part of the composite psychological-biological-environmental model controlling chronic pain. Treatment with pharmaceuticals has a high cost to both the patient and the healthcare system. While psychological interventions (cognitive behavioral therapy [CBT], mindfulness) have shown better outcomes in coping skills, stress reduction and in improving the quality of life. Pain psychiatrists overall are responsible for treating the mental health comorbidities, such as depression and anxiety which tend to worsen with chronic pain. In addition, they address the common problems of opioid dependence and substance abuse in chronic pain patients. Although such integration has numerous advantages, there are several hurdles that must be overcome, including the compartmentalization of healthcare, stigma and lack of access to mental health experts. Parity in participation was seen as key to the future of pain management, which will continue to evolve and be delivered by multidisciplinary teams using novel digital health tools that support holistic patient-centered care. [ABSTRACT FROM AUTHOR]

Parkinson's disease is a complex neurodegenerative disorder presenting a range of motor and non-motor symptoms that greatly impact both patients and caregivers. The diverse needs arising from these symptoms make a multidisciplinary team (MDT) approach crucial for effective management. This article explores the role and benefits of MDTs in Parkinson's care, highlighting how collaborative models improve clinical outcomes and quality of life. MDTs integrate neurologists, nurse specialists, therapists, and other professionals to deliver comprehensive, patient-centered care. The inclusion of patients and caregivers fosters shared decision-making, enhancing health outcomes. However, challenges like limited controlled trials, lack of comprehensive guidelines, and under-referral remain. Innovative models, such as telehealth and community-based care, offer promising solutions, especially in underserved regions. The article advocates for further research and standardized guidelines to optimize the MDT approach for Parkinson's disease. [ABSTRACT FROM AUTHOR]

Copyright of Social Education / Sociální Pedagogika is the property of Tomas Bata University, Research Centre of the Faculty of Humanities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

School nurses are members of the school-based mental and behavioral health support team. This consensus document was developed by school nurses and school nurse leaders in collaboration with leaders from national associations and organizations with a vested interest in K-12 mental and behavioral health. The document is also publicly available on the National Association of School Nurses website. [ABSTRACT FROM AUTHOR]

Students with intellectual and developmental disabilities (IDD) are likely to experience psychiatric symptoms, like depression, anxiety, and distress, throughout their lifetime. Due to communication differences and minimal use of specialized diagnostic assessments for anxiety and depression, emotional pain can often be overlooked or underestimated in students with IDD. This is often complicated by atypical presentations of anxiety and depression, such as externalized aggression, self-injurious behaviors, or other behavioral dysregulation, that can indicate emotional distress, physical pain, or other medical complications. School nurses play an important role in assessing for emotional and physical pain in students with IDD using assessment tools currently available and clinical judgment. Tools that have been created for use in this population may account for the diversity of communication, sensory, and developmental differences in students with IDD. Through leading education and advocacy for the interprofessional school team, school nurses can increase the access that students with IDD have to equitable emotional health evaluations and services. School nurses can also promote emotional wellness for students with IDD through the incorporation of mindful and community activities in the care plan. [ABSTRACT FROM AUTHOR]

Testicular germ cell tumors are the most common tumors in adolescent and young men. They are curable malignancies that should be treated with curative intent, minimizing acute and long-term side effects. Inguinal orchiectomy is the main diagnostic procedure, and is also curative for most localized tumors, while patients with unfavorable risk factors for recurrence, or those who are unable or unwilling to undergo close follow-up, may require adjuvant treatment. Patients with persistent markers after orchiectomy or advanced disease at diagnosis should be staged and classified according to the IGCCCG prognostic classification. BEP is the most recommended chemotherapy, but other schedules such as EP or VIP may be used to avoid bleomycin in some patients. Efforts should be made to avoid unnecessary delays and dose reductions wherever possible. Insufficient marker decline after each cycle is associated with poor prognosis. Management of residual masses after chemotherapy differs between patients with seminoma and non-seminoma tumors. Patients at high risk of relapse, those with refractory tumors, or those who relapse after chemotherapy should be managed by multidisciplinary teams in experienced centers. Salvage treatment for these patients includes conventional-dose chemotherapy (TIP) and/or high-dose chemotherapy, although the best regimen and strategy for each subgroup of patients is not yet well established. In late recurrences, early complete surgical resection should be performed when feasible. Given the high cure rate of TGCT, oncologists should work with patients to prevent and identify potential long-term side effects of the treatment. The above recommendations also apply to extragonadal retroperitoneal and mediastinal tumors. [ABSTRACT FROM AUTHOR]

The UK has a growing ageing population with increased prevalence of long-term conditions. It has the potential to overwhelm the country's healthcare system. The COVID-19 pandemic and its risk of transmission provided an opportunity for people with long-term conditions to focus on self-care and for district nurses to promote self-management. Self-management strategies, such as digital technology, motivational interviewing, social prescribing and shared decision-making can assist them in planning a whole-population approach towards managing physical and mental wellbeing. For this to become a reality, investment is needed to educate the patients, their carers, district nurses, multidisciplinary teams and to ensure the sustainability of self-care methods for future practice. [ABSTRACT FROM AUTHOR]

Background: Expanding primary care multidisciplinary teams (MDTs) was a key component of the 2018 Scottish GP contract, with more than 4700 MDT staff appointed since then. Aim: To explore patients' views on primary care MDT expansion in Scotland. Design & setting: A mixed-methods evaluation, which included a postal survey and semi-structured telephone interviews with patients in Scotland. Method: A survey was undertaken of patients who had recently consulted a GP in deprived urban, affluent urban, and remote and rural areas, assessing awareness of five MDT roles and attitudes towards receptionist signposting. In addition, 30 individual interviews were conducted, exploring patients' MDT-care experiences. Results: Of 1053 survey responders, most were unaware of the option of MDT rather than GP consultations for three out of five roles (69% unaware of link worker appointments; 69% mental health nurse; and 58% pharmacist). Reception signposting was less popular in deprived urban areas (34% unhappy versus 29% in remote and rural versus 21% affluent urban; P<0.001), and in patients with multimorbidity (31% unhappy versus 24% in non-multimorbid; P<0.05). Just over two-thirds of interviewees had multimorbidity and almost all reported positive MDT-care experiences. However, MDT care was generally seen as a supplement rather than a substitute for GP care. Around half of patients expressed concerns about reception signposting. These patients were more likely to also express concerns about GP access in general. Both of these concerns were more common in deprived urban areas than in remote and rural or affluent urban areas. Conclusion: MDT care has expanded in Scotland with limited patient awareness. Although patients understand its potential value, many are unhappy with reception signposting to first-contact MDT care, especially those in deprived urban areas living with multimorbidity. This represents a barrier to the aims of the new GP contract. [ABSTRACT FROM AUTHOR]

Background/Aims: Job satisfaction is an important contributor to the efficacy and success of organisations. An intensive care unit is a highly skilled area of healthcare that can be a physically and mentally challenging environment for staff, potentially impacting job satisfaction. This study aimed to assess job satisfaction levels among multidisciplinary staff members working in the intensive care units of a hospital in Qatar and evaluate how this is affected by sociodemographic and employment factors. Methods: This was a cross-sectional, quantitative study that used a survey method. A total of 142 intensive care unit nurses, physicians and allied health professionals were recruited via random sampling from a tertiary hospital in Qatar. The Minnesota Satisfaction Questionnaire (short form) was used to collect data on respondents' intrinsic, extrinsic and overall job satisfaction levels, using statements scored with 5-point Likert scales. The survey also collected data on respondents' gender, age, job category and years of experience working in intensive care. Data were analysed using Shapiro-Wilk tests, Mann-Whitney U tests, Kruskal–Wallis tests and analysis of variance. Mean overall job satisfaction scores were classified as low (<3.00), moderate (3.00–3.99) or high (>4.00). A P value of <0.05 indicated statistical significance. Results: The mean overall job satisfaction score was 3.82 out of 5.00, indicating moderate satisfaction. There were strong correlations between job satisfaction and both intrinsic (0.940) and extrinsic (0.894) satisfaction. There was a significant difference in job satisfaction levels depending on respondents' years of experience working in intensive care units (P=0.0477), with those who had less than 10 years of experience having the highest job satisfaction levels and those with 20–24 years' experience having the lowest job satisfaction levels. There were no significant differences between the job satisfaction levels of participants in different gender, age and job categories. Conclusions: This study suggests that intensive care unit staff with more years of experience may have lower job satisfaction than those with fewer years of experience. Healthcare organisations should consider implementing targeted interventions to enhance job satisfaction, such as opportunities for professional development, recognition programmes, mentorship programmes, stress management workshops and efforts to improve work-life balance. [ABSTRACT FROM AUTHOR]

Early psychosocial support for parents/legal guardians who have children with variations of sex characteristics (VSCs) is crucial in helping avoid potentially harmful medical procedures. Psychosocial support, including peer support, can help parents/legal guardians choose the best care path for their child, and it remains important throughout childhood. However, there is a lack of data on the provision of psychosocial support for families with a child who has VSCs. We sought knowledge about the timing and types of psychosocial support, and the level of implementation of psychosocial support amongst health and psychosocial care professionals and peer supporters. A survey was conducted using a purposive sample of healthcare professionals and members of peer support groups across Europe. A total of 301 responses were received and analysed using descriptive and inferential methods. The survey results showed that psychosocial support primarily addresses diagnostic procedures, medical treatment, and medical interventions. Whilst the majority of healthcare professionals aspired to have psychosocial support provided at the point where a diagnosis of VSCs was suspected, this was only reported as current practice by a minority of respondents. Overall, the survey indicates that there is a need for greater implementation of psychosocial support, and more collaboration between healthcare professionals and peer support groups in caring for children with VSCs and their families. [ABSTRACT FROM AUTHOR]

Aim: Oncology care provision by multidisciplinary teams (MDTs) is widely acknowledged as best practice. Formal team meetings, led by chairpersons, coordinate decisions on diagnosis, staging, treatment planning, and review. This study addresses a gap in meeting Chairs' perspectives on factors affecting functionality across the meeting cycle, from pre‐meeting patient list triage to post‐meeting dissemination of recommendations. Methods: Semi‐structured interviews were conducted in person with Chairs within two urban geographical regions in New South Wales, Australia as part of a larger project. Though the population of oncology MDT Chairs in Australia is small, the richness and depth of data from nine Chairs were considered to be valuable knowledge in support of extant literature on meeting functionality. An integrated deductive‐inductive approach was applied to data analysis. Results: Perceived facilitators, barriers, and ideals relating to pre‐meeting, in‐meeting, and post‐meeting functionality were identified across five pre‐determined analytic categories: the team; meeting infrastructure; meeting organization and logistics; patient‐centered clinical decision‐making, and; team governance. Key barriers included inadequate information technology, limited support staff, and lack of dedicated time for Chair duties. Corresponding facilitators included robust Information Technology infrastructure and support, provision of clinically knowledgeable MDT meeting coordinators, and formal employment recognition of Chairs' responsibilities and skill sets. Conclusion: Chairs across various tumor streams develop workarounds to overcome barriers and ensure quality meeting outcomes. With more robust support they could enhance value by sharing evidence, conducting audits, and engaging in research. The findings highlight the need for healthcare systems to support tumor stream clinical networks by allocating greater resources to prioritize multidisciplinary meetings and cancer care decision‐making. [ABSTRACT FROM AUTHOR]

Epilepsy care requires a comprehensive understanding of the condition and its multifaceted impact on patients' lives. From a nursing perspective, interventions can play a crucial role in managing epilepsy effectively. This systematic review highlights various nursing interventions that focus on education, medication management, seizure recognition, and psychological support. Nurses are pivotal in educating patients and their families about seizure triggers, the importance of medication adherence, and lifestyle modifications to reduce seizure frequency. They also provide counseling and emotional support, helping patients cope with the psychological aspects of living with epilepsy, which can include anxiety, depression, and social stigma. Additionally, the review examines the implementation of evidence-based practices that enhance patient outcomes. Collaborative initiatives, such as forming multidisciplinary teams, have demonstrated effectiveness in providing holistic care that encompasses not only the medical but also the social and emotional needs of patients. Nursing-led interventions, including seizure action plans and community support programs, foster a supportive environment, empowering patients in their self-management efforts. The findings suggest that targeted nursing interventions can significantly improve adherence to treatment, enhance quality of life, and reduce the overall burden of epilepsy on patients and their families. [ABSTRACT FROM AUTHOR]

Purpose: The number of older people with poor oral health diagnosed with cancer is increasing rapidly. However, integration of oral health in cancer care for older people to prevent or minimize oral health complications of cancer treatments is uncommon, except in head and neck oncology. The aim of this review is to describe the need, role of, and factors influencing the integration of oral health(care) into the treatment of older people with cancer. Methods: MEDLINE, CINAHL, PubMed, Scopus, and Web of Science databases were searched for papers published in the last 10 years that focus on oral health in older people diagnosed with cancer, the impact of oral health on cancer therapy, and integrated oral health in cancer treatment. Results: From 523 related papers, 68 publications were included and summarized as follows: (1) oral complications associated with cancer therapies, (2) the need for oral healthcare in older people with cancer, (3) the role of integration of oral health in cancer care, and (4) influencing factors such as ageism, interprofessional education and collaborations, oral healthcare workforce, oral health literacy, and financial considerations. Conclusion: Integration of oral healthcare is highly recommended for the overall well-being of older people with cancer to prevent, minimize, and manage complications in cancer treatment. However, oral healthcare has not been integrated in cancer care yet, except for head and neck cancers. This review identified a notable gap in the literature, highlighting the need for research on integration of oral healthcare in geriatric oncology. [ABSTRACT FROM AUTHOR]

Clinicians report experiencing bias at work. Although previous studies have characterized these experiences among trainees and clinical faculty, ours is the first to describe experiences of bias within a multidisciplinary hospital medicine group. In our study, 82.5% of surveyed nurse practitioners (NPs), physician assistants (PAs), and physicians reported experiencing gender, racial, or other forms of bias in the workplace. In addition to women reporting higher rates of gender bias and Asian/Black/Latinx/multiracial/other race respondents reporting higher rates of racial bias, half of participants reported experiencing other forms of bias related to gender expression, perceived sexual orientation, body habitus, age, accent, country of origin, or perceived socioeconomic status. Respondents infrequently addressed bias with the person expressing it. Our study expands on the existing literature about experiences of bias by studying a large, multidisciplinary, academic hospital medicine group. With the increasing inclusion of NPs and PAs in hospital medicine, understanding their experiences will enable development of tailored interventions to reduce harm from experiences of bias. [ABSTRACT FROM AUTHOR]

Families have always had to respond to the multiple challenges of everyday life. So what differentiates recent times from the past? The complexity of demands, the speed with which changes occur are all possible explanations, but the lack of time to be together, to be invited to share and reflect on what is happening to us, and in particular to the children in our families, is also a context that distinguishes today's families. Specifically, this study analyzes how the work carried out in multidisciplinary teams can contribute to reversing forms of parenting associated with the risk of social exclusion. [ABSTRACT FROM AUTHOR]

Healthcare systems around the world are facing increasing challenges, particularly due to the increasing prevalence and incidence of infectious and chronic diseases. In Saudi Arabia, these challenges are exacerbated by the increasing population and the threat of pandemics such as COVID-19. To address these issues, a multidisciplinary healthcare model is essential. This approach brings together professionals from different fields, including physicians, nurses, technicians, pharmacists, and physiotherapists, to provide coordinated, patient-centered care. While this model offers many benefits, such as improved patient outcomes, enhanced communication, and improved care coordination, it also faces several challenges, including time pressures, communication barriers, and different priorities among team members. This review explores the benefits and challenges of multidisciplinary teamwork in clinical settings, with a focus on the role of nurses and technicians in enhancing healthcare delivery in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Pleomorphic Dermal Sarcoma (PDS) is increasing in incidence and evidence-based guidelines as to optimal management are lacking. It is unclear from guidance which cancer MDTs should be involved in the care of patients with PDS and there is anecdotally widespread variation in patient pathways and management. Objective: To determine current pathways and opinions regarding management of PDS amongst members of relevant UK MDTs. Methods: A survey was devised, piloted, and circulated to MDT members, via national organisations. Responses were analysed using online SurveyMonkey tools. Results: 105 consultant members of a relevant MDT responded, including 19 skin and 2 sarcoma MDT Chairs. There was widespread variation in referral pathways, with 25.7% of participants reporting no sarcoma MDT involvement in a hypothetical case of a patient with a 2.1 ​cm primary PDS of the scalp, with no clinically apparent regional or distant metastases (N0M0). Opinions on the correct peripheral and deep surgical excision margins (PM/DM) varied, with the majority choosing a 10 ​mm PM (53.3%). Taking periosteum as the deep margin was preferred by 50.5%. Histological clearance margins of at least 5 ​mm at the PM and at least 1 ​mm at the DM were preferred by 33.3% of participants and deemed to be acceptable as definitive treatment. Imaging at diagnosis and for surveillance showed wide variation, with 24.8% not offering any imaging at diagnosis, in the above case. Conclusions: PDS pathways and clinical management have been shown to vary widely amongst UK MDT members. A modified Delphi study is proposed to develop consensus-based guidance.

Health planning provides a structure for the application of epidemiological data to managed populations with the intention of maximising health and identifying targets for intervention. Whilst this is established practice in livestock health, such schemes are rarely applied to free-living wild animal populations. The health of wildlife is important for a variety of reasons including conservation, human health, and ecosystem health, and so it is recommended that a formalised health planning approach be adopted for wildlife, based upon advantages of livestock health schemes identified here. Six key strengths of livestock herd health plans are identified in that these plans are: (1) Outcome driven, (2) Structured and repeatable, (3) They can incorporate both health and welfare considerations and in doing so, establish multidisciplinary management teams, (4) Evidence-based allowing for the prioritisation of key risk factors, (5) Encompassing of both population and individual metrics, and (6) Offer the opportunity for accreditation schemes. The benefits highlighted have implications for both wildlife management and research agendas where the structured format of the health plans will highlight knowledge gaps. Challenges are acknowledged, and it is recognised that livestock health planning cannot simply be copied across to a wildlife context. However, the strengths identified are great enough that it is recommended that wildlife population health planning is developed for active management of individual populations, learning lessons from existing plans.

Background: Expanding primary care multidisciplinary teams (MDTs) was a key component of the 2018 Scottish GP contract, with more than 4700 MDT staff appointed since then. Aim: To explore patients’ views on primary care MDT expansion in Scotland. Design & setting: A mixed-methods evaluation, which included a postal survey and semi-structured telephone interviews with patients in Scotland. Method: A survey was undertaken of patients who had recently consulted a GP in deprived urban, affluent urban, and remote and rural areas, assessing awareness of five MDT roles and attitudes towards receptionist signposting. In addition, 30 individual interviews were conducted, exploring patients' MDT-care experiences. Results: Of 1053 survey responders, most were unaware of the option of MDT rather than GP consultations for three out of five roles (69% unaware of link worker appointments; 69% mental health nurse; and 58% pharmacist). Reception signposting was less popular in deprived urban areas (34% unhappy versus 29% in remote and rural versus 21% affluent urban; P

Abstract Background The caretaking process for older adults with depression and physical multimorbidity is complex. Older patients with both psychiatric and physical illnesses require an integrated and comprehensive approach to effectively manage their care. This approach should address common risk factors, acknowledge the bidirectional relationship between somatic and mental health conditions, and integrate treatment strategies for both aspects. Furthermore, active engagement of healthcare providers in shaping new care processes is imperative for achieving sustainable change. Objective To explore and understand the needs and expectations of healthcare providers (HCPs) concerning the care for older patients with depression and physical multimorbidity. Methods Seventeen HCPs who work with the target group in primary and residential care participated in three focus group interviews. A constructivist Grounded Theory approach was applied. The results were analyzed using the QUAGOL guide. Results Participants highlighted the importance of patient-centeredness, interprofessional collaboration, and shared decision-making in current healthcare practices. There is also a need to further emphasize the advantages and risks of technology in delivering care. Additionally, HCPs working with this target population should possess expertise in both psychiatric and somatic care to provide comprehensive care. Care should be organized proactively, anticipating needs rather than reacting to them. Healthcare providers, including a dedicated care manager, might consider collaborating, integrating their expertise instead of operating in isolation. Lastly, effective communication among HCPs, patients, and their families is crucial to ensure high-quality care delivery. Conclusion The findings stress the importance of a comprehensive approach to caring for older adults dealing with depression and physical comorbidity. These insights will fuel the development of an integrated care model that caters to the needs of this population.

Xiaoqing Wei,1,&ast; Junying Zhang,2,&ast; Youwen Mei,3 Eqiong Li,4 Qianling Dai,1 Xiaoli Yang,1 Dan Luo,5 Biao Li,6 Ping Hua,7 Jian Cai,7 Hua Lai,8 Dongfeng Qi,9 Sha Lai,10 Mi Qin,11 Yonghong Lin4 1Department of Cervical Disease and Cervical Cancer Prevention and Treatment, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 2Clinical Laboratory Department, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 3Department of Reproduction and Infertility, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 4Department of Gynecology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 5Department of Obstetrics, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 6Department of Neonatal Intensive Care Unit, Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 7Department of Pathology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 8Department of Radiation and Interventional Therapy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 9Department of Ultrasonics, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 10Dermatology Department, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China; 11Department of Pediatric Surgery, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yonghong Lin; Xiaoqing Wei, Email linyhcd2011@163.com; xqcherry@163.comObjective: We report a case of Carmi Syndrome in a neonate.Aim: To share our lessons in diagnosis of the case of Carmi Syndrome.Case Report: Carmi Syndrome is an extremely rare autosomal recessive genetic disorder characterized the coexistence of pyloric atresia and junctional epidermolysis bullosa, and with aplasia cutis congenita in approximately 28% patients. In this case, a full-term male neonate was born to a G4P2+1L1 multipara through cesarean section delivery in hospital in a non-consanguineous marriage with 4000mL of II°meconium-stained amniotic fluid. He was found extensive skin loss over lower legs and other parts, with scattered blisters and bilateral microtia. Plain abdominal X-ray revealed a large gastric air bubble with no gas distally. The mother had an intrauterine fetal loss previously for reasons unknown. The dermatologist diagnosed the newborn with Bart Syndrome, while the pediatric surgeon diagnosed congenital pyloric atresia(CPA). The parents refused further treatment and the neonate passed away about 30 hours after birth.Outcome: The neonate passed away about 30 hours after birth.Conclusion: Lessons from this case:①.Rule out Carmi Syndrome in patients with PA, and differentiate Bart syndrome and Carmi Syndrome in patients with abnormal skin manifestations. ②. For rare and/or severe diseases, multidisciplinary teams(MDTs) should be establish. ③. Genetic counseling and prenatal diagnosis are necessary prior to subsequent childbearings. ④.Termination of pregnancy might be contemplated if certain indicators are revealed.Keywords: Carmi syndrome, bart syndrome, epidermolysis bullosa, EB, junctional epidermolysis bullosa, JEB, congenital pyloric atresia, CPA, aplasia cutis congenita, ACC, congenital localized absence of skin, CLAS, pyloric atresia, PA, epidermolysis bullosa with pyloric atresia, EB-PA, multidisciplinary teams, MDT

The incidence of spontaneous or primary spondylodiscitis has been increasing over the years, affecting the aging population with multiple comorbidities. Several conditions influencing treatment outcomes stand out, such as diabetes mellitus, renal insufficiency, cardiovascular and respiratory dysfunction, and malnutrition. Due to these, the question arises regarding properly managing their current conditions and pre-existing disease states. Treatment plans must consider all concomitant comorbidities rather than just the infectious process. This can be done with the help of multidisciplinary teams to provide comprehensive care for patients with pyogenic spondylodiscitis. To date, there is no article regarding comprehensive medicine for spontaneous pyogenic spondylodiscitis; hence, this paper reviews the evidence available in current literature, recognizes knowledge gaps, and suggests comprehensive care for treating patients with spinal infections. Pre-requisites for implementing multidisciplinary teams include leadership, administrative support, and team dynamics. This group comprises an appointed leader, coordinator, and different subspecialists, such as orthopedic surgeons, infectious disease specialists, internists, rehabilitation doctors, psychiatrists, microbiologists, radiologists, nutritionists, pharmacologists, nurses, and orthotists working together with mutual trust and respect. Employing collaborative teams allows faster time for diagnosis and improves clinical outcomes, better quality of life, and patient satisfaction. Forefront communication is clear and open between all team members to provide holistic patient care. With these in mind, the need for employing multidisciplinary teams and the feasibility of its implementation emerges, showing a promising and logical path toward providing comprehensive care in managing multimorbid patients with pyogenic spondylodiscitis.

The transition of Negative Pressure Wound Therapy (NPWT) from hospitals to community care is a significant advancement in patient care, driven by increased practitioner competence and technological improvements. Modern, mobile NPWT systems, equipped with smaller pumps, have expanded treatment options and reduced hospital stays. However, discharging patients with NPWT systems introduces some logistical challenges, including staff training, supply management and effective communication between hospital staff and community teams. Practical challenges include achieving secure seals in difficult anatomical locations, managing patient mobility and adapting care practices to home environments. Despite these challenges, the benefits of community-based NPWT are well-documented, reducing hospital costs and improving patient outcomes. Collaboration with NPWT system providers is essential to ensure appropriate training for community nurses, especially given the variety of products used across different trusts. The successful integration of NPWT into community settings demands a collaborative and multidisciplinary approach, addressing logistical, training and operational barriers to maximise its potential in improving patient outcomes. [ABSTRACT FROM AUTHOR]

Background: The caretaking process for older adults with depression and physical multimorbidity is complex. Older patients with both psychiatric and physical illnesses require an integrated and comprehensive approach to effectively manage their care. This approach should address common risk factors, acknowledge the bidirectional relationship between somatic and mental health conditions, and integrate treatment strategies for both aspects. Furthermore, active engagement of healthcare providers in shaping new care processes is imperative for achieving sustainable change. Objective: To explore and understand the needs and expectations of healthcare providers (HCPs) concerning the care for older patients with depression and physical multimorbidity. Methods: Seventeen HCPs who work with the target group in primary and residential care participated in three focus group interviews. A constructivist Grounded Theory approach was applied. The results were analyzed using the QUAGOL guide. Results: Participants highlighted the importance of patient-centeredness, interprofessional collaboration, and shared decision-making in current healthcare practices. There is also a need to further emphasize the advantages and risks of technology in delivering care. Additionally, HCPs working with this target population should possess expertise in both psychiatric and somatic care to provide comprehensive care. Care should be organized proactively, anticipating needs rather than reacting to them. Healthcare providers, including a dedicated care manager, might consider collaborating, integrating their expertise instead of operating in isolation. Lastly, effective communication among HCPs, patients, and their families is crucial to ensure high-quality care delivery. Conclusion: The findings stress the importance of a comprehensive approach to caring for older adults dealing with depression and physical comorbidity. These insights will fuel the development of an integrated care model that caters to the needs of this population. [ABSTRACT FROM AUTHOR]

Financial exploitation (FE) is one of the most common reports to Adult Protective Services (APS) and the cases are often complex. Consequently, APS caseworkers report FE investigations to be among the most difficult while simultaneously reporting low confidence in productive outcomes for these investigations. This necessitates finding ways to support APS FE investigations. This paper describes the structure, process, and formative findings of a collaboration between forensic accounting examiners and APS workers to investigate complex cases of FE. Among the 77 FE cases completed, forensic examiners reviewed multiple years of financial records which included over 101,000 transactions, totaling over $213,000,000.00 in finances, and identified over $8,000,000 in questionable activity. Scores on the 8-item Client Satisfaction Questionnaire were high indicating high program satisfaction by APS workers, subject matter experts, and forensic examiners. These findings support the feasibility and acceptability of forensic accounting and APS collaborations to investigate complex cases of FE. [ABSTRACT FROM AUTHOR]

Fluid mechanics, a required course in many undergraduate engineering disciplines, is often described as a challenging subject as it weaves together advanced mathematics and physics to solve conventional engineering problems. This study examines the effect of incorporating a physical model project via multidisciplinary teams into two theory-based fluid mechanics courses to address two general questions: Does the design and construction of the physical model aid in understanding fluid mechanics concepts? Does working with students of different engineering disciplines improve student experience and comprehension? The study was conducted in Spring 2023 with a cohort of 49 mechanical and civil engineering students; each project team had a mix of both disciplines. At the end of the semester, all projects were presented at a common venue, followed by an anonymous paper-based survey. The results indicate that around 83.7% of students felt the project had an overall positive impact on their learning experience. Despite initial student apprehension about multidisciplinary teams, 72% of students appreciated the opportunity to work with engineers from other disciplines, with qualitative inputs describing the value added from varied skill sets. In conclusion, this project enabled students to apply their in-class training to a real-world model while working in multidisciplinary teams. The results provide insight into the implementation of similar projects and the value of multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Genomic technologies are now utilized for the genetic diagnosis of vascular anomalies. This provides the opportunity for genetic counselors to make a significant contribution to patient care for this complex disease. The aim of this study was to explore Australian healthcare professionals' perspectives on the relatively recent integration of molecular diagnostic testing for vascular anomalies, with or without genetic counseling support. Nine semi‐structured interviews were conducted with Australian healthcare professionals involved in the provision of care for individuals with vascular anomalies. Thematic analysis identified six themes: (1) Molecular diagnosis is beneficial; (2) psychosocial needs can motivate families to pursue a molecular diagnosis; (3) molecular genetic testing for vascular anomalies is complex; (4) genetic service provision is not a one size fits all; (5) a client‐centered approach for genetic service provision can go a long way; and (6) the value of genetic counselors. Based on our findings, implementation of a vascular anomalies genetic diagnostic program inclusive of genetic counseling may be challenging, yet such programs are likely to benefit both patients and their families, as well as healthcare professionals. As this paradigm shift unfolds, genetic counselors have an opportunity to contribute to the vascular anomaly field by educating healthcare professionals and patients, by participating in multidisciplinary clinics to support complex cases and by raising awareness regarding their practice and potential contributions. [ABSTRACT FROM AUTHOR]

Pediatric burn care has improved to the point where even patients with massive burns have a reasonable chance of survival. An important component of this success is the pediatric multidisciplinary burn team. The pediatric burn team is made up of all the disciplines that are required to provide optimal care of the patient as well as their family. The pediatric burn team in its initial iteration was multidisciplinary, with each discipline focusing on their own area without much overlap. However, over time the burn team has become more cooperative and interdisciplinary leading to improved outcomes for children with burn injuries. Ultimately, pediatric burn teams may be able to function in a transdisciplinary manner which would potentially allow for even more innovation in the care of burn patients. [ABSTRACT FROM AUTHOR]

Multidisciplinary teams (MDTs) are common in colorectal cancer and have been deemed important when providing care. Yet they take place outside of the patient, often with little consideration of the patient's views, goals and desires. In this paper specific examples from a patient perspective are integrated with the social science literature to provide an overview of areas of disconnect between MDT recommendations and the individual patient. The reasons for these disconnects are explored, including how MDTs relate to dyadic patient–clinician relationships, weak incorporation of patient‐oriented outcomes in MDTs, poor integration of nonmedical patient information and the patient perspective and the impact of team dynamics and cognitive decision biases. Consideration of these issues should facilitate higher‐quality MDT recommendations that are also more acceptable to patients. [ABSTRACT FROM AUTHOR]

Introduction: In 2015, in Poland, the oncological package (OP) was established. This law constituted a fast track of oncological diagnosis and treatment and obligatory multidisciplinary team meetings (MDT). Aim: The aim of this study was to analyze the impact of OP on rectal cancer treatment. Methods: The study was a multicenter, retrospective analysis of data collected from five centers. It included clinical data of patients operated on due to rectal cancer between 2013 and 2019. For most analyses, patients were categorized into three groups: 2013–2014 – before OP (A), 2015–2016 – early development of OP (B), 2017–2019 – further OP functioning (C). Results: A total of 1418 patients were included. In all time intervals, the majority of operations performed were anterior resections. There was a significantly lower local tumor stage (T) observed in subsequent time intervals, while there were no significant differences for N and M. In period C, the median of resected nodes was significantly higher than in previous periods. Four of the centers showed an increasing tendency in the use of preoperative radiotherapy. The study indicated a significant increase in the use of short-course radiotherapy (SCRT) and a decrease in the number of patients who did not receive any form of preoperative therapy in subsequent periods. In the group that should receive radiotherapy (T3/4 or N+ and M0), the use of SCRT was also significantly increasing. Conclusions: In the whole cohort, there was a significant increase in the use of preoperative radiotherapy and a decrease in the T stage, changing with the development of OP. Nevertheless, this relation is indirect and more data should be gathered for further conclusions. [ABSTRACT FROM AUTHOR]

Introduction: Making good teams are the base of management in general. A multidisciplinary medical team (MDT) is a group of health and care staff who are members of different professions and organizations (e.g. GPs, social workers, nurses), that work together to make decisions regarding the treatment of individual patients and service users. MDTs are engaged in both health and care settings. Methods: In this paper, the authors present information and views from valid professional-scientific sources (papers, books, brochures) about the basic principles and development of teams for medical healthcare that contribute to the development of the implementation of new concepts in health management (MH) for and against teamwork in this areas. Topic: A successful team relies on a well-composed human resource. Each of the member of team added their knowledge and skills to the prescribing process, so that decisions about the best therapy option, for example choice of antibiotics and dosages were made based on more evidence from the medical literature than if they were made by just one person. Clinical pharmacologists will certainly be necessary participants in such teams, be - cause their knowledge of pharmacokinetics, side effects and efficacy of the selected drug is required. For successful personnel management in a team that is able to handle all the challenges and obstacles that multidisciplinary teamwork brings, appropriate education and professional skills of the main manager are required. An example of MDT in a modern therapeutic approach is the collaboration between hospital pharmacology and hospital transfusion. Teamwork has its advantages and disadvantages that a good leader can use or overcome. Conclusion: Multidisciplinary health teams often have the problem of immeasurable in - vestments in order to achieve satisfactory therapeutic results. The formation of multidisciplinary teams in healthcare is a mandatory type of work in a successful healthcare institution. In addition to continuous medical education, it is desirable to introduce education for work in all positions in the health team. The most important goal of MDT is the well-being of the patient, which requires high ethical and professional qualities of the staff. [ABSTRACT FROM AUTHOR]

Cancer in pregnancy, defined as a cancer diagnosed during pregnancy, is a rare but severe condition presenting both clinical and ethical challenges. During the last two decades a paradigm shift has occurred towards recommending similar staging and treatment regimens of pregnant and non‐pregnant cancer patients. This strategy is a result of an increasing number of reassuring reports on chemotherapy treatment in pregnancy after the first trimester. The management of cancer in pregnancy should be managed in a multidisciplinary team where staging, oncological treatment, social and mental care, timing of delivery, and follow‐up of the infant should be planned. Due to the rarity, centralization is recommended to allow experience accumulation. Furthermore, national and international advisory boards are supportive when there is a lack of expertise. [ABSTRACT FROM AUTHOR]

While multidisciplinary tumor boards (MTBs) are widely used in managing patients with cancer, their impact on patient care and outcome is not routinely measured in different settings. The authors conducted a literature review in Medline, Google Scholar, Embase, and Web of Science using the following keywords: cancer, multidisciplinary, tumor board, quality performance indicator, lung cancer, and lymphoma. Standards from various accreditation and professional organizations were reviewed to compile relevant standards for MTB. A list of quality performance indicators that can be used to improve MTBs’ performance and impact was compiled. Specific examples for non-Hodgkin lymphoma and lung cancer MTBs were presented. Guidance was provided to help MTB team members select implement the appropriate quality measures. The functions and impact of MTBs should be monitored and evaluated by a set of measures that help guide MTBs to improve their performance and provide better care to their patients.

Abstract Background Residents struggle to express clinical uncertainty, often exhibiting negative cognitive, behavioral, and emotional responses to uncertainty when engaging with patients or supervisors. However, the Integrative Model of Uncertainty Tolerance posits that individuals may have positive or negative responses to perceived uncertainty. Situational characteristics, such as interactions with other health professionals, can impact whether the response is positive or negative. The team context in which residents interact with resident peers and supervisors could represent varying situational characteristics that enable a spectrum of responses to uncertainty. Understanding the situational characteristics of multidisciplinary teams that allow residents to display positive responses to perceived uncertainty could inform strategies to foster positive responses to uncertainty in other contexts. We explored resident responses to perceived uncertainty in a simulated multidisciplinary team context. Methods A simulation-primed qualitative inquiry approach was used. Fourteen residents from Cardiology and Obstetrics and Gynecology participated in simulation scenarios involving pregnant patients with heart disease. We incorporated epistemic fidelity through the deliberate inclusion of ambiguity and complexity to prompt uncertainty. Audio recordings of debriefing sessions were analyzed using directed content analysis. Results Residents recognized that uncertainty is unavoidable, and positive responses to uncertainty are crucial to team dynamics and patient safety. While residents had positive responses to expressing uncertainty to peers, they had predominantly negative responses to expressing uncertainty to supervisors. Predominant negative response to supervisors related to judgement from supervisors, and impacts on perceived trustworthiness or independence. Although residents recognized expressing uncertainty to a supervisor could identify opportunities for learning and resolve their uncertainty, the negative responses overshadowed the positive responses. Residents highly valued instances in which supervisors were forthcoming about their own uncertainty. Conclusions Through participation in simulations with epistemic fidelity, residents reflected on how they perceive and respond to uncertainty in multidisciplinary teams. Our findings emphasize the role of situational characteristics, particularly peers and supervisors, in moderating responses to perceived uncertainty. The productive discussions around responses to uncertainty in debriefing sessions suggest further studies of multidisciplinary simulations could enhance our understanding of how uncertainty is expressed, and potentially be used as an instructional intervention to promote positive responses to uncertainty.

Abstract Background Many hospitals worldwide have set up multidisciplinary Value Improvement (VI) teams that use the Value-Based Health Care (VBHC) theory to improve patient value. However, it remains unclear what the level of VBHC implementation is within these teams. We therefore studied the current level of VBHC implementation in VI teams. Methods A questionnaire was developed based on the strategic agenda for value transformation and real-world experiences with VBHC implementation. The questionnaire consisted of 21 questions, mapped to seven domains, and was sent out to 25 multidisciplinary VI teams. Median scores for individual questions (scale = 1–5) and average scores per domain were calculated. Results One hundred forty VI team members completed the questionnaire. The overall average score is 3.49. The ‘culture and responsibility’ domain obtained the highest average score (µ = 4.11). The domain ‘measure and improve outcomes’ and the domain ‘multidisciplinary team’ obtained average scores that are slightly higher than the overall average (µ = 3.78 and µ = 3.76 respectively), and the domains ‘strategy and organizational policy,’ ‘collaboration and sharing,’ and ‘IT and data’ scored a little below the overall average (µ = 3.41, µ = 3.32, and µ = 3.29 respectively). The domain ‘costs and reimbursement’ obtained the lowest average score (µ = 2.42) of all domains, indicating that the implementation of this particular aspect of VBHC remains lagging behind. Conclusions Our results indicate activity in each of the questionnaire domains. To bring VBHC implementation to the next level, more attention should be given to the financial aspects. Our questionnaire can be used in future studies to identify improvements or differences within VI teams.

Abstract Background The assessment of primary care organizations is considered to be essential for improving care. However, the assessments’ acceptability to professionals poses a challenge. Developing assessment programmes in collaboration with the end-users is a strategy that is widely encouraged to make interventions better targeted. By doing so, it can help to prevent resistance and encourage adherence to the assessment. This process, however, is rarely reported. This paper aims to fill this gap by describing the process of the co-production of an assessment programme for community health centres (CHCs) affiliated to the Federation of Community Health Centres (FCHC) in French-speaking Belgium. Methods We conducted a documentary study on the co-production of the assessment programme before carrying out semi-structured interviews with the stakeholders involved in its development. Results CHCs in French-speaking Belgium are increasing in number and are becoming more diverse. For the FCHC, this growth and diversification pose challenges for the meaning of CHC (an identity challenge) and what beneficiaries can expect in terms of the quality of organizations declaring themselves CHC (a quality challenge). Faced with this double challenge, the FCHC decided to develop an assessment programme, initially called Label, using participatory action research. During the co-production process, this initial programme version was abandoned in favour of a new name “DEQuaP”. This new name embodies new objectives and new design regarding the assessment programme. When studying the co-production process, we attributed these changes to two controversies. The first concerns how much and which type of variety is desired among CHCs part of the FCHC. The second concerns the organization of the FCHC in its capacity as a federation. It shed light on tensions between two professional segments that, in this paper, we called “political professionalism” and “pragmatic professionalism”. Conclusions These controversies show the importance of underlying challenges behind the development of an assessment programme for CHCs. This provided information about the evolution of the identity of multidisciplinary organizations in primary care. Issues raised in the development of this assessment programme also show the importance of considering assessment methods that reflect and embody the current realities of these organizations and the way of developing these assessment methods.