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[PMID]: 29068995 [Au] Autor: Lee K; Kim MJ; Park J; Park JM; Kim KH; Shin DW; Kim H; Jeon W; Kim H [Ad] Endereço: aDepartment of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang bDepartment of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. [Ti] Título: The effect of distraction by dual work on a CPR practitioner's efficiency in chest compression: A randomized controlled simulation study. [So] Source: Medicine (Baltimore);96(43):e8268, 2017 Oct. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: In the clinical setting, the dispersed practitioners' attention often leads to decreased competence in their performance. We aimed to investigate the effect of distracted practitioners on the quality of chest compression during cardiopulmonary resuscitation. METHODS: A randomized controlled crossover simulation study was conducted. Participants were recruited from among doctors, nurses, and paramedics working in a university tertiary hospital. The paced auditory serial addition test (PASAT) was used as a tool for distracting participants. In the crossover design, each participant played 2 scenarios with a 20-minute time gap, by a random order; 2-minute continuous chest compressions with and without PASAT being conducted. The primary outcome was the percentage of compression with an adequate compression rate. Secondary outcomes were the percentage of compression with adequate depth, the percentage of compression with full chest wall recoil, mean compression rate (per minute), mean compression depth, and subjective difficulty of chest compression. RESULTS: Forty-four participants were enrolled, and all of them completed the study. It was found that the percentage of compression with an adequate compression rate was lower when the PASAT was conducted. Although there was no difference in the percentage of compression with adequate depth (P = .88), the percentage of compression with complete chest recoil was lower when PASAT was conducted. In addition, while the mean compression rate was higher when PASAT was conducted, the mean compression depth was not significantly different (P = .65). The subjective difficulty was not different (P = .69). CONCLUSIONS: Health care providers who are distracted have a negative effect on the quality of chest compression, in terms of its rate and chest wall recoil. TRIAL REGISTRATION: www.ClinicalTrials.gov, NCT03124290. [Mh] Termos MeSH primário: Viés de Atenção Reanimação Cardiopulmonar Pessoal de Saúde Manequins Desempenho Profissional/normas [Mh] Termos MeSH secundário: Adulto Reanimação Cardiopulmonar/métodos Reanimação Cardiopulmonar/psicologia Reanimação Cardiopulmonar/normas Feminino Pessoal de Saúde/psicologia Pessoal de Saúde/normas Seres Humanos Masculino Avaliação de Resultados (Cuidados de Saúde) Competência Profissional/normas Profissionalismo/normas Melhoria de Qualidade Análise e Desempenho de Tarefas Fatores de Tempo Local de Trabalho [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171123 [Lr] Data última revisão: 171123 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171026 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008268

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[PMID]: 28991923 [Au] Autor: Fleury MJ; Grenier G; Bamvita JM; Farand L [Ad] Endereço: Department of Psychiatry, McGill University, Montreal, Quebec, Canada. [Ti] Título: Relations between mental health team characteristics and work role performance. [So] Source: PLoS One;12(10):e0185451, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Effective mental health care requires a high performing, interprofessional team. Among 79 mental health teams in Quebec (Canada), this exploratory study aims to 1) determine the association between work role performance and a wide range of variables related to team effectiveness according to the literature, and to 2) using structural equation modelling, assess the covariance between each of these variables as well as the correlation with other exogenous variables. Work role performance was measured with an adapted version of a work role questionnaire. Various independent variables including team manager characteristics, user characteristics, team profiles, clinical activities, organizational culture, network integration strategies and frequency/satisfaction of interactions with other teams or services were analyzed under the structural equation model. The later provided a good fit with the data. Frequent use of standardized procedures and evaluation tools (e.g. screening and assessment tools for mental health disorders) and team manager seniority exerted the most direct effect on work role performance. While network integration strategies had little effect on work role performance, there was a high covariance between this variable and those directly affecting work role performance among mental health teams. The results suggest that the mental healthcare system should apply standardized procedures and evaluation tools and, to a lesser extent, clinical approaches to improve work role performance in mental health teams. Overall, a more systematic implementation of network integration strategies may contribute to improved work role performance in mental health care. [Mh] Termos MeSH primário: Comportamento Cooperativo Pessoal de Saúde Transtornos Mentais/terapia Saúde Mental/recursos humanos Desempenho Profissional [Mh] Termos MeSH secundário: Reforma dos Serviços de Saúde Acesso aos Serviços de Saúde Seres Humanos Cultura Organizacional Equipe de Assistência ao Paciente Quebeque Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171031 [Lr] Data última revisão: 171031 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171010 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0185451

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[PMID]: 28726508 [Au] Autor: Beker K; Garces-Descovich A; Mangosing J; Cabral-Goncalves I; Hallett D; Mortele KJ [Ad] Endereço: 1 Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical Center, 330 Brookline Ave, Boston, MA 02215. [Ti] Título: Optimizing MRI Logistics: Prospective Analysis of Performance, Efficiency, and Patient Throughput. [So] Source: AJR Am J Roentgenol;209(4):836-844, 2017 Oct. [Is] ISSN: 1546-3141 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: The objective of this study is to optimize MRI logistics through evaluation of MRI workflow and analysis of performance, efficiency, and patient throughput in a tertiary care academic center. SUBJECTS AND METHODS: For 2 weeks, workflow data from two outpatient MRI scanners were prospectively collected and stratified by value added to the process (i.e., value-added time, business value-added time, or non-value-added time). Two separate time cycles were measured: the actual MRI process cycle as well as the complete length of patient stay in the department. In addition, the impact and frequency of delays across all observations were measured. RESULTS: A total of 305 MRI examinations were evaluated, including body (34.1%), neurologic (28.9%), musculoskeletal (21.0%), and breast examinations (16.1%). The MRI process cycle lasted a mean of 50.97 ± 24.4 (SD) minutes per examination; the mean non-value-added time was 13.21 ± 18.77 minutes (25.87% of the total process cycle time). The mean length-of-stay cycle was 83.51 ± 33.63 minutes; the mean non-value-added time was 24.33 ± 24.84 minutes (29.14% of the total patient stay). The delay with the highest frequency (5.57%) was IV or port placement, which had a mean delay of 22.82 minutes. The delay with the greatest impact on time was MRI arthrography for which joint injection of contrast medium was necessary but was not accounted for in the schedule (mean delay, 42.2 minutes; frequency, 1.64%). Of 305 patients, 34 (11.15%) did not arrive at or before their scheduled time. CONCLUSION: Non-value-added time represents approximately one-third of the total MRI process cycle and patient length of stay. Identifying specific delays may expedite the application of targeted improvement strategies, potentially increasing revenue, efficiency, and overall patient satisfaction. [Mh] Termos MeSH primário: Eficiência Imagem por Ressonância Magnética/estatística & dados numéricos Pacientes/estatística & dados numéricos Desempenho Profissional Fluxo de Trabalho [Mh] Termos MeSH secundário: Seres Humanos Estudos Prospectivos Registros como Assunto Centros de Atenção Terciária [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171006 [Lr] Data última revisão: 171006 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170721 [St] Status: MEDLINE [do] DOI: 10.2214/AJR.16.17698

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[PMID]: 28704086 [Au] Autor: Foster S [Ad] Endereço: Chief Nurse at Heart of England NHS Foundation Trust. [Ti] Título: Making effective use of dashboards. [So] Source: Br J Nurs;26(13):783, 2017 Jul 13. [Is] ISSN: 0966-0461 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, considers some of the pitfalls users might encounter when collating and interpreting data. [Mh] Termos MeSH primário: Apresentação de Dados Melhoria de Qualidade Desempenho Profissional [Mh] Termos MeSH secundário: Benchmarking Seres Humanos Reino Unido [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170919 [Lr] Data última revisão: 170919 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 170714 [St] Status: MEDLINE [do] DOI: 10.12968/bjon.2017.26.13.783

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[PMID]: 28445433 [Au] Autor: Ivandic I; Kamenov K; Rojas D; Cerón G; Nowak D; Sabariego C [Ad] Endereço: Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377 Munich, Germany. iivandic@med.lmu.de. [Ti] Título: Determinants of Work Performance in Workers with Depression and Anxiety: A Cross-Sectional Study. [So] Source: Int J Environ Res Public Health;14(5), 2017 Apr 26. [Is] ISSN: 1660-4601 [Cp] País de publicação: Switzerland [La] Idioma: eng [Ab] Resumo: Depression and anxiety are highly prevalent disorders with an impact on existential aspects of person's life, including employment i.e., work performance (WP). In order to develop appropriate strategies, it is essential to identify determinants of WP. The objective of this study was to identify the built, social, attitudinal and health system-related environmental determinants of WP in workers with anxiety or depression in total ( = 1211) and regarding the level of disability. Hierarchical binary logistic regression was performed on data obtained from implementation of the WHO Model Disability Survey (MDS) in Chile in 2015. Hindering aspects of means of transportation and workplace, and the use of personal assistance were determinants of WP for all workers with anxiety or depression. Results differed with level of disability. Hindering aspects of means of transportation and workplace, and discrimination were determinants of WP for persons with mild to moderate disability, while hindering aspects of the workplace and dwelling, and the use of personal assistance were determinants of WP for persons with severe disability. Our results emphasize the need for a broader understanding of determinants of WP and the requirement for an integrative approach in developing both universal and specific strategies that go beyond workplace settings. [Mh] Termos MeSH primário: Ansiedade/epidemiologia Depressão/epidemiologia Desempenho Profissional/estatística & dados numéricos Local de Trabalho/psicologia [Mh] Termos MeSH secundário: Adulto Ansiedade/etiologia Chile/epidemiologia Estudos Transversais Depressão/etiologia Feminino Seres Humanos Masculino Meia-Idade Prevalência Fatores de Risco Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170824 [Lr] Data última revisão: 170824 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170427 [St] Status: MEDLINE

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[PMID]: 28414737 [Au] Autor: Georgantzis N; Vasileiou E; Kotzaivazoglou I [Ad] Endereço: School of Agriculture Policy and Development, University of Reading, Reading, United Kingdom. [Ti] Título: Peer norm guesses and self-reported attitudes towards performance-related pay. [So] Source: PLoS One;12(4):e0174724, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Due to a variety of reasons, people see themselves differently from how they see others. This basic asymmetry has broad consequences. It leads people to judge themselves and their own behavior differently from how they judge others and others' behavior. This research, first, studies the perceptions and attitudes of Greek Public Sector employees towards the introduction of Performance-Related Pay (PRP) systems trying to reveal whether there is a divergence between individual attitudes and guesses on peers' attitudes. Secondly, it is investigated whether divergence between own self-reported and peer norm guesses could mediate the acceptance of the aforementioned implementation once job status has been controlled for. This study uses a unique questionnaire of 520 observations which was designed to address the questions outlined in the preceding lines. Our econometric results indicate that workers have heterogeneous attitudes and hold heterogeneous beliefs on others' expectations regarding a successful implementation of PRP. Specifically, individual perceptions are less skeptical towards PRP than are beliefs on others' attitudes. Additionally, we found that managers are significantly more optimistic than lower rank employees regarding the expected success of PRP systems in their jobs. However, they both expect their peers to be more negative than they themselves are. [Mh] Termos MeSH primário: Atitude Grupo Associado Autorrelato Desempenho Profissional/economia [Mh] Termos MeSH secundário: Feminino Grécia Seres Humanos Masculino Percepção Setor Público/economia Setor Público/recursos humanos Setor Público/organização & administração Reembolso de Incentivo Autoimagem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170509 [Lr] Data última revisão: 170509 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170418 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0174724

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[PMID]: 28376464 [Au] Autor: Saultz A; Saultz JW [Ad] Endereço: Department of Educational Leadership, Miami University, Oxford, Ohio. [Ti] Título: Measuring Outcomes: Lessons From the World of Public Education. [So] Source: Ann Fam Med;15(1):71-76, 2017 Jan. [Is] ISSN: 1544-1717 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The quality and efficiency of American health care are increasingly measured using clinical and financial data with a goal of improving clinical practice. Proponents believe such efforts can improve outcomes, motivate clinicians, and inform the public about quality. Detractors point to problems with the accuracy of these measures and the risk of creating perverse incentives for both physicians and patients. Drawing on lessons from similar performance management policies in public education, we provide guidance about this trend for primary care physicians and health care policy makers. We argue that public school teacher evaluations that use value-added modeling foretell specific pitfalls for the use of similar models to evaluate physician effectiveness, and that unintended consequences of performance management in both education and health care can include the narrowing of purpose, deprofessionalization, and a loss of local/community control. [Mh] Termos MeSH primário: Avaliação de Resultados (Cuidados de Saúde)/economia [Mh] Termos MeSH secundário: Pessoal Administrativo Assistência à Saúde/normas Educação em Saúde/normas Seres Humanos Avaliação de Resultados (Cuidados de Saúde)/tendências Médicos de Atenção Primária Reembolso de Incentivo/economia Professores Escolares/normas Instituições Acadêmicas Estados Unidos Desempenho Profissional [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171113 [Lr] Data última revisão: 171113 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170405 [St] Status: MEDLINE [do] DOI: 10.1370/afm.1995

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[PMID]: 28319690 [Au] Autor: O'Donnell LA; Deldin PJ; Grogan-Kaylor A; McInnis MG; Weintraub J; Ryan KA; Himle JA [Ad] Endereço: Departments of Social Work and Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA. Electronic address: lisa.odonnel@gmail.com. [Ti] Título: Depression and executive functioning deficits predict poor occupational functioning in a large longitudinal sample with bipolar disorder. [So] Source: J Affect Disord;215:135-142, 2017 Jun. [Is] ISSN: 1573-2517 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: BACKGROUND: Bipolar Disorder (BD) is characterized by impairments in psychosocial functioning with occupational disability being one of the most significant. Depression and neurocognitive deficits are features of BD most commonly associated with poor occupational functioning (OF). Few studies have examined these features over an extended period of time focusing on distinct aspects of work functioning. METHODS: This longitudinal study included 273 adults with bipolar I disorder (N=173), bipolar II disorder (N=69), and bipolar not otherwise specified (N=31). The participants underwent an annual clinical assessment, neuropsychological testing, and work functioning measures over 5 years. We employed multilevel modeling (MLM) to determine which demographic, clinical, and neurocognitive characteristics influence 4 aspects of work functioning (work attendance, conflict, enjoyment, performance) over this 5-year period. LIMITATIONS: Work functioning was measured using a self-report measure, which may be confounded by responder bias and is not tailored for distinct occupations. Due to insufficient power, medication use was not accounted for and our sample may not generalize to the broader BD population. RESULTS: Using MLM, those with higher levels of depression and greater cognitive flexibility deficits were more likely to experience poorer work attendance (p<0.01), lower quality of work (p<0.01), and reduced satisfaction from work (p<0.001). These occupational hardships persisted over the 5-year period. CONCLUSIONS: This study emphasizes the need for interventions that specifically focus on the treatment of depressive symptoms and neurocognitive deficits within the context of work functioning, particularly attendance at work, to enable BD patients to live more productive, financially secure, and satisfying lives. [Mh] Termos MeSH primário: Absenteísmo Transtorno Bipolar/psicologia Transtornos Cognitivos/psicologia Função Executiva Relações Interpessoais Satisfação no Emprego Desempenho Profissional [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Transtorno Bipolar/complicações Transtornos Cognitivos/complicações Feminino Seres Humanos Estudos Longitudinais Masculino Meia-Idade Modelos Psicológicos Testes Neuropsicológicos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170703 [Lr] Data última revisão: 170703 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170321 [St] Status: MEDLINE

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[PMID]: 28293772 [Au] Autor: Yokota H; Goto M; Bamba C; Kiba M; Yamada K [Ad] Endereço: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan. hjmykt@koto.kpu-m.ac.jp. [Ti] Título: Reading efficiency can be improved by minor modification of assigned duties; a pilot study on a small team of general radiologists. [So] Source: Jpn J Radiol;35(5):262-268, 2017 May. [Is] ISSN: 1867-108X [Cp] País de publicação: Japan [La] Idioma: eng [Ab] Resumo: PURPOSE: To assess whether alterations in the type of duty assignment system can affect the reading efficiency and stress level of diagnostic radiologists. MATERIALS AND METHODS: Fourteen board-certified diagnostic radiologists were enrolled. We investigated three different reading systems for 1 week each. System 1 is our default, in which there are no assigned duties and everyone finishes when all cases are done. In system 2, two late shift readers are assigned every day, and, after everyone else leaves at a fixed time (5:30 p.m.), they take all remaining cases until they are finished. In system 3, a dedicated single reader is assigned to finish 30 cases, and everyone else will read all remaining cases. The total time required for reading and the number of cases read were recorded. In addition, participants completed two questionnaires regarding work-related stress. RESULTS: There was a trend toward shorter finishing time in system 2 and 3 compared to system 1 (P = 0.072 and 0.012). In terms of working stress, the subjective burden was lighter when systems 2 or 3 were employed. CONCLUSION: Minor modification of the duty assignment system has the potential to improve working efficiency and may reduce the work-related stress of diagnostic radiologists. [Mh] Termos MeSH primário: Radiologistas/normas Radiologia/métodos [Mh] Termos MeSH secundário: Certificação Seres Humanos Imagem por Ressonância Magnética/métodos Imagem por Ressonância Magnética/normas Projetos Piloto Radiologistas/psicologia Radiologia/normas Estresse Fisiológico Estresse Psicológico Tomografia Computadorizada por Raios X/métodos Tomografia Computadorizada por Raios X/normas Desempenho Profissional Carga de Trabalho [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 171104 [Lr] Data última revisão: 171104 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170316 [St] Status: MEDLINE [do] DOI: 10.1007/s11604-017-0629-8

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[PMID]: 28245877 [Au] Autor: Shen GC; Nguyen HT; Das A; Sachingongu N; Chansa C; Qamruddin J; Friedman J [Ad] Endereço: Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York, 55 West 125 Street Room 806, New York, NY, 10027, United States of America. Gordon.Shen@sph.cuny.edu. [Ti] Título: Incentives to change: effects of performance-based financing on health workers in Zambia. [So] Source: Hum Resour Health;15(1):20, 2017 Feb 28. [Is] ISSN: 1478-4491 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Performance-based financing (PBF) has been implemented in a number of countries with the aim of transforming health systems and improving maternal and child health. This paper examines the effect of PBF on health workers' job satisfaction, motivation, and attrition in Zambia. It uses a randomized intervention/control design to evaluate before-after changes for three groups: intervention (PBF) group, control 1 (C1; enhanced financing) group, and control 2 (C2; pure control) group. METHODS: Mixed methods are employed. The quantitative portion comprises of a baseline and an endline survey. The survey and sampling scheme were designed to allow for a rigorous impact evaluation of PBF or C1 on several key performance indicators. The qualitative portion seeks to explain the pathways underlying the observed differences through interviews conducted at the beginning and at the three-year mark of the PBF program. RESULTS: Econometric analysis shows that PBF led to increased job satisfaction and decreased attrition on a subset of measures, with little effect on motivation. The C1 group also experienced some positive effects on job satisfaction. The null results of the quantitative assessment of motivation cohere with those of the qualitative assessment, which revealed that workers remain motivated by their dedication to the profession and to provide health care to the community rather than by financial incentives. The qualitative evidence also provides two explanations for higher overall job satisfaction in the C1 than in the PBF group: better working conditions and more effective supervision from the District Medical Office. The PBF group had higher satisfaction with compensation than both control groups because they have higher compensation and financial autonomy, which was intended to be part of the PBF intervention. While PBF could not address all the reasons for attrition, it did lower turnover because those health centers were staffed with qualified personnel and the personnel had role clarity. CONCLUSIONS: In Zambia, the implementation of PBF schemes brought about a significant increase in job satisfaction and a decrease in attrition, but had no significant effect on motivation. Enhanced health financing also increased stated job satisfaction. [Mh] Termos MeSH primário: Pessoal de Saúde Satisfação no Emprego Motivação Reorganização de Recursos Humanos Qualidade da Assistência à Saúde Reembolso de Incentivo Desempenho Profissional [Mh] Termos MeSH secundário: Adulto Altruísmo Atitude do Pessoal de Saúde Assistência à Saúde Feminino Seres Humanos Masculino Administração de Recursos Humanos Inquéritos e Questionários Local de Trabalho Zâmbia [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170302 [St] Status: MEDLINE [do] DOI: 10.1186/s12960-017-0179-2

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