***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Sharing information with the team is critical in developing a shared mental model in an emergency , and fundamental to effective teamwork . We developed a structured call-out tool , encapsulated in the acronym ' SNAPPI ' : Stop ; Notify ; Assessment ; Plan ; Priorities ; Invite ideas . We explored whether a video-based intervention could improve structured call-outs during simulated crises and if this would improve information sharing and medical management . METHODS In a simulation-based r and omized , blinded study , we evaluated the effect of the  video-intervention teaching SNAPPI  on scores for SNAPPI , information sharing , and medical management using baseline and follow-up crisis simulations . We assessed information sharing using a probe technique where  nurses and technicians  received unique , clinical ly relevant information probes before the simulation .  Shared knowledge of probes was measured in a written , post-simulation test . We also scored sharing of diagnostic options with the team and medical management . RESULTS Anaesthetists '  scores for SNAPPI were significantly improved , as was the number of diagnostic options they shared . We found a non-significant trend to improve information-probe sharing and medical management in the intervention group , and across all simulations , a significant correlation between SNAPPI and information-probe sharing . Of note , only 27 % of the clinical ly relevant information about the patient provided to the nurse and technician in the pre-simulation information probes was subsequently learnt by the anaesthetist . CONCLUSIONS We developed a structured communication tool , SNAPPI , to improve information sharing between anaesthetists and their team , taught it using a video-based intervention , and provide initial evidence to support its value for improving communication in a crisis It is important to underst and the effects of a new care model on health professionals ' satisfaction , which may help inform organizations ' decisions regarding the adoption of the model . This study evaluates the effect of the Guided Care model of primary care on physicians ' , Guided Care Nurses ' and practice staff satisfaction with processes of care for chronically ill older patients . In Guided Care , a specially educated registered nurse works with 2 - 5 primary care physicians , performing 8 clinical activities for 50 - 60 chronically ill older patients . This model was tested in a 3-year matched-pair cluster-r and omized controlled trial with 14 pods ( teams of physicians and staff ) r and omly assigned , within pairs , to provide Guided Care or usual care . Physicians and Guided Care Nurses were surveyed at baseline and annually for 3 years . Staff were surveyed at baseline and 2 years later . Physicians ' satisfaction with chronic care processes , knowledge of patients , and care coordination were measured , as well as Guided Care Nurses ' satisfaction with chronic care processes and staff perceptions of quality of care . Findings suggest that Guided Care improved physician satisfaction with patient/family communication and management of chronic care , and it may bolster staff beliefs that care is patient oriented . Differences in other aspects of care were not statistically significant BACKGROUND Previous research has shown that communication between members of multidisciplinary teams ( MDTs ) is often suboptimal and communication about trials between MDTs and their patients is difficult . Educational interventions can help dyadic exchanges with different aspects of trial recruitment but less work has focussed on team interventions . METHODS 22 multidisciplinary cancer teams in the UK participated in an RCT of a novel Teams Talking Trials ( TTT ) Workshop aim ed at improving the following : awareness , involvement , communication and recruitment to cancer trials . MDTs were r and omised following either 6 or 12 months of audits , which were repeated after the intervention . Audits included numbers approached about trials , team members ' attitudes , involvement and awareness of their teams ' trial portfolios . RESULTS There was no significant difference in the rate of approaching patients about trials post workshop ( estimated improvement 22 % higher regression coefficient of 0.2 , exp . (0.2)=1.22 ) . There was improvement in team members ' involvement in trials in 4 areas ( p≤0.04 ) : the pressure to enter patients into RCTs , the likelihood of a start-up meeting to discuss a newly accepted trial , the informational role played by individuals and recognition of this HCP 's role by other team members . Also , confidence in communication about RCTS increased and awareness of different aspects of trial management improved on all 14 aspects ( p=0.001 ) . CONCLUSION Attendance by teams at focussed workshops design ed to enhance communication and trial recruitment improved several aspects of team functioning , but a significant impact on the number of patients approached could not be demonstrated Background Crew re source management ( CRM ) has the potential to enhance patient safety in intensive care units ( ICU ) by improving the use of non-technical skills . However , CRM evaluation studies in health care are inconclusive with regard to the effect of this training on behaviour and organizational outcomes , due to weak study design s and the scarce use of direct observations . Therefore , the aim of this study is to determine the effectiveness and cost-effectiveness of CRM training  on attitude , behaviour and organization after one year , using a multi- method approach and matched control units . The purpose of the present article is to describe the study protocol and the underlying choices of this evaluation study of CRM in the ICU in detail . Methods / Design Six ICUs participated in a paired controlled trial , with one pre-test and two post test measurements ( respectively three months and one year after the training ) . Three ICUs were trained and compared to matched control ICUs . The 2-day classroom-based training was delivered to multidisciplinary groups . Typical CRM topics on the individual , team and organizational level were discussed , such as situational awareness , leadership and communication . All levels of Kirkpatrick 's evaluation framework ( reaction , learning , behaviour and organisation ) were assessed using question naires , direct observations , interviews and routine ICU administration data . Discussion It is expected that the CRM training acts as a generic intervention that stimulates specific interventions . Besides effectiveness and cost-effectiveness , the assessment of the barriers and facilitators will provide insight in the implementation process of CRM.Trial registration Netherl and s Trial Register ( NTR ) : Promotoras from the communities in which interventions are implemented can be effective contributors to validity and fidelity efforts . This article describes a 48-week r and omized controlled trial Madres para la Salud ( Mothers for Health ) and illustrates the use of promotoras as collaborative members of the research team to contribute to attaining integrative validity and treatment fidelity . Madres para la Salud implements a culturally tailored physical activity program to effect changes in body fat , systemic and fat tissue inflammation , and depression symptoms . The significance of Madres para la Salud treatment validity and fidelity processes includes cultural tailoring of a social support intervention , and a promotora model to incorporate initial and ongoing fidelity monitoring OBJECTIVE The aim of the study was to evaluate the interprofessional SDM training program " Fit for SDM " in medical rehabilitation , which was implemented in two steps : ( 1 ) university staff trained providers in executive positions as trainers and ( 2 ) the providers trained their staff .  METHODS For the evaluation of the first step a question naire for shared decision-making ( SDM ) skills and satisfaction with the training was completed by the providers in executive positions . A staff survey was used in a cluster-r and omized controlled study to determine the overall impact of the train-the-trainer program on internal and external participation in the team . RESULTS The providers in the six clinics evaluated their SDM competences and satisfaction very positively after training ( step 1 ) . External participation was enhanced by application of the training content , with significant changes recorded for females and nurses in particular . However , it had no direct influence on internal participation . CONCLUSIONS This is the first interprofessional SDM train-the-trainer program in Germany to bridge interprofessionalism ( internal participation ) and SDM ( external participation ) ; it was implemented successfully and evaluated positively . PRACTICE IMPLICATION S Establishing interprofessional SDM training programs should be encouraged for all health care professionals . Implementation in the interprofessional setting should consider interprofessional team factors There is evidence for a team-based approach in the management of chronic disease in primary health care . However , the st and ard of care is variable , probably reflecting the limited organisational capacity of health services to provide the necessary structured and organised care for this group of patients . This study aim ed to evaluate the impact of a structured intervention involving non-GP staff in GP practice s  on the quality of care for patients with diabetes or cardiovascular disease . A cluster r and omised trial was undertaken across 60 GP practice s. The intervention was implemented in 30 practice s with staff and patients interviewed at baseline and at 12 - 15 months follow up . The change in team roles was evaluated using a  question naire completed by practice staff . The quality of care was evaluated using the Patient Assessment of Chronic Illness Care question naire . We found that although the team roles of staff improved in the intervention practice s and there were significant differences between practice s , there was no significant difference between those in the intervention and control groups in patient-assessed quality of care after adjusting for baseline-level score and covariates at the 12-month follow up . Practice team roles were not significantly associated with change in Patient Assessment of Chronic Illness Care scores .  Patients with multiple conditions were more likely to assess their quality of care to be better . Thus , although previous research has shown a cross-sectional association between team work and quality of care , we were unable to replicate these findings in the present study . These results may be indicative of insufficient time for organisational change to result in improved patient-assessed quality of care , or because non-GP staff roles were not sufficiently focussed on the aspects of care assessed . The findings provide important information for research ers when design ing similar studies IMPORTANCE Hospital readmissions are common and costly , and no single intervention or bundle of interventions has reliably reduced readmissions . Virtual wards , which use elements of hospital care in the community , have the potential to reduce readmissions , but have not yet been rigorously evaluated . OBJECTIVE To determine whether a virtual ward-a model of care that uses some of the systems of a hospital ward to provide interprofessional care for community-dwelling patients -can reduce the risk of readmission in patients at high risk of readmission or death when being discharged from hospital . DESIGN , SETTING , AND PATIENTS High-risk adult hospital discharge patients in Toronto were r and omly assigned to either the virtual ward or usual care .  A total of 1923 patients were r and omized during the course of the study : 960 to the usual care group and 963 to the virtual ward group . The first patient was enrolled on June 29 , 2010 , and follow-up was completed on June 2 , 2014 . INTERVENTIONS Patients assigned to the virtual ward received care coordination plus direct care provision ( via a combination of telephone , home visits , or clinic visits ) from an interprofessional team for several weeks after hospital discharge . The interprofessional team met daily at a central site to design and implement individualized management plans . Patients assigned to usual care typically received a typed , structured discharge summary , prescription for new medications if indicated , counseling from the resident physician , arrangements for home care as needed , and recommendations , appointments , or both for follow-up care with physicians as indicated . MAIN OUTCOMES AND MEASURES The primary outcome was a composite of hospital readmission or death within 30 days of discharge . Secondary outcomes included nursing home admission and emergency department visits , each of the components of the primary outcome at 30 days , as well as each of the outcomes ( including the composite primary outcome ) at 90 days , 6 months , and 1 year . RESULTS There were no statistically significant between-group differences in the primary or secondary outcomes at 30 or 90 days , 6 months , or 1 year . The primary outcome occurred in 203 of 959 ( 21.2 % ) of the virtual ward patients and 235 of 956 ( 24.6 % ) of the usual care patients ( absolute difference , 3.4 % ; 95 % CI , -0.3 % to 7.2 % ; P = .09 ) . There were no statistically significant interactions to indicate that the virtual ward model of care was more or less effective in any of the prespecified subgroups . CONCLUSIONS AND RELEVANCE In a diverse group of high-risk patients being discharged from the hospital , we found no statistically significant effect of a virtual ward model of care on readmissions or death at either 30 days or 90 days , 6 months , or 1 year after hospital discharge . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01108172 A project based at the Alfred Emergency and Trauma Centre in Melbourne , Australia aim ed to st and ardise trauma resuscitation , documentation and interventions by developing best practice algorithms . The primary study objective was to demonstrate a reduction in management errors using a real-time computer based algorithm ( the study group ) compared to the control group in an open r and omised controlled interventional study . A baseline control group was also used for comparison with usual ( current ) practice . In order to examine the existing evidence and algorithms in trauma care , nine teams of emergency nurses and doctors were formed . Specific literature search es performed by each team revealed a paucity of evidence supporting clinical practice in the trauma setting for procedures . Subsequently , the multidisciplinary teams worked together and developed algorithms based on best practice . The process revealed three main areas of challenges in the development of algorithms : ( i ) clinical , ( ii ) research and ( iii ) nursing challenges . The completion of the project demonstrated benefits in the real-time computer based algorithm with a reduction in the error rate per patient from the baseline control group to the intervention study group ( 2.30 vs. 2.13 , p=0.04 ) and error-free resuscitations increasing from 16 % to 21.8 % ( p=.049 ) . This project supported the implementation of a real-time computer based algorithm system with improved protocol compliance and reduced errors and morbidity Background There are many avoidable deaths in hospitals because the care team is not well attuned . Training in emergency situations is generally followed on an individual basis . In practice , however , hospital patients are treated by a team composed of various disciplines . To prevent communication errors , it is important 
    Output:
    
Compared to multidisciplinary audio conferencing , multidisciplinary video conferencing may reduce the average length of treatment and may reduce the number of multidisciplinary conferences needed per patient and the patient length of stay .
Given that the certainty of evidence from the included studies was judged to be low to very low , there is not sufficient evidence to draw clear conclusions on the effects of IPC interventions .