Laurie Cluff

Evaluating Efforts to Optimize TeamSTEPPS Implementation in Surgical and Pediatric Intensive Care Units

BACKGROUND An evidence-based teamwork system, Team-STEPPS, was implemented in an academic medical centers pediatric and surgical ICUs. METHODS A multidisciplinary change team of unit- and department-based leaders was formed to champion the initiative; develop a customized action plan for implementation; train frontline staff; and identify process, team outcome, and clinical outcome objectives for the intervention. The evaluation consisted of interviews with key staff, teamwork observations, staff surveys, and clinical outcome data. RESULTS All PICU, SICU, and respiratory therapy staff received TeamSTEPPS training. Staff reported improved experience of teamwork posttraining and evaluated the implementation as effective. Observed team performance significantly improved for all core areas of competency at 1 month postimplementation and remained significantly improved for most of the core areas of competency at 6 and 12 months postimplementation. Survey data indicated improvements in staff perceptions of teamwork and communication openness in both units. From pre- to posttraining, the average time for placing patients on extracorporeal membrane oxygenation (ECMO) decreased significantly. The average duration of adult surgery rapid response team events was 33% longer at postimplementation versus pre-implementation. The rate of nosocomial infections at postimplementation was below the upper control limit for seven out of eight months in both the PICU and the SICU. CONCLUSIONS The implementation of a customized 2.5-hour version of the TeamSTEPPS training program in two areas--the PICU and SICU--that had demonstrated successful ability to innovate suggests that the training was successful.

Young adults in the workplace: A multisite initiative of substance use prevention programs

document when you quote from it. You must not sell the document or make a profit from reproducing it. assisted in the writing of the book. The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS. Introduction Cross-site evaluations have become a common methodology to provide the best evidence possible from studies examining complex social phenomena. Cross-site evaluations are designed to compare program characteristics across multiple venues, to use common data across sites, and to identify the relative effectiveness of programs and program characteristics (Sambrano et al. Unlike clinical trials, which test programs under ideal settings, cross-site (or multisite) evaluations often test the impact of different programmatic and design elements as they are implemented in real-world settings. Government agencies are increasingly turning to cross-site evaluations of the programs they sponsor to ensure accountability of the individuals and organizations they fund, to inform policy decisions, and to gain an understanding of how government-funded programs affect targeted populations. This chapter provides an overview of the design and methods of the Young Adults in the Workplace (YIW) cross-site evaluation. By assessing program content and implementation processes, identifying diversity in the YIW interventions and populations, and using this diversity to examine the workplace and programmatic characteristics that mediate and moderate the effectiveness of various intervention components and strategies, the cross-site evaluation will provide the Substance Abuse and Mental Health Services Administration (SAMHSA) with knowledge to meet the objectives of the YIW initiative. The YIW initiative includes several interrelated components that enable SAMHSA to integrate data across funded programs, allowing the agency to examine program effectiveness at the program and cross-site levels and to use expert knowledge to strengthen each component to best inform public policy at the national level. Chapter 1 provides a detailed description of the YIW initiative; here we provide a brief overview that establishes the framework for the cross-site evaluation. As depicted in Figure 8.1, the YIW cross-site components include technical assistance to the grantees to strengthen program implementation and grantee-level evaluations, cross-site data collection to support a cross-site evaluation, consultation and knowledge exchange workshops to provide expert input at all levels of the evaluation, and knowledge dissemination to ensure the transfer of information from service to science. The cross-site data collection initiative is informed by SAMHSAs national outcome measures (NOMs), a set of outcome measures that SAMHSA discretionary grant …

Elements of a workplace culture of health, perceived organizational support for health, and lifestyle risk:

Purpose: We investigated the impact of elements of a workplace culture of health (COH) on employees’ perceptions of employer support for health and lifestyle risk. Design: We used 2013 and 2015 survey data from the National Healthy Worksite Program, a Centers for Disease Control and Prevention (CDC)-led initiative to help workplaces implement health-promoting interventions. Setting: Forty-one employers completed the CDC Worksite Health Scorecard to document organizational changes. Participants: Eight hundred twenty-five employees provided data to evaluate changes in their health and attitudes. Measures: We defined elements of a COH as environmental, policy, and programmatic supports; leadership and coworker support; employee engagement (motivational interventions); and strategic communication. Outcomes included scores of employees’ perceptions of employer support for health and lifestyle risk derived from self-reported physical activity, nutrition, and tobacco use. Analysis: We estimated effects using multilevel regression models. Results: At the employee level and across time, regression coefficients show positive associations between leadership support, coworker support, employee engagement, and perceived support for health (P < .05). Coefficients suggest a marginally significant negative association between lifestyle risk and the presence of environmental and policy supports (P < .10) and significant associations with leadership support in 2015 only (P < .05). Conclusion: Relational elements of COH (leadership and coworker support) tend to be associated with perceived support for health, while workplace elements (environmental and policy supports) are more associated with lifestyle risk. Employers need to confront relational and workplace elements together to build a COH.

Comparing medical and recreational cannabis use among employees: associations with health and work-related outcomes

Abstract Nearly one in five US employees reports having used cannabis in the past year. As policies and laws regarding cannabis use rapidly change, concerns have arisen over employees’ use of cannabis, for both medical and recreational purposes. While extant workplace research has not distinguished between types of cannabis users, other studies have found that medical users are clinically and socio-demographically different from non-medical users. This study utilized a sample of employed National Survey on Drug Use and Health (NSDUH) respondents to examine differences in workplace characteristics and health outcomes among employed medical, recreational, and mixed-use cannabis users. While some differences were initially seen when examining health and work-related outcomes between the groups, several changed after controlling for other important health-related factors. One key difference between the user groups is the higher percentages of medical and mixed-use cannabis users in the construction and mining industries. This study discusses future research needs, as well as practical implications for workers and employers.

Training Employers to Implement Health Promotion Programs: Results From the CDC Work@Health® Program:

Purpose: Centers for Disease Control and Prevention (CDC) initiated the Work@Health Program to teach employers how to improve worker health using evidence-based strategies. Program goals included (1) determining the best way(s) to deliver employer training, (2) increasing employers’ knowledge of workplace health promotion (WHP), and (3) increasing the number of evidence-based WHP interventions at employers’ worksites. This study is one of the few to examine the effectiveness of a program designed to train employers how to implement WHP programs. Design: Pre- and posttest design. Setting: Training via 1 of 3 formats hands-on, online, or blended. Participants: Two hundred six individual participants from 173 employers of all sizes. Intervention: Eight-module training curriculum to guide participants through building an evidence-based WHP program, followed by 6 to 10 months of technical assistance. Measures: The CDC Worksite Health ScoreCard and knowledge, attitudes, and behavior survey. Analysis: Descriptive statistics, paired t tests, and mixed linear models. Results: Participants’ posttraining mean knowledge scores were significantly greater than the pretraining scores (61.1 vs 53.2, P < .001). A year after training, employers had significantly increased the number of evidence-based interventions in place (47.7 vs 35.5, P < .001). Employers’ improvements did not significantly differ among the 3 training delivery formats. Conclusion: The Work@Health Program provided employers with knowledge to implement WHP interventions. The training and technical assistance provided structure, practical guidance, and tools to assess needs and select, implement, and evaluate interventions.

The Centers for Disease Control and Prevention: Findings From The National Healthy Worksite Program

Objective: To evaluate employers’ implementation of evidence-based interventions, and changes in employees’ behaviors associated with participating in the national healthy worksite program (NHWP). Methods: NHWP recruited 100 small and mid-sized employers and provided training and support for 18 months. Outcome measures were collected with an employer questionnaire, an employee survey, and biometric data at baseline and 18 months later. Results: The 41 employers who completed the NHWP implemented significantly more evidence-based interventions and had more comprehensive worksite health promotion programs after participating. Employees made significant improvements in physical activity and nutritional behaviors, but did not significantly improve employee weight. Conclusions: Training and technical support can help small and mid-sized employers implement evidence-based health interventions to promote positive employee behavior changes. A longer follow up period may be needed to assess whether NHWP led to improvements in clinical outcomes.

Building Capacity for Workplace Health Promotion: Findings From the Work@Health® Train-the-Trainer Program:

Small- and mid-sized employers are less likely to have expertise, capacity, or resources to implement workplace health promotion programs, compared with large employers. In response, the Centers for Disease Control and Prevention developed the Work@Health® employer training program to determine the best way to deliver skill-based training to employers of all sizes. The core curriculum was designed to increase employers’ knowledge of the design, implementation, and evaluation of workplace health strategies. The first arm of the program was direct employer training. In this article, we describe the results of the second arm—the program’s train-the-trainer (T3) component, which was designed to prepare new certified trainers to provide core workplace health training to other employers. Of the 103 participants who began the T3 program, 87 fully completed it and delivered the Work@Health core training to 233 other employers. Key indicators of T3 participants’ knowledge and attitudes significantly improved after training. The curriculum delivered through the T3 model has the potential to increase the health promotion capacity of employers across the nation, as well as organizations that work with employers, such as health departments and business coalitions.

Industry and Occupation Variations in Nonmedical Prescription Pain Reliever Use

Nonmedical use of prescription pain relievers can be a serious problem for employers. Despite growing attention to prescription drug abuse, little is known about which industries or occupations are at the highest risk for misuse. This study used data from the National Survey on Drug Use and Health to compare each industry to every other industry to identify significant differences in rates of past-year prescription drug misuse. Findings suggest that for industries with the highest prevalence rates, prescription misuse cannot be explained by basic demographics and likely involves elements inherent to the work context and requirements.