Interprofessional collaboration during an emergency ward’s rounds

Abstract

Final Draft Interprofessional Collaboration during an Emergency Ward's RoundsPurpose -This case study explores interprofessional collaboration during ward rounds on a Finnish emergency and infection ward from the viewpoint of three central professional groups: physicians, nurses and secretaries.Design/methodology/approach -We utilise an ethnographically informed approach, with observations and interviews as the data collection devices. The data comprise ten interviews with staff members and ten hours of observations. The data were analysed using qualitative thematic analysis.Findings -The ward rounds were found to be rather physician-and medicine-centred, and mostly not interprofessional. Nurses and secretaries in particular expressed dissatisfaction with many of the current ward rounds work practices. Ward rounds are an essential part of collaboration in implementing the emergency-natured operational aim of the ward, yet we found that the ward rounds are complicated by diverging professional views and expectations, variable work practices and interactional inequality.Originality/value -This study makes a contribution to the research of collaboration in emergency care and ward rounds, both of which are little-studied fields. Further, contextspecific studies of collaboration have been called for in order to eventually create a model of shared expertise. The findings of this study can be utilised in studying and developing emergency care contexts. Introduction Interprofessional collaborationTasks in health care are becoming more and more intricate. A demand for even better collaboration among professionals has thus arisen (Hoskins, 2012), as it has been seen to improve the quality of health care (MacNaughton et al., 2013), in particular, patient safety (Baker et al., 2006) and patient-based, holistic care (McCallin, 2001;D'Amour et al., 2005;Baker et al., 2006). Characteristic of interprofessional collaboration is that work, its practices and the object of work are examined as a whole, combining expertise from different professional fields in a work community and work group (Housley, 2003). Interprofessionalism has thus also been called shared and collegial expertise. Patient care is a task shared among professionals, which posits that tasks and collaboration are synchronised (Baker et al., 2006). However, such ideals are rarely present in the reality of health care. Instead, the realisation of interprofessional collaboration in different health care contexts varies; the degree of interprofessional collaboration depends on organisations and work tasks (Millward and Jeffries, 2001;Collin et al., 2012).In this case study, our aim is to explore interprofessional collaboration in an emergency care context, more specifically during ward rounds, from the viewpoints of three central professional groups: physicians, nurses and secretaries. Various local and context-specific studies of interprofessional collaboration have been called for in order to eventually create a general model of shared expertise (Collin et al., 2015...

Vivências De Conflitos Éticos Na Prática Do Enfermeiro Em Unidade De Emergência

“…É válido destacar que, o conflito maior acontece entre a equipe multiprofissional, principalmente com o médico e Técnico de Enfermagem (TE), onde o segundo quer ser superior ao enfermeiro e este quer adentrar a área do médico (Enf 5). É necessário destacar que a prestação do cuidado atrelado a sistematização da assistência é de suma importância para recuperação da saúde do paciente e atendimento a suas necessidades humanas básicas (COLLIN;PALONIEMI;HERRANEN, 2015;COLLIN et al, 2015) A possibilidade de emergir conflitos éticos diz respeito a estrutura organizacional, escassez de recursos, sobrecarga e estresse emocional (Enf 3 e Enf 1). A Unidade de Emergência Hospitalar (UEH), configura-se como um dos setores hospitalares que mais desgastam física e mentalmente os profissionais podendo levar os mesmos ao desencadeamento do estresse (SILVA SANTANA; SERVO; SOUSA, 2018).…”

Work intensification and ambidexterity - the notions of extreme and ‘everyday’ experiences in emergency contexts: surfacing dynamics in the ambulance service

“…Given its civic importance, and the transitions taking place therein, emergency services represent an important area for examination corning how 'extreme' situations unfold in relation to everyday contexts. Extant literature on the emergency services has considered a number of prevalent issues and topics including: network structures and command systems (Griffith and Roberts 2015); culture change (Wankhade et al 2018); performance (Barton & Beynon 2012); decision-making (Shaw et al 2013); inter-professional collaboration (Collin et al 2015); leadership dynamics (Van Wart 2014); and mental health (Wagner et al 2016). Much of this work has generally concentrated on a functionalistic frame of reference typically focusing on issues of efficiency and effectiveness.…”