The observer effect in a hospital setting - Experiences from the observed and the observers

Svensberg, Karin; Kalleberg, Birgitte Grøstad; Mathiesen, Liv; Andersson, Yvonne; Rognan, Stine Eidhammer; Sporrong, Sofia Kälvemark

doi:10.1016/j.sapharm.2021.07.011

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…The musicians we observed viewed us as students of the craft of Baul music; given the rarity of interaction between Baul musicians and academics (Krakauer 2016), they were not prone to being intimidated by our academic status. People often behave differently when being observed (McCambridge, Witton, and Elbourne 2014; Pillow 2003), so we tried to mitigate this effect by spending more time with participants and visiting them on multiple occasions; if some respondents were uncomfortable with us or tempted to show off, we reasoned that this tendency would subside over time as they grew accustomed to us (Svensberg et al 2021). We visited musicians at their homes as well as in performance scenarios, expecting them to be more comfortable and less tempted to show off during home visits.…”

Section: Full-cycle Research Methodsmentioning

confidence: 99%

Marching to Her Own Beat: Asynchronous Teamwork and Gender Differences in Performance on Creative Projects

Ranganathan,

Das

2023

Am Sociol Rev

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Women have traditionally been held back from performing to their full potential in creative project teams, where they typically constitute a minority. However, due to recent technological developments, the structure of teamwork is rapidly evolving. Specifically, teamwork is now often performed asynchronously: members of teams work at different times, by themselves, rather than simultaneously and together. How will this shift to asynchronous teamwork affect the performance of men and women on creative project teams? This article argues that women will perform better when teamwork is asynchronous rather than synchronous, because working alone will afford them greater freedom for creative expression. We argue that men will not experience the same boost in performance, and thus the spread of asynchronous teamwork has the potential to reduce gender disparities in performance. We explore this question in the context of folk-music ensembles in eastern India. After collecting ethnographic and interview data from folk musicians to develop our theory, we conducted a field experiment in which individual singers, men and women, recorded a song both synchronously and asynchronously with the same set of instrumentalists. This article contributes to the study of gender inequality, creativity, and the temporal restructuring of work.

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Section: Full-cycle Research Methodsmentioning

confidence: 99%

Marching to Her Own Beat: Asynchronous Teamwork and Gender Differences in Performance on Creative Projects

Ranganathan,

Das

2023

Am Sociol Rev

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“…How we “entered the setting”, i.e., the internal medicines ward as observers, was critical for the validity of the results. A focus group study was performed to assess the effect of our observations on the HCPs, four weeks after the observations terminated (Svensberg et al, 2021 ). In addition, the semi-structured patient interviews included a question about how they had experienced being observed.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…In addition, the semi-structured patient interviews included a question about how they had experienced being observed. Although the effect of the researcher in the social setting can never be controlled for, the results indicated that the observer effect in relation to medication communication seemed to be small and temporary (Svensberg et al, 2021 ). The medication communication appeared not to be strongly affected by the presence of the observers, and this strengthens the validity of the data.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…However, relations were built by eye contact or small talk in the corridor, confirmed by the patients’ description of how they perceived the observers as “my guardian” and “almost as my daughter”. One factor possibly contributing to success in observing the discharge process was that many HCPs reported a feeling of safety as they already “knew the observers” that is, were familiar with clinical pharmacists at the ward (Svensberg et al, 2021 ).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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‘The way you talk, do I have a choice?’ Patient narratives of medication decision-making during hospitalization

Rognan,

Jørgensen,

Mathiesen

et al. 2023

International Journal of Qualitative Studies on Health and Well

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Objective Based on the principle of the autonomy of the patient, shared decision-making (SDM) is the ideal approach in clinical encounters. In SDM, patients and healthcare professionals (HCPs) share knowledge and power when faced with the task of making decisions. However, patients are often not involved in the decision-making process. In this study, we explore medication decision-making during hospitalization and how power in the specific patient—HCP relationship is articulated, as analysed by Foucauldian theory. Methods A qualitative case study, comprising observations of patient-HCP encounters at an internal medicines ward at a university hospital in Norway, followed by semi-structured interviews. The narratives ( n = 4 patients) were selected from a larger study ( n = 15 patients). The rationale behind the choice of these patients was to include diverse and rich accounts. The four patients in their 40s–70s were included close to the day of presumed discharge. Results The narratives provide an insight into the patients as persons, their perspectives, including what mattered to them during their hospitalization, especially in relation to medications. Overall, SDM was not observed in this study. Even though all the participants actively tried to keep their autonomous capacity and to resist the HCPs’ use of power, they were not able to change the established dynamics. Moreover, they were not allowed an equal voice to those of HCPs and thus not to escape the system’s objectification and subjectification of them. Conclusion There is a need for HCPs to get more familiarized with SDM. The healthcare system and the individual HCP need to make more room for dialogue with the patients about their preferences. A part of this is also how health care systems are structured and scheduled, thus, it is important to empower patients and HCPs alike.

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“…It can also be subject to bias in either data collection or interpretation as the behaviors being observed may be affected, known as the Hawthorne effect. 16,17 As more digital devices are used in modern clinical environments, they can provide alternative sources to assess health care processes. 18,19 One such technology is the smart infusion pump system.…”

Section: Background and Significancementioning

confidence: 99%

Uncovering Discrepancies in IV Vancomycin Infusion Records between Pump Logs and EHR Documentation

2022

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Background Infusion start time, completion time, and interruptions are the key data points needed in both area under the concentration–time curve (AUC)- and trough-based vancomycin therapeutic drug monitoring (TDM). However, little is known about the accuracy of documented times of drug infusions compared with automated recorded events in the infusion pump system. A traditional approach of direct observations of infusion practice is resource intensive and impractical to scale. We need a new methodology to leverage the infusion pump event logs to understand the prevalence of timestamp discrepancies as documented in the electronic health records (EHRs). Objectives We aimed to analyze timestamp discrepancies between EHR documentation (the information used for clinical decision making) and pump event logs (actual administration process) for vancomycin treatment as it may lead to suboptimal data used for therapeutic decisions. Methods We used process mining to study the conformance between pump event logs and EHR data for a single hospital in the United States from July to December 2016. An algorithm was developed to link records belonging to the same infusions. We analyzed discrepancies in infusion start time, completion time, and interruptions. Results Of the 1,858 infusions, 19.1% had infusion start time discrepancy more than ± 10 minutes. Of the 487 infusion interruptions, 2.5% lasted for more than 20 minutes before the infusion resumed. 24.2% (312 of 1,287) of 1-hour infusions and 32% (114 of 359) of 2-hour infusions had over 10-minute completion time discrepancy. We believe those discrepancies are inherent part of the current EHR documentation process commonly found in hospitals, not unique to the care facility under study. Conclusion We demonstrated pump event logs and EHR data can be utilized to study time discrepancies in infusion administration at scale. Such discrepancy should be further investigated at different hospitals to address the prevalence of the problem and improvement effort.

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The observer effect in a hospital setting - Experiences from the observed and the observers

Cited by 10 publications

References 12 publications

Marching to Her Own Beat: Asynchronous Teamwork and Gender Differences in Performance on Creative Projects

Marching to Her Own Beat: Asynchronous Teamwork and Gender Differences in Performance on Creative Projects

‘The way you talk, do I have a choice?’ Patient narratives of medication decision-making during hospitalization

Uncovering Discrepancies in IV Vancomycin Infusion Records between Pump Logs and EHR Documentation

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