Managing boundaries at the accident scene – a qualitative study of collaboration exercises

Abstract

Purpose – The purpose of this paper is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration. Design/methodology/approach – Interviews with 23 participants from four collaboration exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis. Findings – Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision making. Originality/value – The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.

Perceived Usefulness of Maritime Cross-Border Collaboration Exercises

“…Local, professionally trained emergency responders handle most daily emergencies [18]. A crisis however, is more transboundary in nature, and rarely confined by administrative and geographical boundaries [19].…”

Boundary Work to Conduct Business as Usual: Interaction at the Boundary Between the Affected Organization and Emergency Responders

“…A review of crisis management literature indicates that the majority of the studies were concerned with the "core" actors, that is, different types of professional preparedness and emergency services (Andersson, Carlstrom, Ahgren, & Berlin, 2014;Berlin & Carlstr€ om, 2009;Jerzy, 2016) and organizations working in high-reliability environments (Hales & Chakravorty, 2016;Mousavi et al, 2018;Roberts & Bea, 2001). Another stream of research examines more "peripheral" emergency actors, particularly different types of organized (Benson, Twigg, & Myers, 2001;Kapucu, Arslan, & Demiroz, 2010;Robinson, Murphy, & Bies, 2014) and unorganized volunteers (Barsky et al, 2007;Harris et al, 2017) and their relationship to the core actors (Egan & Tischler, 2010;Johansson, Danielsson, Eriksson, Kvarnl€ of, & Karlsson, 2018;Kvarnl€ of & Johansson, 2014;Rivera, 2016;Scanlon, Helsloot, & Groenendaal, 2014).…”

Urgent care centre in Sweden—the integration of teams and perceived effects

“…Earlier studies have shown that the number of visits to the ED can be reduced if health‐care providers integrate and collaborate by establishing reliable reporting routines, access to information such as medical data, and an open‐minded approach between staff from the organisations involved . Patients with multifaceted needs cause conflicts between health‐care entities in assessment of the patients' needs and determination of responsible unit for delivering health care, resulting in longer transfer time between the units …”

“…18 Patients with multifaceted needs cause conflicts between health-care entities in assessment of the patients' needs and determination of responsible unit for delivering health care, 19 resulting in longer transfer time between the units. 20,21 Another important internal factor is the lack of a reliable triage with good continuity, which prevents a smooth inflow of patients within the hospital and between different units. One remedy calls for the use of senior physicians to increase the competence of the triage team, thus improving the sensitivity and specificity of triaging at the ED and decreasing LOS.…”