Once‐a‐week psychiatric ward round or daily inpatient team meeting? A multidisciplinary mental health team's experience of new ways of working

Fiddler, Magdalen; Borglin, Gunilla; Galloway, A.; Jackson, Carl; McGowan, Linda; Lovell, Karina

doi:10.1111/j.1447-0349.2009.00652.x

Cited by 21 publications

(41 citation statements)

References 26 publications

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“…On the one hand, the traditional, physician-dominated ward round has been seen to bring safety and structure to the work; on the other hand, it is rigid and prevents efficient collaboration (Fiddler et al, 2010). Nurses, for example, have expressed discontentment with ward rounds due to their often minimal role in them (e.g.…”

Section: Ward Roundsmentioning

confidence: 99%

“…Ward rounds are often the sole occasions where physicians, nurses and patients can discuss care aims or discharge, for example (Weber et al, 2007). In a few studies, interventions have been implemented to develop ward rounds in a more interprofessional direction, and experiences of these interventions have been examined with surveys (O'Leary et al, 2010) and interviews (Fiddler et al, 2010). Interprofessional ward rounds have, in fact, yielded positive results: for instance, the deployment of a structured form focussed on the central issues in ward rounds, as a tool to enhance interprofessional communication, was found to improve collaboration significantly (O'Leary et al, 2010).…”

Section: Ward Roundsmentioning

confidence: 99%

“…Although ward rounds are, essentially, opportunities for interprofessionalism, in practice their implementation varies and they are often dominated by (senior) physicians (Weber et al, 2007;Walton and Steinert, 2010). In emergency care, time is of the essence, and smooth collaboration during ward rounds is thus also indispensable.On the one hand, the traditional, physician-dominated ward round has been seen to bring safety and structure to the work; on the other hand, it is rigid and prevents efficient collaboration (Fiddler et al, 2010). Nurses, for example, have expressed discontentment with ward rounds due to their often minimal role in them (e.g.…”

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Interprofessional collaboration during an emergency ward’s rounds

Collin

Herranen

Valleala

et al. 2015

International Journal of Emergency Services

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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...

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Section: Ward Roundsmentioning

confidence: 99%

Section: Ward Roundsmentioning

confidence: 99%

mentioning

confidence: 99%

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Interprofessional collaboration during an emergency ward’s rounds

Collin

Herranen

Valleala

et al. 2015

International Journal of Emergency Services

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“…Snell et al [22] argue that more research is needed, focusing on the context and the specific needs of the medical profession, to better understand what physicians themselves consider as hinders and enablers for improvement work, like changing the ward round. Fiddler and colleagues [19] argue that despite an increased awareness about the importance of understanding the experiences of those involved in a change, research is still sparse to investigate how professionals view changes to ward rounds. Our study explored physician experiences after changing the ward round in an internal medicine department at a mid-size hospital in Sweden.…”

mentioning

confidence: 99%

“…Although evidence is growing that effective working from multidisciplinary team-rounding improves patient outcomes [4] , there is insufficient evidence to guide successful changes in ward rounds [19] . A recent Cochrane intervention review with the focus on interprofessional collaboration [20] , including two round studies, concluded that interprofessional collaboration can improve healthcare processes and outcomes, but that more studies are needed to draw generalizable inferences.…”

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confidence: 99%