Team talk and team decision processes: a qualitative discourse analytical approach to 10 real-life medical emergency team encounters

Gundrosen, Stine; Thomassen, Gøril; Wisborg, Torben; Aadahl, Petter

doi:10.1136/bmjopen-2018-023749

Cited by 6 publications

(5 citation statements)

References 54 publications

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“…Discourse analytical methods have also been utilized on other material in health services research, e.g. on recorded conversations between health care workers in different settings [ 43 ] and on interviews with clinicians [ 44 ]. It has, however, been suggested that discourse analysis is an underutilized methodology within health care system research [ 45 ], and a search in PubMed performed in September 2019, using the phrase “discharge summary discourse analysis” did not return any results.…”

Section: Discussionmentioning

confidence: 99%

Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

Pedersen

Pétursson

Hetlevik

et al. 2021

BMC Health Serv Res

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Background The acute treatment for stroke takes place in hospitals and in Norway follow-up of stroke survivors residing in the communities largely takes place in general practice. In order to provide continuous post stroke care, these two levels of care must collaborate, and information and knowledge must be transferred between them. The discharge summary, a written report from the hospital, is central to this communication. Norwegian national guidelines for treatment of stroke, issued in 2010, therefore give recommendations on the content of the discharge summaries. One ambition is to achieve collaboration and knowledge transfer, contributing to integration of the health care services. However, studies suggest that adherence to guidelines in general practice is weak, that collaboration within the health care services does not work the way the authorities intend, and that health care services are fragmented. This study aims to assess to what degree the discharge summaries adhere to the guideline recommendations on content and to what degree they are used as tools for knowledge transfer and collaboration between secondary and primary care. Methods The study was an analysis of 54 discharge summaries for home-dwelling stroke patients. The patients had been discharged from two Norwegian local hospitals in 2011 and 2012 and followed up in primary care. We examined whether content was according to guidelines’ recommendations and performed a descriptive and interpretative discourse analysis, using tools adapted from an established integrated approach to discourse analysis. Results We found a varying degree of adherence to the different advice for the contents of the discharge summaries. One tendency was clear: topics relevant here and now, i.e. at the hospital, were included, while topics most relevant for the later follow-up in primary care were to a larger degree omitted. In most discharge summaries, we did not find anything indicating that the doctors at the hospital made themselves available for collaboration with primary care after dischargeof the patient. Conclusions The discharge summaries did not fulfill their potential to serve as tools for collaboration, knowledge transfer, and guideline implementation. Instead, they may contribute to sustain the gap between hospital medicine and general practice.

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Section: Discussionmentioning

confidence: 99%

Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

Pedersen

Pétursson

Hetlevik

et al. 2021

BMC Health Serv Res

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“…These elements gave nurse managers the strength to go on as leaders. In addition, they wanted to be offered continuous support in different forms, both administrative and emotional, along with proper education and training throughout their time as leaders (Gundrosen, Thomassen, Wisborg, & Aadahl, 2018).…”

Section: Discussionmentioning

confidence: 99%

Nurse managers in perioperative settings and their reasons for remaining in their jobs: A qualitative study

et al. 2020

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Aim The study describes what helps nurse managers maintain the strength to keep going as leaders. Background Good leadership is important for the quality of patient care, patient satisfaction in care and efficiency. Many nurse managers stay on despite challenges at work. Methods Twelve nurse managers were interviewed. Data were analysed by systematic text condensation according to Malterud. Results The results were as follows: A—Walking side by side with my employees; B—Knowing that I mean something to my employees; C—Talking to myself—asking myself tough questions; D—Having someone to talk to, to decrease the feeling of being alone; E—Leading and managing in my own way—the fear of not succeeding is my motivation. Conclusion The nurse managers built their own strategies to get through and get on when difficult situations arose. In order to succeed in leading their employees, the nurse managers gathered their inner strength through moving caritatively back and forth between the ‘secret room’ and the ‘staff room’ in the house of leadership. Implications in Nursing Management The manuscript gives insights into where nurse managers found sources of strengths in their everyday work. To realize their employees’ strengths and motivation made a difference for nurse managers as a driving force. By having someone to talk to and by asking themselves tough questions, they were prepared for the challenges that came.

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“…This key‐element label was attributed to 89 sources (Abramson & Mizrahi, 2003; Ambrose‐Miller & Ashcroft, 2016; Andermo et al, 2015; Anquinet et al, 2015; Baggs, 1994; Baggs et al, 2007; Baggs & Schmitt, 1995; Bajwa et al, 2020; Bartholdson et al, 2021; Bentovim & Gilmour, 1981; Berg et al, 2020. ; Bokhour, 2006; Borrett & Gould, 2021; Botes, 2000; Briggs, 1999; Brooks et al, 2017; Bunch, 2000; Caenepeel & Jobin, 2005; Cook et al, 2001; Coombs, 2003, 2014; Coombs & Ersser, 2004; Cranley et al, 2022; de Casterlé et al, 2006; Dekussche, 2005; Dimech et al, 2021; Duner, 2013; Durand et al, 2022; Ervin et al, 2018; Faith & Chidwick, 2009; Fein et al, 2016; Fiddick et al, 2020; Firn et al, 2020; Forbes et al, 2020; Forsgärde et al, 2021; Fox & Comeau‐Vallée, 2020; Fratianne et al, 1992; Friedman, 2020; Gair & Hartery, 2001; Geist & Chandler, 1984; Grafham et al, 2004; Greenhalgh et al, 2008; Gundrosen et al, 2018; Hagoel et al, 2011; Haines et al, 2018; Heath et al, 2016; Heerschap et al, 2019; Helzer et al, 2020; Ho et al, 2005; Husson, 2011; Jensen et al, 2013; Johal & Danbury, 2021; Jordan, 1982; Joseph & Conrad, 1989; Kane, 1975; Kayser & Kaplan, 2020; Kilpatrick...…”

Section: Resultsmentioning

confidence: 99%

Interprofessional clinical decision‐making process in health: A scoping review

Bouchez,

Cagnon,

Hamouche

et al. 2023

Journal of Advanced Nursing

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AimsTo describe the key elements of the interprofessional decision‐making process in health, based on published scientific studies. To describe the authors, reviews and subject matter of those publications.DesignScoping review of the literature.Data SourcesMEDLINE, APA Psycinfo OpenGrey, Lissa and Cochrane databases were searched in December 2019 and January 2023.Review MethodsReferences were considered eligible if they (i) were written in French or English, (ii) concerned health, (iii) studied a clinical decision‐making process, (iv) were performed in an interprofessional context. ‘PRISMA‐scoping review’ guidelines were respected. The eligible studies were analysed and classified by an inductive approachResultsWe identified 1429 sources of information, 145 of which were retained for the analysis. Based on these studies, we identified five key elements of interprofessional decision‐making in health. The process was found to be influenced by group dynamics, the available information and consideration of the unique characteristics of the patient. An organizational framework and specific training favoured improvements in the process.ConclusionDecision‐making can be based on a willingness of the healthcare organization to promote models based on more shared leadership and to work on professional roles and values. It also requires healthcare professionals trained in the entire continuum of collaborative practices, to meet the unique needs of each patient. Finally, it appears essential to favour the sharing of multiple sources of accessible and structured information. Tools for knowledge formalization should help to optimize interprofessional decision‐making in health.ImpactThe quality of a team decision‐making is critical to the quality of care. Interprofessional decision‐making can be structured and improved through different levels of action. These improvements could benefit to patients and healthcare professionals in every settings of care involving care collaboration.Impact StatementInterprofessional decision‐making in health is an essential lever of quality of care, especially for the most complex patients which are a contemporary challenge. This scoping review article offers a synthesis of a large corpus of data published to date about the interprofessional clinical decision‐making process in healthcare. It has the potential to provide a global vision, practical data and a list of references to facilitate the work of healthcare teams, organizations and teachers ready to initiate a change.

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Team talk and team decision processes: a qualitative discourse analytical approach to 10 real-life medical emergency team encounters

Cited by 6 publications

References 54 publications

Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

Nurse managers in perioperative settings and their reasons for remaining in their jobs: A qualitative study

Interprofessional clinical decision‐making process in health: A scoping review

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