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- Rydenfält, Christofer, et al.
(författare)
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Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.
- 2013
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 25:2, s. 182-187
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: /st>Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. OBJECTIVE: /st>To investigate the actual usage of the checklist in practice and to catalogue deviations for the purpose of identifying improvements. DESIGN: /st>Twenty-four surgical procedures were video recorded. The time-out was analysed quantitatively assessing compliance with a predefined observational protocol based on the checklist and qualitatively to describe reasons for non-compliance. SETTING: /st>The operating unit of a Swedish county hospital. MAIN OUTCOME MEASURES: /st>Compliance with checklist items and the participation of different personnel groups. Activities were conducted during the time-out. RESULTS: /st>Highest compliance was associated with patient ID, type of procedure and antibiotics; the worst with site of incision, theatre nurse team reviews and imaging information. Team member introductions occurred in half of the operations. Surgeons and the anaesthesia team dominated the time-out. CONCLUSION: /st>The checklist is not always applied as intended. The components that facilitate communication are often neglected. The time-out does not appear to be conducted as a team effort. It is plausible that the personnel's conception of risk and the perceived importance of different checklist items are factors that influence checklist usage. To improve compliance and involve the whole team, the concept of risk and the perceived relevance of checklist items for all team members should be addressed.
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- Rydenfält, Christofer, et al.
(författare)
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Social structures in the operating theatre: how contradicting rationalities and trust affect work.
- 2012
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402. ; 68:4, s. 783-795
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This article is a report of a study of how healthcare professionals involved in surgery orientate themselves to their common task, and how this orientation can be affected by the social and organizational context. Background. Previous research indicates that surgical teams are not as cohesive as could be expected and that communication failures frequently occur. However, little is known about how these problems are related to their social, cultural and organizational context. Methods. Semi-structured interviews were conducted with 15 healthcare professionals, representing all personnel categories of the surgical team. During the interview, a virtual model, visualizing a real operating theatre, was used to facilitate reflection. The interviews were conducted in 2009. Themes were created from the interviews, with a focus on similarities and differences. An activity analysis was conducted based on the themes. Findings. Poor team functionality and communication failures in the operating theatre can to some degree be explained by differences in activity orientation between professions and by insufficient support from social and organizational structures. Differences in activity orientation resulted in different views between professional groups in their perceptions of work activities, resulting in tension. Insufficient support resulted in communication thresholds that inhibited the sharing of information. Conclusion. Organizing work to promote cross-professional interaction can help the creation of social relations and norms, providing support for a common view. It can also help to decrease communication thresholds and establish stronger relations of trust. How this organization structure should be developed needs to be further investigated.
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- Olsson, Annika, et al.
(författare)
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An action learning method for increased innovation capability in organisations
- 2010
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Ingår i: Action Learning: Research and Practice. - : Informa UK Limited. - 1476-7341 .- 1476-7333. ; 7:2, s. 167-179
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Tidskriftsartikel (refereegranskat)abstract
- Product innovation in highly complex and technological areas, such as medical technology, puts high requirements on the innovation capability of an organisation. Previous research and publications have highlighted organisational issues and learning matters as important and necessary for the development of innovation capability. Action learning requires reflections of the ways things are carried out, changes in current actions, implementation and improvement and thereafter another round of reflections. This could be difficult for one organisation to carry out internally and so this research uses a learning network setup involving several organisations for inter-organisational action learning. The purpose of this article is to describe the learning network setup used in a current action learning project in the med tech industry, and to discuss the initial experiences gained. The research project aims at increasing the innovation capability of the participating organisations. The method used is based on action learning and involves representatives from industrial partners, public health organisations and academic partners. The different organisations run innovation projects over a time period of three years, and meet three times a year in learning network sessions with the purpose of developing knowledge by action learning interaction between the different. During these learning network sessions the participants are facilitated to go through different phases: reflections, new concepts, new actions, implementations and new reflections. The paper elaborates on theories of innovation capability and learning networks, and thereafter the methods of action research, experiential learning and action learning. The action learning network structure, the experiences gained in the initial phases of the project, and the experience of action learning and learning networks is then presented. The importance of trust building between partners in the network in order to facilitate action learning and development of innovation capability is experienced and discussed, as is the learning that takes place in the interaction between academics from different disciplines in their interaction with the practitioners.
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