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- Rydenfält, Christofer, et al.
(author)
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An action-oriented method for interprofessional organization development at a hospital operating unit
- 2017
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In: Action Research. - : SAGE Publications. - 1476-7503 .- 1741-2617. ; 15:2, s. 177-197
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Journal article (peer-reviewed)abstract
- The complexity of modern interdisciplinary health care practices, where different specialties work together to solve complex problems, challenges traditional approaches to organizational development and quality improvement. An example of this is surgery. This article describes and evaluates an action-oriented method to facilitate organizational development and innovation at an operating unit, centered on interprofessional aspects of health care, a method that shares some features with action learning. At its core the method had a group with members from all specialties in an operating team, who participated in regular meetings facilitated by a process leader, according to experiential learning principles. The group was evaluated using mixed methods (including interaction process analysis (IPA)), of which video recorded group meetings and interviews constituted the main sources of data. Results showed that the group achieved a successful organizational change. Indications of the success of the group process were the low level of conflicts and the high level of task focus. Interprofessional boundaries appeared to be bridged as all members participated in formulation of both problems and solutions while not being afraid to voice different opinions. Problems could be attributed to lack of awareness of the group at the operating unit at which the intervention took place.
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- Rydenfält, Christofer, et al.
(author)
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Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.
- 2013
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In: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 25:2, s. 182-187
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Journal article (peer-reviewed)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.
(author)
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Organizing for teamwork in healthcare : an alternative to team training?
- 2017
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In: Journal of Health Organization and Management. - 1477-7266. ; 31:3, s. 347-362
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Journal article (peer-reviewed)abstract
- Purpose: The purpose of this paper is to explore how organizational design could support teamwork and to identify organizational design principles that promote successful teamwork. Design/methodology/approach: Since traditional team training sessions take resources away from production, the alternative approach pursued here explores the promotion of teamwork by means of organizational design. A wide and pragmatic definition of teamwork is applied: a team is considered to be a group of people that are set to work together on a task, and teamwork is then what they do in relation to their task. The input – process – output model of teamwork provides structure to the investigation. Findings: Six teamwork enablers from the healthcare team literature – cohesion, collaboration, communication, conflict resolution, coordination, and leadership – are discussed, and the organizational design measures required to implement them are identified. Three organizational principles are argued to facilitate the teamwork enablers: team stability, occasions for communication, and a participative and adaptive approach to leadership. Research limitations/implications: The findings could be used as a foundation for intervention studies to improve team performance or as a framework for evaluation of existing organizations. Practical implications: By implementing these organizational principles, it is possible to achieve many of the organizational traits associated with good teamwork. Thus, thoughtful organization for teamwork can be used as an alternative or complement to the traditional team training approach. Originality/value: With regards to the vast literature on team training, this paper offers an alternative perspective on how to improve team performance in healthcare.
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