Integrating the FRAM and ethnography in nursing research : Insights from a project on complex care transitions

• The challenge of ensuring patient safety and continuity of care during complex care transitions necessitates a deeper understanding beyond what traditional research methodologies typically offer. This study explores the integration of the Functional Resonance Analysis Method (FRAM) with ethnographically derived patient scenarios to thoroughly investigate the complexities, variabilities, and unforeseen dynamics within these transitions.Adopting an ethnographic methodology, we have developed patient scenarios through comprehensive document reviews, participant observations and interviews with 37 healthcare professionals across multiple healthcare environments. These scenarios set the stage for applying the FRAM analysis, enabling an in-depth analysis of the care transition process. This approach is pivotal for identifying critical moments and decisions that significantly affect patient safety and for revealing potential system vulnerabilities.Our research sheds light on the daily practices and challenges healthcare professionals face during complex care transitions. It highlights systemic vulnerabilities and areas prone to risks while emphasizing effective practices. It underscores the importance of patient and family participation in facilitating safe and seamless transitions. From our findings, we present a "safe care transition pathway," offering a structured approach that encapsulates strategies for patient and family participation, and recommendations for overcoming identified vulnerabilities.Our study demonstrates that combining the FRAM with ethnographic research and patient scenarios offers a comprehensive and nuanced methodology for analyzing complex healthcare processes. This approach is particularly valuable for uncovering the variabilities and emergent behaviors that can affect care transitions. It provides a scaffold for future nursing research and practice to improve understanding and management of complex care transitions in healthcare environments. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Nyckelord

Vårdvetenskap

Caring Science

Publikations- och innehållstyp

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