Entangled in complexity: An ethnographic study of organizational adaptability and safe care transitions for patients with complex care needs

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Hedqvist, Ann-Therese,DoktorandLinnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Department of Health and Caring Sciences, Linnaeus University, Kalmar/Växjö, Sweden; Ambulance Service, Region Kalmar County, Västervik, Sweden,ReAction (författare)

Entangled in complexity : An ethnographic study of organizational adaptability and safe care transitions for patients with complex care needs

Artikel/kapitelEngelska2024

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2024
John Wiley & Sons,2024
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LIBRIS-ID:oai:DiVA.org:lnu-128968
https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-128968URI
https://doi.org/10.1111/jan.16203DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:vti:diva-20875URI

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Språk:engelska
Sammanfattning på:engelska

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Aim: The aim of this study was to visualize vulnerabilities and explore the dynamics of inter-professional collaboration and organizational adaptability in the context of care transitions for patients with complex care needs.Design: An ethnographic design using multiple convergent data collection techniques.Methods: Data collection involved document review, participant observations and interviews with healthcare and social care professionals (HSCPs). Narrative analysis was employed to construct two illustrative patient scenarios, which were then examined using the Functional Resonance Analysis Method (FRAM). Thematic analysis was subsequently applied to synthesize the findings.Results: Inconsistencies in timing and precision during care transitions pose risks for patients with complex care needs as they force healthcare systems to prioritize structural constraints over individualized care, especially during unforeseen events outside regular hours. Such systemic inflexibility can compromise patient safety, increase the workload for HSCPs and strain resources. Organizational adaptability is crucial to managing the inherent variability of patient needs. Our proposed ‘safe care transition pathway’ addresses these issues, providing proactive strategies such as sharing knowledge and increasing patient participation, and strengthening the capacity of professionals to meet dynamic care needs, promoting safer care transitions.Conclusion: To promote patient safety in care transitions, strategies must go beyond inter-professional collaboration, incorporating adaptability and flexible resource planning. The implementation of standardized safe care transition pathways, coupled with the active participation of patients and families, is crucial. These measures aim to create a resilient, person-centred approach that may effectively manage the complexities in care transitions.Implications: The recommendations of this study span the spectrum from policy-level changes aimed at strategic resource allocation and fostering inter-professional collaboration to practical measures like effective communication, information technology integration, patient participation and family involvement. Together, the recommendations offer a holistic approach to enhance care transitions and, ultimately, patient outcomes.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Omvårdnad hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Nursing hsv//eng
care transitions
complex care needs
Functional Resonance Analysis Method
inter-professional collaboration
organizational adaptability
patient safety
resilience
Vårdvetenskap
Caring Science

Biuppslag (personer, institutioner, konferenser, titlar ...)

Praetorius, Gesa,1980-Statens väg- och transportforskningsinstitut,Förare och fordon, FOF,Department of Maritime Operations, University of South-Eastern Norway, Norway(Swepub:vti)gesa.praetorius@vti.se (författare)
Ekstedt, Mirjam,ProfessorLinnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Department of Health and Caring Sciences, Linnaeus University, Kalmar/Växjö, Sweden; Department of Learning, Informatics, Management and Ethics, LIME, Karolinska Institutet, Stockholm, Sweden(Swepub:lnu)miekaa (författare)
Lindberg, CatharinaLinnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),ReAction,Department of Health and Caring Sciences, Linnaeus University, Kalmar/Växjö, Sweden(Swepub:lnu)caliae (författare)
LinnéuniversitetetInstitutionen för hälso- och vårdvetenskap (HV) (creator_code:org_t)

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Ingår i:Journal of Advanced Nursing: John Wiley & Sons0309-24021365-2648

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