Interprofessional Teamwork in the Emergency Department - Communicating for Patient Safety
Interprofessional teams may improve patient safety through successful communication and effective teamwork. However, ineffective teamwork occurs despite the implementation of various strategies and can compromise patient safety by causing adverse events. In addition, patients and healthcare professionals may perceive the communication and teamwork in the interprofessional team differently. Therefore, the overall aim of this thesis was to explore and describe the interprofessional communication processes and teamwork used during team assessment of the patient in the emergency department, with the focus on patient safety from the perspectives of healthcare professionals and patients. Multiple methods were used in the four studies of this thesis. A cross-sectional study (Study I) and a structured observational study (Study II) evaluated the effects after an organizational change to the emergency department interprofessional teamwork environment. Interviews were conducted with healthcare professionals (Study III) and patients (Study IV). The findings show that organizational changes contribute to changes in communication, teamwork strategies, and safety attitudes within the interprofessional team. The interprofessional team and patients expressed a desire for a better-structured flow of information in the emergency department, and indicated a need for increased psychological safety. The main conclusion of this thesis is that interprofessional teamwork in the emergency department is complex and demanding, yet important for the psychological safety of both healthcare professionals and patients in the emergency department. The request for structured delivery of information, despite years of knowledge about communication and information demand, remains as an essential factor for increasing the enablers of interprofessional teamwork in the emergency department. A crucial addition to the general knowledge of interprofessional care and a reminder of the important work of the organization and healthcare professionals in clinical care is the voice of the patient. The patient is an important part of the interprofessional teamwork to enhance quality and safe care. If healthcare professionals listen to the receiver of the healthcare service then the outcome can be tailored to foster and support safe delivery of quality care.
Parts of work
I. Milton, J., Chaboyer, W., Åberg, N. D., Erichsen Andersson, A., Oxelmark, L. Safety attitudes and working climate after organizational change in a major emergency department in Sweden. International Emergency Nursing 2020;53:100830. ::doi::10.1016/j.ienj.2020.100830II. Milton, J., Gillespie, B. M., Åberg, N. D., Erichsen Andersson, A., Oxelmark, L. Interprofessional teamwork before and after organizational change in a tertiary emergency department: an observational study. Journal of Interprofessional Care. [In press]. ::doi::10.1080/13561820.2022.2065250III. Milton, J., Erichsen Andersson, A., Åberg, N. D., Gillespie, B. M., Oxelmark, L. Perceptions of interprofessional teamwork in the emergency department; qualitative assessments of critical Incidents. Submitted.IV. Milton, J., Åberg, N. D., Erichsen Andersson, A., Gillespie, B. M., Oxelmark, L. The art of information exchange in an emergency department – a patient perspective. Submitted.
Doctor of Philosophy (Health Care Sciences)
University of Gothenburg, Sahlgrenska Academy
Institute of Health and Care Sciences
Fredagen den 17 juni 2022, kl. 9.00, Hörsal Arvid Carlsson, Academicum, Medicinaregatan 3, Göteborg.
Date of defence