A team mental model approach to understanding team effectiveness in an emergency department: A qualitative study

2021 ◽  
pp. 135581962110312
Author(s):  
Sarah Wise ◽  
Christine Duffield ◽  
Margaret Fry ◽  
Michael Roche
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Nurse Practitioners ◽  
Mental Model ◽  
Team Effectiveness ◽  
Structured Interviews ◽  
Model Concept ◽  
Team Members ◽  
Workplace Conditions ◽  
Team Mental Model

Objectives To demonstrate how the team mental model concept can broaden our understanding of team effectiveness in health care by exploring the knowledge that underpins it, and the workplace conditions that sustain it in a metropolitan emergency department (ED) in Sydney, Australia. Methods This study draws on accounts of 19 ED clinicians (registered nurses, doctors and nurse practitioners) of their teamwork practice and perceptions of their team’s effectiveness through semi-structured interviews. Analysis was conducted in two stages. A thematic analysis was followed by a template analysis using the a priori themes of task, team, team process and goal knowledge to specify the content of the team’s mental model. Results The content of the ED team’s mental model revealed that the knowledge the team employed to coordinate their work was deeply embedded in the team’s tasks and the workplace context. Team effectiveness not only relied on how well team members coordinate, but also their ability to perform their own role effectively and efficiently. Three workplace conditions were identified as enablers to individuals acquiring the knowledge needed to work effectively in the team: stability in team membership; workplace experience; and the spatial-temporal conditions of emergency work where permanent emergency doctors and nurses executed their tasks concurrently, regularly interacted and shared a common goal. Conclusions Getting health care teams ‘on the same page’ is a long-standing challenge. This study suggests that solutions may lay in the organisation of health care work, creating team stability and opportunities for team members to interact that allows a team mental model to emerge.

scholarly journals STRATEGIES FOR FAMILIES OF CHILDREN SERVED IN PEDIATRIC FIRST AID: THE SEARCH FOR THE CONSTRUCTION OF INTEGRALITY

2015 ◽  
Vol 24 (4) ◽  
pp. 1027-1034 ◽  
Author(s):  
Fernanda Luisa Buboltz ◽  
Andressa da Silveira ◽  
Eliane Tatsch Neves
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Services ◽  
Quality Care ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Structured Interviews ◽  
Care Services ◽  
First Choice ◽  
Primary Care Health

This qualitative study aimed to understand the strategies of families in the pursuit of health care for children treated in a Pediatric Emergency Department. Semi-structured interviews were held with twelve family caregivers of children attended in PED at a teaching hospital in the period March-June 2013. The data were analyzed based on the premises of content analysis. Results showed that the lack of problem-solving ability of primary care health services increases the demand for emergency care services. Relatives seek the Pediatric Emergency Department as first choice care, weaving alternative networks as a strategy to ensure quality care for their children. The restructuring of health services is recommended, based on the attributes of primary health care, overcoming the current paradigm, focused on the disease and medical consultation with one that considers comprehensive care for children and their family.

scholarly journals Physician perceptions of the types of roles interpreters play in limited English proficient pediatric encounters and how they evaluate the quality of interpretation

2019 ◽  
Vol 20 ◽  
Author(s):  
Rebecca J. Schwei ◽  
Natalie Guerrero ◽  
Alissa L. Small ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Limited English Proficient ◽  
Health Care Systems ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Team Members ◽  
Medical Interpreters ◽  
Care Systems

AbstractPurposeThe purpose of this study is to understand different roles that interpreters play in a pediatric, limited English proficient (LEP) health care encounter and to describe what factors within each role inform physicians’ assessment of the overall quality of interpretation.BackgroundLanguage barriers contribute to lower quality of care in LEP pediatric patients compared to their English-speaking counterparts. Use of professional medical interpreters has been shown to improve communication and decrease medical errors in pediatric LEP patients. In addition, in many pediatric encounters, interpreters take on roles beyond that of a pure language conduit.MethodsWe conducted 11 semi-structured interviews with pediatricians and family medicine physicians in one health system. Transcripts were audio-recorded and transcribed verbatim. We analyzed our data using directed content analysis. Two study team members coded all transcripts, reviewed agreement, and resolved discrepancies.FindingsPhysicians described four different interpreter roles: language conduit, flow manager, relationship builder, and cultural insider. Within each role, physicians described components of quality that informed their assessment of the overall quality of interpretation during a pediatric encounter. We found that for many physicians, a high-quality interpreted encounter involves multiple roles beyond language transmission. It is important for health care systems to understand how health care staff conceptualize these relationships so that they can develop appropriate expectations and trainings for medical interpreters in order to improve health outcomes in pediatric LEP patients.

scholarly journals Drivers and Barriers to the Use of Health Information Exchange Amongst Clinicians in the Emergency Department

2020 ◽  
Vol 3 ◽  
Author(s):  
Ben Richter ◽  
Brian Dixon
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Information ◽  
Nurse Practitioners ◽  
Information Exchange ◽  
Health Care Organizations ◽  
Health Information Exchange ◽  
Major Barrier ◽  
Single Sign On ◽  
Patient Reported

Background:   Health Information Exchange (HIE) describes the exchange of medical data between various health care organizations. Though research is limited, widespread use of HIE may improve patient outcomes while improving efficiency and thus lowering health care costs for patients. The paucity of existing research necessitates further study into the effects of HIE use in the clinical setting. The Indiana Network for Patient Care (INPC) is one of the most comprehensive HIE networks in the country, and provides an ideal environment for conducting research regarding factors that influence HIE use.   Methods:  A group of 20 clinicians from the Emergency Department were chosen to answer a set of questions regarding their HIE use. This group included physicians, nurse practitioners, physician assistants, and registered nurses from various health care organizations across the state of Indiana. Interview questions were centered around four main themes: Performance Expectancy, Effort Expectancy, Social Influence, and Facilitating Conditions. Interviews were recorded and transcribed, then subject to qualitative analysis using NVivo software.   Results:  The Single Sign-On and EHR Button were the most commonly discussed features in terms of facilitating HIE use. Providers used HIE most often when the patient reported previous admission at a different hospital, or when the patient was incapacitated and could not provide information. Although clinicians had unanimous social support for using HIE, inadequate training regarding HIE was apparent, and served as the most common barrier to its use.   Conclusion/Impact:  The implementation of Single Sign-On and access to the INPC via a button integrated into the user’s EHR are critical for widespread use of HIE, while lack of physician training serves as a major barrier to its use. Implementing SSO and EHR button features while improving HIE training may spurn additional use of HIE and thus lower costs for both hospitals and patients.  

scholarly journals Sharedness of team mental models in the course of design-related interaction between architects and clients

2017 ◽  
Vol 3 ◽  
Author(s):  
Hernan Casakin ◽  
Petra Badke-Schaub
Keyword(s):  
Mental Models ◽  
Mental Model ◽  
Information Exchange ◽  
Early Stage ◽  
Design Team ◽  
Concept Generation ◽  
Team Members ◽  
Design Activities ◽  
Team Mental Model ◽  
The Individual

This study deals with the role of mental models in the coordination of team activities during design problem-solving. The work centers on the sharedness of mental models in a design team setting, mainly on the interaction between an architect and two clients. A major goal is to gain insight into how modifications in mental models affect coordination, and how sharedness develops through the process. Our focus is to explore, through a case study, the individual contributions of the architect and the clients to coordination of the work process, and how sharedness of the development of the team mental model evolves in the early stage of concept generation. Our claim is that work teams develop a certain degree of sharedness of the mental models of individual team members during information exchange. This team mental model can be insufficient or even wrong, but as long as the team members feel agreement in the team, they coordinate their work on that basis. Thus, sharedness of mental models is believed to be a powerful team asset, especially when it is reached in the earlier phases of the design process. Our findings suggest that in order to attain sharedness among design team members, design activities related to the task mental model should be encouraged, specifically the generation of new ideas and the analysis of solutions. Implications for practice and education are suggested.

Building team effectiveness through adaptation: Team knowledge and implicit and explicit coordination

2019 ◽  
Vol 9 (2-3) ◽  
pp. 71-98 ◽  
Author(s):  
Ramón Rico ◽  
Cristina B. Gibson ◽  
Miriam Sánchez-Manzanares ◽  
Mark A. Clark
Keyword(s):  
Team Performance ◽  
Mental Model ◽  
Adaptive Response ◽  
Team Effectiveness ◽  
Structural Characteristics ◽  
Team Adaptation ◽  
Team Mental Model ◽  
Implicit And Explicit ◽  
Implicit Coordination ◽  
Action Phases

We develop a theory of team adaptation that centers on team knowledge structures and coordination processes. Specifically, we explain that when a team’s task changes, there may be a disruption in the extent to which their team mental model (TMM) fits the current situation. Whether this is the case is likely to depend on team compositional factors, emergent states, and structural characteristics of the team. When there is a lack of correspondence between the TMM and the situation, this then requires a shift in the extent to which the team uses implicit or explicit coordination processes. We also explain that the team performance phase matters, such that during action phases, a prevalence of implicit coordination relative to explicit coordination results in greater effectiveness; during a transition phase, the opposite is likely. In this way, we address central questions in the field: what types of task changes require team adaptive response, what happens during the adaptation process, and how this influences team effectiveness over time.

scholarly journals ‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tara N. Officer ◽  
Jackie Cumming ◽  
Karen McBride-Henry
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Consumer Satisfaction ◽  
Care Delivery ◽  
Realist Evaluation ◽  
Structured Interviews ◽  
Primary Health ◽  
Advanced Practitioner

Abstract Background Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services. Methods As part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research. Results Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion. Conclusions This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.

Mirror, Mirror: Guided Storytelling and Team Reflexivity’s Influence on Team Mental Models

2017 ◽  
Vol 49 (3) ◽  
pp. 267-305 ◽  
Author(s):  
Rachel Tesler ◽  
Susan Mohammed ◽  
Katherine Hamilton ◽  
Vincent Mancuso ◽  
Michael McNeese
Keyword(s):  
Team Performance ◽  
Mental Model ◽  
Substantial Evidence ◽  
Team Members ◽  
Team Mental Models ◽  
Team Mental Model ◽  
Model Similarity ◽  
Positive Effect ◽  
Mirror Mirror ◽  
Methodological Ground

Because substantial evidence supports team mental model similarity as a positive predictor of team performance, it is important that we help team members to develop a shared understanding of relevant team content. The current study extended the list of team mental model antecedents to include guided storytelling as an effective team intervention. In the first known empirical investigation of planned story usage in teams, we broke new methodological ground by pioneering a team intervention to proactively harness the benefits of narrative. Results revealed that the combination of presenting important information in story format and giving members time to reflect upon their strategies had a positive effect on team mental model similarity. In addition, the positive indirect effect of storytelling on team performance via team mental model similarity was stronger when guided team reflexivity was present than absent. These findings provide encouraging evidence for the continued examination of storytelling and reflexivity in teams.

Virtual Teams in Health Care

2011 ◽  
pp. 189-223
Author(s):  
Mary DeGori ◽  
Fang Zhao
Keyword(s):  
Health Care ◽  
Conceptual Framework ◽  
Virtual Teams ◽  
Team Effectiveness ◽  
Virtual Team ◽  
Organisational Culture ◽  
Test Case ◽  
Team Members ◽  
Survey Tool ◽  
Empirical Survey

This chapter describes an in-depth analysis of the methods to increase the effectiveness of virtual teams in health care using the Northern Alliance Hospital Admission Risk Program (HARP) Chronic Disease Management (CDM) Program as the test case. A conceptual framework of the specific components required for virtual team effectiveness and a survey tool to examine a team’s performance (based on virtual team member perception) with each of these components is presented. The proposed conceptual framework of virtual team effectiveness categorises the determinants influencing the effectiveness of virtual teams into four key frames of leadership, team components, organisational culture, and technology. An empirical survey of 38 virtual team members within the Northern Alliance HARP CDM Program demonstrates high levels of agreement with leadership and some team components, however, limited agreement with the organisational culture and technology components.

scholarly journals The congruence of mental models in entrepreneurial teams – implications for performance and satisfaction in teams operating in an emerging economy

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Paweł Ziemiański ◽  
Katarzyna Stankiewicz ◽  
Michał T. Tomczak ◽  
Beata Krawczyk-Bryłka
Keyword(s):  
Mental Models ◽  
Mental Model ◽  
Emerging Economy ◽  
Theory And Practice ◽  
Online Questionnaire ◽  
Content Type ◽  
Team Members ◽  
Team Mental Models ◽  
Entrepreneurial Teams ◽  
Team Mental Model

Purpose The paper aims to explore the relationship between the congruence of mental models held by the members of entrepreneurial teams operating in an emerging economy (Poland) and entrepreneurial outcomes (performance and satisfaction). Design/methodology/approach The data obtained from 18 nascent and 20 established entrepreneurial teams was analysed to answer hypotheses. The research was quantitative and was conducted using an online questionnaire. Data was collected from each of the teams at two stages. Members of entrepreneurial teams were surveyed independently, which allowed measuring the congruence of their mental models pertaining to running a venture. Findings Findings reveal that team members’ mental model congruence is significantly related to financial performance and members’ satisfaction in the case of established entrepreneurial teams. However, in the case of nascent teams, there is no relationship between analysed variables. Practical implications Implications for theory and practice are offered with a special emphasis on entrepreneurship education. The concept of team mental model congruence is proposed to be included in training of nascent entrepreneurial teams, experienced companies and students. Originality/value The concept of team mental models investigated by the authors has been underexplored in entrepreneurship research. Results indicate that at least in some entrepreneurial teams, team mental models’ congruence is related to obtained outcomes. The paper proposes that principles of effectuation and causation can serve as the lens through which the mental model pertaining to running a venture can be analysed. It allows expanding studies on the congruence of team mental models in entrepreneurial teams beyond the strategic consensus.

Sign in / Sign up

Export Citation Format

Share Document