Managing Emergencies: Key Competencies for Incident Management Teams

2011 ◽  
Vol 4 ◽  
pp. 1-10 ◽  
Author(s):  
Peter A.J. Hayes ◽  
Mary M. Omodei
Keyword(s):  
Communication Skills ◽  
Procedural Knowledge ◽  
High Reliability ◽  
Management Teams ◽  
Incident Management ◽  
Structured Interviews ◽  
High Stakes ◽  
Team Members ◽  
Key Competencies ◽  
Uncertain Time

AbstractEach year Australian fire and land management agencies deploy Incident Management Teams (IMTs) to manage bushfires. An important question is: what are the key competencies required for IMT personnel? Recent research in high reliability organisations suggests that teamwork-related competencies are likely to be most important because incident management depends critically upon interdependent team members, often operating in dynamic, uncertain, time pressured, and high stakes environments. This study used semi-structured interviews with experienced IMT personnel (N = 15) to identify 12 key competencies important for bushfire IMT roles. Analysis of 30 bushfire incidents described by interviewees confirmed that three competencies (a) interpersonal and communication skills, (b) leadership, and (c) IMT procedural knowledge were central. Potential implications for organisational decision making in emergency contexts in general are outlined.

scholarly journals Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy

2020 ◽  
Author(s):  
Valentina Lichtner ◽  
Bryony Dean Franklin ◽  
Luciano Dalla-Pozza ◽  
Johanna I Westbrook
Keyword(s):  
Qualitative Study ◽  
High Reliability ◽  
Patient Treatment ◽  
Structured Interviews ◽  
Computerized Provider Order Entry ◽  
Team Members ◽  
Paediatric Hospital ◽  
Use Of Time ◽  
Safety Risks ◽  
Safety Models

Abstract Background: There are serious safety risks associated with chemotherapy, often associated with interdependencies in regimens administered over months or years. Various strategies are used to manage these risks. Computerized provider order entry (CPOE) systems are also implemented to improve medication safety. Little is known regarding the effect of CPOE on how clinicians manage chemotherapy interdependencies and their associated safety strategies.Methods: We conducted a multi-method qualitative study in a paediatric hospital. We analysed 827 oncology incidents reported following CPOE implementation and carried out semi-structured interviews with doctors (n=10), nurses (n=6), a pharmacist, and oncology CPOE team members (n=2). Results were interpreted according to safety models (ultra-safe, high-reliability organisations [HROs], or ultra-adaptive). Results: Incident reports highlighted two interrelated types of interdependencies: those within organisation of clinical activities and those inherent in chemotherapy regimens. Clinicians reported strategies to address chemotherapy risks and interdependencies. These included rigid rules and ‘no go’ contexts for treatment to proceed, typical of the ultra-safe model; use of time (e.g. planning only so far ahead) and sensitivity to operations, typical of HROs. We identified three different time horizons in CPOE use in relation to patients’ treatments: life-long, the whole regimen, and the ‘here and now’. CPOE supported ultra-safe strategies through automation and access to rules/standardisation, but also created difficulties and contributed to incidents. It supported the ‘here and now’ better than a life-long or whole regimen view of a patient treatment. Sensitivity to operations was essential to anticipate and resolve uncertainties, hazards, CPOE limitations, and mismatches between CPOE processes and workflow in practice. Conclusions: Within oncology, CPOE appears to move the ‘mix’ of risk strategies towards ultra-safe models of safety and protocol-mandated care. However, in order to operate ultra-safe strategies embedded in CPOE and stay on protocol it is essential for clinicians to be thoughtful and show sensitivity to operations in CPOE use. CPOE design can be advanced by better consideration of mechanisms to support interdependencies.

scholarly journals Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy

2020 ◽  
Author(s):  
Valentina Lichtner ◽  
Bryony Dean Franklin ◽  
Luciano Dalla-Pozza ◽  
Johanna I Westbrook
Keyword(s):  
Qualitative Study ◽  
High Reliability ◽  
Structured Interviews ◽  
Computerized Provider Order Entry ◽  
Team Members ◽  
Paediatric Hospital ◽  
Use Of Time ◽  
Safety Risks ◽  
Incident Reports ◽  
Safety Models

Abstract Background There are serious safety risks associated with chemotherapy, often associated with interdependencies in regimens administered over months or years. Various strategies are used to manage these risks. Computerized provider order entry (CPOE) systems are also implemented to improve medication safety. Little is known regarding the effect of CPOE on how clinicians manage chemotherapy interdependencies and their associated safety strategies. Methods We conducted a multi-method qualitative study in a paediatric hospital. We analysed 827 oncology incidents reported following CPOE implementation and carried out semi-structured interviews with doctors (n = 10), nurses (n = 6), a pharmacist, and oncology CPOE team members (n = 2). Results were interpreted according to safety models (ultra-safe, high-reliability organisations [HROs], or ultra-adaptive). Results Incident reports highlighted two interrelated types of interdependencies: those within organisation of clinical activities and those inherent in chemotherapy regimens. Clinicians reported strategies to address chemotherapy risks and interdependencies. These included rigid rules and ‘no go’ contexts for treatment to proceed, typical of the ultra-safe model; use of time (e.g. planning only so far ahead) and sensitivity to operations, typical of HROs. CPOE supported ultra-safe strategies through automation and access to rules/standardisation. However, sensitivity to operations was needed to anticipate and resolve uncertainties, hazards, CPOE limitations, and mismatches between CPOE processes and workflow in practice. Conclusions Within oncology, CPOE appears to move the ‘mix’ of risk strategies towards ultra-safe models of safety and protocol-mandated care. However, operating ultra-safe strategies embedded in CPOE and staying on protocol necessitate sensitivity to operations in CPOE use. CPOE design can be advanced by better consideration of mechanisms to support interdependencies.

‘Are we on the same wavelength?’ International nurses and the process of confronting and adjusting to clinical communication in Australia

2017 ◽  
Vol 13 (3) ◽  
pp. 263-274 ◽  
Author(s):  
Tonia Crawford ◽  
Peter Roger ◽  
Sally Candlin
Keyword(s):  
Communication Skills ◽  
Thematic Analysis ◽  
Care Setting ◽  
Linguistically Diverse ◽  
The Other ◽  
Culturally And Linguistically Diverse ◽  
Central Theme ◽  
Structured Interviews ◽  
Clinical Communication ◽  
Professional Experiences

Effective communication skills are important in the health care setting in order to develop rapport and trust with patients, provide reassurance, assess patients effectively and provide education in a way that patients easily understand (Candlin and Candlin, 2003). However with many nurses from culturally and linguistically diverse (CALD) backgrounds being recruited to fill the workforce shortfall in Australia, communication across cultures with the potential for miscommunication and ensuing risks to patient safety has gained increasing focus in recent years (Shakya and Horsefall, 2000; Chiang and Crickmore, 2009). This paper reports on the first phase of a study that examines intercultural nurse patient communication from the perspective of four Registered Nurses from CALD backgrounds working in Australia. Five interrelating themes that were derived from thematic analysis of semi-structured interviews are discussed. The central theme of ‘adjustment’ was identified as fundamental to the experiences of the RNs and this theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability.

Factors affecting fire suppression costs as identified by incident management teams

2006 ◽  
Author(s):  
Janie Canton-Thompson ◽  
Brooke Thompson ◽  
Krista Gebert ◽  
David Calkin ◽  
Geoff Donovan ◽  
...  
Keyword(s):  
Fire Suppression ◽  
Management Teams ◽  
Incident Management ◽  
Factors Affecting

scholarly journals Mobilizing foreign language students for multilingual crisis translation in Shanghai

Multilingua ◽  
2020 ◽  
Vol 39 (5) ◽  
pp. 587-595 ◽  
Author(s):  
Yongyan Zheng
Keyword(s):  
Foreign Language ◽  
Language Proficiency ◽  
Local Community ◽  
University Student ◽  
Technical Knowledge ◽  
Structured Interviews ◽  
Close Collaboration ◽  
Team Members ◽  
Student Volunteers ◽  
The University

AbstractThis paper examines the multilingual translation efforts of a group of university student volunteers during the COVID-19 outbreak in Shanghai. Data were collected through semi-structured interviews of the volunteer team leader, team members, and a local community health worker. Findings identified time constraints, limited language proficiency, and limited technical knowledge as the major challenges confronting the university volunteers. In order to overcome the challenges, they worked in close collaboration and used translingual and network strategies to facilitate prompt and high-quality crisis translation. Findings suggest that foreign language university students in local universities may serve as readily available multilingual resources and can be mobilized in prompt response to the grassroots multilingual needs of the local community in times of crisis. The paper ends with implications for measures and strategies to enhance effective emergency language service and crisis communication for global multilingual cities.

scholarly journals Exploring the potential for introducing home monitoring of blood pressure during pregnancy into maternity care: current views and experiences of staff—a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e037874
Author(s):  
Lisa Hinton ◽  
James Hodgkinson ◽  
Katherine L Tucker ◽  
Linda Rozmovits ◽  
Lucy Chappell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Home Monitoring ◽  
Structured Interviews ◽  
Group Discussions ◽  
Self Monitoring ◽  
Team Members ◽  
Registration Number ◽  
In Pregnancy

ObjectiveOne in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.DesignExploratory study using a qualitative approach.SettingEight hospitals, English National Health Service.ParticipantsObstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).MethodsSemi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.ResultsThe main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.ConclusionsThe potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women’s health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.Trial registration numberNCT03334149.

Advancing Translational Research by Enabling Collaborative Teamwork: The TRACT Approach

2012 ◽  
Vol 2 (3) ◽  
Author(s):  
Nedal H. Arar ◽  
Divya Nandamudi
Keyword(s):  
Content Analysis ◽  
Translational Research ◽  
Research Work ◽  
Structured Interviews ◽  
Team Collaboration ◽  
Team Members ◽  
Effective Strategies ◽  
Multiple Cycles ◽  
And Function ◽  
Collaborative Activities

Background: The work of multidisciplinary research teams (MDRTs) is vital for translational research. The objectives of this study were 1) to understand the structure and function of MDRTs, and 2) to develop effective strategies to enhance collaboration among team members. Methods and Findings: Semi-structured interviews were conducted with 23 participants involved in multidisiplinary research work at two San Antonio, Texas, institutions. Interview materials were tape-recorded, transcribed, and content analyzed using qualitative methods.Themes that emerged from the content analysis were used to develop and refine strategies to enhance the work of MDRTs. The findings showed that MDRTs operate through multiple cycles of: 1) team formation, 2) team collaboration, 3) sustainable collaborative activities, and 4) team maturity. Content analysis identified four interrelated basic elements within the MDRT tract that facilitate team cycles: 1) shared interest/vision among agreeable team leader and members, 2) viable means of communication, 3) available resources, and 4) perceived gain/benefit of teamwork.Conclusions: Our findings highlighted several opportunities and challenges in the formation, dynamics, and growth of MDRTs. Effective strategies to enhance teamwork should levearge these opportunities and address challenges, taking into consideration the interdependent aspects of the basic elements within the MDRTs tract.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals A Rasch-Based Validation of ELT Certificate-LORT

2020 ◽  
Vol 13 (9) ◽  
pp. 94
Author(s):  
Xin Qu
Keyword(s):  
Teacher Candidates ◽  
Rating Scales ◽  
Rating Scale ◽  
Qualitative Interviews ◽  
Structured Interviews ◽  
High Stakes ◽  
Efl Teacher ◽  
The Difference ◽  
Group Interviews

The present study was executed with the purpose of validating ELT Certificate Lesson Observation and Report Task (ELTC-LORT), which was developed by China Language Assessment to certify China’s EFL teachers by performance-based testing. The ELT Certificate has high-stakes considering its impacts on candidates’ recruitment, ELT in China and quality of education, so it is crucially important for its validation so as to guarantee fairness and justice. The validity of task construct and rating rubric went through a process suited for many-facet Rasch measurement supplemented with qualitative interviews. Participants (N = 40) were provided with a video excerpt from a real EFL lesson, and required to deliver a report on the teacher’s performance. Two raters graded the records of the candidates’ reports using rating scales developed to measure EFL teacher candidates’ oral English proficiency and ability to analyze and evaluate teaching. Many-facet Rasch analysis demonstrated a successful estimation, with a noticeable spread among the participants and their traits, proving the task functioned well in measuring candidates’ performance and reflecting the difference of their ability. The raters were found to have good internal self-consistency, but not the same leniency. The rating scales worked well, with the average measures advancing largely in line with Rasch expectations. Semi-structured interviews as well as focus group interviews were executed to provide knowledge regarding the raters’ performance levels and the functionalities of the rating scale items. The findings provide implications for further research and practice of the Certificate.

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