BibTex format
@article{Bonaconsa:2021:10.1136/bmjqs-2020-012372,
author = {Bonaconsa, C and Mbamalu, O and Mendelson, M and Boutall, A and Warden, C and Rayamajhi, S and Pennel, T and Hampton, M and Joubert, I and Tarrant, C and Holmes, A and Charani, E},
doi = {10.1136/bmjqs-2020-012372},
journal = {BMJ Quality & Safety},
pages = {812--824},
title = {Visual mapping of team dynamics and communication patterns on surgical ward rounds: an ethnographic study},
url = {http://dx.doi.org/10.1136/bmjqs-2020-012372},
volume = {30},
year = {2021}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background: Team dynamics influence infection prevention and management practices and implementation of antibiotic stewardship (AS). Using an innovative visual mapping approach, alongside traditional qualitative methods, we aimed to study team dynamics and flow of communication (who gets to speak, and whose voice is heard) during surgical ward rounds, and how team dynamics and communication patterns may shape decision-making in relation to infection management and AS.Materials/methods: Between May and November 2019, data were gathered through direct observations of ward rounds and face-to-face interviews with ward round participants in selected surgical specialties at a tertiary hospital in South Africa. Using a visual mapping method – sociograms – content and flow of communication and the social links between individual participants were plotted. Field notes from observations and interview transcripts were analysed using a grounded theory approach.Results: Data were gathered from 60 hours of ward round observations, including 1024 individual patient discussions; 60 sociograms, interviews with healthcare professionals (60) and patients (7). The nature of discussions about AS and IPC on ward rounds vary across specialties and are affected by the content and structure of the clinical update provided, the consultant’s leadership and interaction style, and competing priorities at the bedside. Registrars act as gatekeepers, initiating antibiotic discussions; consultants are key decision-makers. Other team members have limited input in ward round conversations, despite having recognised roles in AS and IPC. Hierarchies in teams manifest themselves on ward rounds in where staff position themselves, influencing their contribution to care. Varied leadership styles affect ward-round dynamics, in particular, whether nurses and patients are actively engaged in key decisions on infection management and antibiotic therapy, and whether actions are assigned to i
AU - Bonaconsa,C
AU - Mbamalu,O
AU - Mendelson,M
AU - Boutall,A
AU - Warden,C
AU - Rayamajhi,S
AU - Pennel,T
AU - Hampton,M
AU - Joubert,I
AU - Tarrant,C
AU - Holmes,A
AU - Charani,E
DO - 10.1136/bmjqs-2020-012372
EP - 824
PY - 2021///
SN - 2044-5415
SP - 812
TI - Visual mapping of team dynamics and communication patterns on surgical ward rounds: an ethnographic study
T2 - BMJ Quality & Safety
UR - http://dx.doi.org/10.1136/bmjqs-2020-012372
UR - https://qualitysafety.bmj.com/content/30/10/812
UR - http://hdl.handle.net/10044/1/85607
VL - 30
ER -
