Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom
Abstract Background Healthcare systems are operating under substantial pressures, and often simply cannot provide the standard of care they aspire to within the available resources. Organisations, managers, and individual clinicians make constant adaptations in response to these pressures, which are...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Patient Safety in Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13037-024-00390-3 |
| _version_ | 1797273579441618944 |
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| author | Dulcie Irving Bethan Page Jane Carthey Helen Higham Shabnam Undre Charles Vincent |
| author_facet | Dulcie Irving Bethan Page Jane Carthey Helen Higham Shabnam Undre Charles Vincent |
| author_sort | Dulcie Irving |
| collection | DOAJ |
| description | Abstract Background Healthcare systems are operating under substantial pressures, and often simply cannot provide the standard of care they aspire to within the available resources. Organisations, managers, and individual clinicians make constant adaptations in response to these pressures, which are typically improvised, highly variable and not coordinated across clinical teams. The purpose of this study was to identify and describe the types of everyday pressures experienced by surgical teams and the adaptive strategies they use to respond to these pressures. Methods We conducted interviews with 20 senior multidisciplinary healthcare professionals from surgical teams in four major hospitals in the United Kingdom. The interviews explored the types of everyday pressures staff were experiencing, the strategies they use to adapt, and how these strategies might be taught to others. Results The primary pressures described by senior clinicians in surgery were increased numbers and complexity of patients alongside shortages in staff, theatre space and post-surgical beds. These pressures led to more difficult working conditions (e.g. high workloads) and problems with system functioning such as patient flow and cancellation of lists. Strategies for responding to these pressures were categorised into increasing or flexing resources, controlling and prioritising patient demand and strategies for managing the workload (scheduling for efficiency, communication and coordination, leadership, and teamwork strategies). Conclusions Teams are deploying a range of strategies and making adaptations to the way care is delivered. These findings could be used as the basis for training programmes for surgical teams to develop coordinated strategies for adapting under pressure and to assess the impact of different combinations of strategies on patient safety and surgical outcomes. |
| first_indexed | 2024-03-07T14:46:26Z |
| format | Article |
| id | doaj.art-2f16fd68f31d478aa5844426909417c1 |
| institution | Directory Open Access Journal |
| issn | 1754-9493 |
| language | English |
| last_indexed | 2024-03-07T14:46:26Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Patient Safety in Surgery |
| spelling | doaj.art-2f16fd68f31d478aa5844426909417c12024-03-05T19:58:21ZengBMCPatient Safety in Surgery1754-94932024-02-0118111510.1186/s13037-024-00390-3Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United KingdomDulcie Irving0Bethan Page1Jane Carthey2Helen Higham3Shabnam Undre4Charles Vincent5Department of Experimental Psychology, University of OxfordDepartment of Experimental Psychology, University of OxfordJane Carthey ConsultingNuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation TrustDepartment of Urology, East and North Hertfordshire NHS Foundation TrustDepartment of Experimental Psychology, University of OxfordAbstract Background Healthcare systems are operating under substantial pressures, and often simply cannot provide the standard of care they aspire to within the available resources. Organisations, managers, and individual clinicians make constant adaptations in response to these pressures, which are typically improvised, highly variable and not coordinated across clinical teams. The purpose of this study was to identify and describe the types of everyday pressures experienced by surgical teams and the adaptive strategies they use to respond to these pressures. Methods We conducted interviews with 20 senior multidisciplinary healthcare professionals from surgical teams in four major hospitals in the United Kingdom. The interviews explored the types of everyday pressures staff were experiencing, the strategies they use to adapt, and how these strategies might be taught to others. Results The primary pressures described by senior clinicians in surgery were increased numbers and complexity of patients alongside shortages in staff, theatre space and post-surgical beds. These pressures led to more difficult working conditions (e.g. high workloads) and problems with system functioning such as patient flow and cancellation of lists. Strategies for responding to these pressures were categorised into increasing or flexing resources, controlling and prioritising patient demand and strategies for managing the workload (scheduling for efficiency, communication and coordination, leadership, and teamwork strategies). Conclusions Teams are deploying a range of strategies and making adaptations to the way care is delivered. These findings could be used as the basis for training programmes for surgical teams to develop coordinated strategies for adapting under pressure and to assess the impact of different combinations of strategies on patient safety and surgical outcomes.https://doi.org/10.1186/s13037-024-00390-3Health servicesHealthcareSurgeryTeamsPressureCrisis management |
| spellingShingle | Dulcie Irving Bethan Page Jane Carthey Helen Higham Shabnam Undre Charles Vincent Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom Patient Safety in Surgery Health services Healthcare Surgery Teams Pressure Crisis management |
| title | Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom |
| title_full | Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom |
| title_fullStr | Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom |
| title_full_unstemmed | Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom |
| title_short | Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in the United Kingdom |
| title_sort | adaptive strategies used by surgical teams under pressure an interview study among senior healthcare professionals in four major hospitals in the united kingdom |
| topic | Health services Healthcare Surgery Teams Pressure Crisis management |
| url | https://doi.org/10.1186/s13037-024-00390-3 |
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