Categories | Enablers of interprofessional teamwork in the ED | Barriers to interprofessional teamwork in the ED |
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Subcategories | ||
Salience of reflection | Self-awareness to scrutinize oneself Awareness of individual limits was used as a motivation to improve and maintain competency Team reflection as a way of interprofessional learning Sharing perspectives of the same experienced situation provided awareness of the team capacity and motivation | Self-awareness to scrutinize oneself Lack of ability and opportunity to engage in self-reflection caused HCPs to exceed their limits or use to much self-critique Team reflection as a way of interprofessional learning Deprioritizing reflection within the team resulted in a failure of interprofessional teamwork |
Professional experience makes a difference | Experience is a crucial component of professional practice HCPs who had adequate academic and clinical experience to manage teamwork and patient assessment Expectation of professional experience Explicit expectations allowed interprofessional teams to adapt to a situation Need for continuous development and training Clinical education and simulation training led to stringency with respect to professional roles and the concept of teamwork | Experience is a crucial component of professional practice Lack of experience (academic and clinical) hindered the teamwork and delayed the patient assessment Expectation of professional experience A preconception of professional experience had a negative impact on interprofessional teamwork Need for continuous development and training Lack of professional and clinical training led to misunderstandings and failure to carry out the work |
Demanding physical and psychosocial work environment | The physical work environment Positive aspects of being physically close | The physical work environment Consequences of alarm fatigue, small assessment space and chaotic environment Dealing with emotions related to stress Stress-induced unpleasant behaviors during interprofessional teamwork and concealed emotions |
Balancing communication demands | Applying communication (tools, climate, and attitudes) The correct use of communication tools and the opportunity to work in an enabling team climate encompassing positive attitudes Art of concise and clear information The ability to address the intended information to the appropriate colleague, at the right time Silent communication Non-verbal behavior complemented or sometimes replaced verbal communication | Applying communication (tools, climate, and attitudes) Inadequate use of communication tools and unpleasant attitudes led to teamwork failures |
Lacking management support, structure, and planning | ED considered an unsuitable place of care Patients received medically advanced treatments for which the HCPs lacked familiarity or had insufficient space, time or equipment in the ED Mismatch of available resources and excessive workload Shortage of resources Discordant views on strategies of care Differences of opinions across wards between management and staff with respect to the use of strategies and the focus of care as part of the interprofessional teamwork | |
Tensions between professional role and responsibility | Gender roles and hierarchies of expertise Positioning and disagreements (gender norms and other hierarchies) Violation of personal and professional integrity Disrespect for professional expertise and overstepping boundaries | |
Different views on interprofessional teamwork | Personal relations and favoritism Strong personal relationships with team members contributed to trust and psychological safety Perspective on teamwork attributes Clear interprofessional team goals and routines (i.e., leadership) guided the interprofessional team forward | Inadequate involvement/intrusion by the patient Patients either interrupted the team or overheard inappropriate information Personal relations and favoritism Favoring colleagues based on personal relations and appreciation led to disrespect for others in the interprofessional team Perspective on teamwork attributes Lack of defined routines, purposes, and descriptions led to discrepant perceptions on how to carry out the interprofessional teamwork |
Confidence in interprofessional team members | Joint team assessments Additive value of the different areas of expertise generated a comprehensive assessment of the patient Mutual need for interprofessional support Sharing vulnerability and emotional dedication in the interprofessional team led to an increased feeling of being supported | Joint team assessments Disregarding professional boundaries led to failed interprofessional teamwork, duplication of work, and work overload Mutual need for interprofessional support Frustration with unsupportive colleagues |