A Qualitative Analysis of Observed Behavior of Pediatric Rapid Response Team Performance
| Autor: | Katherine Patterson Kelly, Amanda B. Levin, Alexander M Cartron, Ashley L Siems |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Teamwork
business.industry media_common.quotation_subject Applied psychology Psychological intervention Qualitative property General Medicine Pediatrics Inter-rater reliability Patient safety Distress Pediatrics Perinatology and Child Health Medicine Rapid response team business media_common Coding (social sciences) |
| Zdroj: | Hospital Pediatrics. |
| ISSN: | 2154-1671 2154-1663 |
| Popis: | BACKGROUND AND OBJECTIVES Pediatric rapid response teams (RRTs) enhance patient safety, reduce cardiorespiratory arrests outside the PICU, and detect deteriorating patients before decompensation. RRT performance may be affected by failures in communication, poor team dynamics, and poor shared decision-making. We aimed to describe factors associated with team performance using direct observation of pediatric RRTs. METHODS Our team directly observed 73 in situ RRT activations, collected field notes of qualitative data, and analyzed the data using conventional content analysis. To assess accuracy of coding, 20% of the coded observations were reassessed for interrater reliability. The codes influencing team performance were categorized as enhancers or threats to RRT teamwork and organized under themes. We constructed a framework of the codes and themes, organized along a spectrum of orderly versus chaotic RRTs. RESULTS Three themes influencing RRT performance were teamwork, leadership, and patient and family factors, with underlying codes that enhanced or threatened RRT performance. Novel factors that were found to threaten team performance included indecision, disruptive behavior, changing leadership, and family or patient distress. Our framework delineating features of orderly and chaotic RRTs may be used to inform training and design of RRTs to optimize performance. CONCLUSIONS Observations of in situ RRT activations in a pediatric hospital both verified previously described characteristics of RRTs and identified new characteristics of team function. Our proposed framework for understanding these enhancers and threats may be used to inform future interventions to improve RRT performance. |
| Databáze: | OpenAIRE |
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