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Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians

BACKGROUND: Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised. OBJECTIVES: To explore sociocultural factors influencing acute care clinicians’ compliance with an e...

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Autores principales: Flenady, Tracy, Dwyer, Trudy, Sobolewska, Agnieszka, Lagadec, Danielle Le, Connor, Justine, Kahl, Julie, Signal, Tania, Browne, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422559/
https://www.ncbi.nlm.nih.gov/pubmed/32782002
http://dx.doi.org/10.1186/s12913-020-05615-6
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author Flenady, Tracy
Dwyer, Trudy
Sobolewska, Agnieszka
Lagadec, Danielle Le
Connor, Justine
Kahl, Julie
Signal, Tania
Browne, Matthew
author_facet Flenady, Tracy
Dwyer, Trudy
Sobolewska, Agnieszka
Lagadec, Danielle Le
Connor, Justine
Kahl, Julie
Signal, Tania
Browne, Matthew
author_sort Flenady, Tracy
collection PubMed
description BACKGROUND: Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised. OBJECTIVES: To explore sociocultural factors influencing acute care clinicians’ compliance with an early warning system commonly used in Queensland public hospitals in Australia. METHODS: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia. RESULTS: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication. CONCLUSIONS: The overarching organisational context including the hospital’s embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians’ and teams’ compliance or non-compliance with early warning system’s monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.
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spelling pubmed-74225592020-08-21 Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians Flenady, Tracy Dwyer, Trudy Sobolewska, Agnieszka Lagadec, Danielle Le Connor, Justine Kahl, Julie Signal, Tania Browne, Matthew BMC Health Serv Res Research Article BACKGROUND: Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised. OBJECTIVES: To explore sociocultural factors influencing acute care clinicians’ compliance with an early warning system commonly used in Queensland public hospitals in Australia. METHODS: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia. RESULTS: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication. CONCLUSIONS: The overarching organisational context including the hospital’s embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians’ and teams’ compliance or non-compliance with early warning system’s monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff. BioMed Central 2020-08-11 /pmc/articles/PMC7422559/ /pubmed/32782002 http://dx.doi.org/10.1186/s12913-020-05615-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Flenady, Tracy
Dwyer, Trudy
Sobolewska, Agnieszka
Lagadec, Danielle Le
Connor, Justine
Kahl, Julie
Signal, Tania
Browne, Matthew
Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
title Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
title_full Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
title_fullStr Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
title_full_unstemmed Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
title_short Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
title_sort developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422559/
https://www.ncbi.nlm.nih.gov/pubmed/32782002
http://dx.doi.org/10.1186/s12913-020-05615-6
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