P-14

Gelre Hospitals has developed several initiatives to improve patient safety, with a focus on acute care, through the use of Medical Team Work (MTW). Now that care is becoming more complex and intensive, it requires extra effort from hospitals to ensure safe, reliable and effective care. Two developments come together here:

1. importance of situational awareness in the clinical process;

2. importance of clinical leadership of nurses.

Ad 1. It is important for every health care worker to work safely, including in non-acute situations (clinical process). One of the most essential safety problems in hospitals is the lack of professionals being 'sensitive for operations'. A great focus on operations is necessary. It contributes to more situational awareness (SA).

Ad 2. Clinical leadership can also increase SA. Because of being 'sensitive for operations', SA is obtained on the basis of which a professional takes decisions and takes action. And conversely, through clinical leadership, a better SA is created.

Safe, reliable and effective ‘shared decision-making’, can only take place if there is shared SA. This presupposes a distributed SA, which is the process of meeting the right image / puzzle pieces of the situation at the different times in the clinical process.

Relevance, purpose and research question:

Gelre Hospitals wants to change the implemented MTW for acute processes into the standard clinical process but does not know how to give it a good hand.

Within the Dutch hospital setting, few research has been done into teamwork and patient safety in clinical care processes, and into how such a team can achieve distributed SA. Unknown is research into how clinical leadership in the clinical process can contribute to this.

The purpose of this project is to realize, together with care professionals (action learning), an effective method (with toolbox), to improve patient safety within clinical (non-acute) processes.

The research question for this project is:

How can clinical teams (within Gelre) effectively implement MTW, using clinical leadership, resulting in an improved distributed situational awareness?

Questions, dilemma’s or choices, difficulties

• experiences with action research within hospital setting?

• operationalize distributed situational awareness?

• operationalize clinical leadership in the clinical process;

• European law on privacy (AVG) that makes it difficult to conduct research in a hospital environment.

Distributed Situation Awareness