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Healthcare teams as complex adaptive systems: understanding team behaviour through team members’ perception of interpersonal interaction
- Source :
- BMC HEALTH SERVICES RESEARCH, BMC Health Services Research, Vol 18, Iss 1, Pp 1-13 (2018), BMC Health Services Research
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- BACKGROUND: Complexity science has been introduced in healthcare as a theoretical framework to better understand complex situations. Interdisciplinary healthcare teams can be viewed as Complex Adaptive Systems (CAS) by focusing more on the team members' interaction with each other than on the characteristics of individual team members. Viewing teams in this way can provide us with insights into the origins of team behaviour. The aim of this study is to describe the functioning of a healthcare team as it originates from the members' interactions using the CAS principles as a framework and to explore factors influencing workplace learning as emergent behaviour. METHODS: An interview study was done with 21 palliative home-care nurses, 20 community nurses and 18 general practitioners in Flanders, Belgium. A two-step analysis consisted of a deductive approach, which uses the CAS principles as coding framework for interview transcripts, followed by an inductive approach, which identifies patterns in the codes for each CAS principle. RESULTS: All CAS principles were identified in the interview transcripts of the three groups. The most prevalent principles in our study were principles with a structuring effect on team functioning: team members act autonomously guided by internalized basic rules; attractors shape the team functioning; a team has a history and is sensitive to initial conditions; and a team is an open system, interacting with its environment. The other principles, focusing on the result of the structuring principles, were present in the data, albeit to a lesser extent: team members' interactions are non-linear; interactions between team members can produce unpredictable behaviour; and interactions between team members can generate new behaviour. Patterns, reflecting team behaviour, were recognized in the coding of each CAS principle. Patterns of team behaviour, identified in this way, were linked to interprofessional competencies of the Interprofessional Collaboration Collaborative. Factors influencing workplace learning were identified. CONCLUSIONS: This study provides us with insights into the origin of team functioning by explaining how patterns of interactions between team members define team behaviour. Viewing healthcare teams as Complex Adaptive Systems may offer explanations of different aspects of team behaviour with implications for education, practice and research. ispartof: Bmc Health Services Research vol:18 issue:1 ispartof: location:England status: published
- Subjects :
- Systems Analysis
Palliative care
Knowledge management
COMMUNICATION
Nurses, Community Health
COLLABORATION
Health informatics
Health administration
0302 clinical medicine
Belgium
Adaptation, Psychological
MEDICAL-EDUCATION
Health care
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Cooperative Behavior
Complex adaptive system
media_common
030504 nursing
lcsh:Public aspects of medicine
Health Policy
Nursing research
SCIENCE
INTERPROFESSIONAL TEAMWORK
Complexity science
PATIENT SAFETY
0305 other medical science
Research Article
media_common.quotation_subject
Systems Theory
Interpersonal interaction
NURSING-HOMES
Interviews as Topic
03 medical and health sciences
Patient safety
Interprofessional relations
General Practitioners
Home Health Nursing
Perception
Humans
Learning
Patient Care Team
business.industry
PALLIATIVE HOME-CARE
Complex adaptive systems
lcsh:RA1-1270
FRAMEWORK
Healthcare teams
Hospice and Palliative Care Nursing
IDENTITY
Interdisciplinary communication
business
Subjects
Details
- ISSN :
- 14726963
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....c035cd667c9783f243d135526dc6378f