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Exploring interdisciplinary communication pathways for escalating pre-medical emergency team deterioration: a mixed-methods study

journal contribution
posted on 2023-07-28, 05:27 authored by Stephanie K Sprogis, Judy CurreyJudy Currey, Daryl Jones, Julie ConsidineJulie Considine
ObjectiveTo explore clinicians' use and perceptions of interdisciplinary communication pathways for escalating care within the pre-medical emergency team (pre-MET) tier of rapid response systems.MethodA sequential mixed-methods study was conducted using observations and interviews. Participants were clinicians (nurses, allied health, doctors) caring for orthopaedic and general medicine patients at one hospital. Descriptive and thematic analyses were conducted.ResultsEscalation practices were observed for 13 of 27 pre-MET events. Leading communication methods for escalating pre-MET events were alphanumeric pagers (61.5%) and in-person discussions (30.8%). Seven escalated pre-MET events led to bedside pre-MET reviews by doctors. Clinician interviews (n = 29) culminated in two themes: challenges in escalation of care, and navigating information gaps. Clinicians reported deficiencies in communication methods for escalating care that hindered interdisciplinary communication and clinical decision-making pertaining to pre-MET deterioration.ConclusionPolicy-defined escalation pathways were inconsistently utilised for pre-MET deterioration. Available communication methods for escalating pre-MET events inadequately fulfilled clinicians' needs. Variable perceptions of escalation pathways illuminated a lack of of a shared mental model about clinicians' roles and responsibilities. To optimise timely and appropriate management of patient deterioration, communication infrastructure and interdisciplinary collaboration must be enhanced.

History

Journal

Australian Health Review

Pagination

1-8

Location

Australia

ISSN

0156-5788

eISSN

1449-8944

Language

en

Publisher

CSIRO Publishing