Understanding Interpersonal and Organizational Dynamics Among Providers Responding to Crisis

Area of Science:

• Medical Education
• Patient Safety
• Surgical Care

Background:

• Effective patient rescue involves recognizing problems, communicating concerns, and treating complications.
• Managing postoperative complications presents unique challenges in clinical settings.

Purpose of the Study:

• To identify facilitators and barriers in managing postoperative complications.
• To understand clinician perspectives on improving patient rescue.

Main Methods:

• Qualitative study using semistructured interviews with 57 clinicians at an academic medical center.
• Thematic analysis and consensus coding were performed using NVivo 11.
• A framework matrix approach synthesized data to identify themes.

Main Results:

• Clinicians reported delays in care due to difficulties in recognizing patient deterioration.
• Challenges were identified in knowing whom and when to contact, and reaching decision-makers.
• Significant variation in communication processes among providers caring for surgical patients was observed.

Conclusions:

• Communication breakdowns are key barriers to effective patient rescue for postoperative complications.
• Standardizing and improving communication strategies are crucial for timely identification and escalation of care.
• Targeted interventions can enhance the management of surgical patients' postoperative complications.