Interprofessional sense-making in the emergency department: A SenseMaker study

Area of Science:

• Healthcare Management
• Organizational Behavior
• Clinical Operations

Background:

• Emergency Departments (EDs) are critical hospital entry points requiring effective information processing and decision-making.
• Interprofessional teams, primarily doctors and nurses, must navigate dynamic environments through collective sense-making.
• Collective sense-making is essential for adaptive capability and coping in changing conditions.

Purpose of the Study:

• To explore the process of collective, interprofessional sense-making within emergency departments.
• To identify factors influencing sense-making and decision-making among doctors and nurses.
• To understand how sense-making impacts adaptive capability in ED settings.

Main Methods:

• A qualitative study involving 84 doctors and nurses from five Cape Town EDs.
• Utilized the SenseMaker® tool to capture and self-analyze 84 stories over eight weeks.
• Employed content analysis for stories and pattern analysis for self-codified data in R-studio.

Main Results:

• Identified differences in how doctors and nurses perceive appropriate actions (situational vs. policy-based).
• Revealed contrasting communication preferences: informal for doctors, formal for nurses.
• Highlighted asymmetric information and disjointed decision-making as key issues.

Conclusions:

• Found an operational disconnect between doctors and nurses due to information asymmetry, decision-making differences, and communication styles.
• Emphasized the need to integrate varied sense-making experiences to enhance adaptive capability.
• Proposed strengthening feedback loops to improve interprofessional team effectiveness in EDs.