Interprofessional Learning and Improving at the Paediatric Ward: A Participatory Action Research Practising Safety-II...

Area of Science:

• Healthcare Improvement
• Patient Safety
• Organizational Learning

Background:

• Healthcare professionals face time constraints impacting patient safety.
• Safety-II theory emphasizes learning from practice variability, patient participation, and interprofessional collaboration.
• Integrating these elements is crucial for enhancing safety in complex hospital environments.

Purpose of the Study:

• To investigate how interprofessional teams can leverage practice variability for daily learning and improvement.
• To explore methods for enhancing situational awareness during bedside ward-rounds.

Main Methods:

• Participatory action research (PAR) was employed in a pediatric ward of a Dutch hospital.
• Data collection involved 115 semi-structured interviews and participant observations.
• Safety-II concepts were introduced to facilitate reflection on practice among all stakeholders.

Main Results:

• Exchanging perspectives among parents, nurses, and physicians improved mutual understanding and individual learning.
• Tailored standards and stimulated interactions fostered collective learning, expectation alignment, and recognition of practice variability.
• Unexpected benefits included improvements in time management, professional pride, and job satisfaction, though knowledge transfer to newcomers was challenging.

Conclusions:

• Daily interprofessional interactions and standards tailored to concerns can enhance learning in hospital units.
• Participatory action research is an effective, adaptive approach for engaging stakeholders and driving improvement in complex healthcare settings.
• Addressing conflicting priorities is essential for fostering daily interactions and implementing new standards.