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Developing a sociocultural framework of compliance: An exploration of factors related to the use of early warning systems among acute care clinicians

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Version 2 2022-09-15, 02:03
Version 1 2021-01-17, 12:43
journal contribution
posted on 2022-09-15, 02:03 authored by Tracy FlenadyTracy Flenady, Trudy DwyerTrudy Dwyer, Agnieszka Sobolewska, Marie Le LagadecMarie Le Lagadec, Justine ConnorJustine Connor, Julie Kahl, Tania SignalTania Signal, Matthew BrowneMatthew Browne
Background: Early warning systems (EWS) are most effective when clinicians monitor patients' vital signs and comply with the recommended escalation of care protocols once deterioration is recognised. Objectives: To explore sociocultural factors influencing acute care clinicians' compliance with an early warning system commonly used in Queensland public hospitals in Australia. Methods: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia. Results: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication. Conclusions: The overarching organisational context including the hospital's embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians' and teams' compliance or non-compliance with early warning system's monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff. © 2020 The Author(s).






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BioMed Central

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CC BY 4.0

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Central Queensland Hospital and Health Services, Rockhampton

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  • Yes


BMC Health Services Research