Assessing risks to paediatric patients: conversation analysis of situation awareness in huddle meetings in England

Author:

Hayes Jacqueline,Lachman PeterORCID,Edbrooke-Childs Julian,Stapley Emily,Wolpert Miranda,Deighton Jessica

Abstract

ObjectivesTo analyse the language and conversation used in huddles to gain a deeper understanding of exactly how huddles proceed in practice and to examine the methods by which staff members identify at-risk patients.SettingPaediatric wards in four English hospitals, which were part of a 12-hospital cohort participating in the Situation Awareness for Everyone programme. Wards varied by geographical region and type of hospital.ParticipantsPaediatric staff on wards in four English hospitals.DesignEthnomethodology and conversation analysis of recorded safety huddles.MethodsThis study represents the first analysis of huddle interaction. All huddle meetings taking place on four wards across four different hospitals were audio recorded and transcribed. The research question examined was: how are staff identifying at-risk patients in huddles? The ethnomethodological conversation analytic approach was used to analyse the transcripts.ResultsHuddlers made use of categories that allowed them to efficiently identify patients for each other as needing increased attention. Lexicon included the use of ‘no concerns’, ‘the one to watch’, ‘watcher’ and ‘acute concerns’. Huddlers used the meetings to go beyond standardised indicators of risk to identify relative risk and movement in patients towards deterioration, relative to the last huddle meeting and to their usual practices. An implicit category, termed here ‘pre-concerns’, was used by staff to identify such in-between states. Sequential analysis also highlighted the conversational rights that were held implicitly by staff in different clinical roles.ConclusionPractical implications and recommendations for huddlers are considered. These included that for increased situation awareness, it is recommended that all staff are active in the huddle conversation and not only the most senior team members.

Funder

WellChild

Health Foundation

Publisher

BMJ

Subject

General Medicine

Reference25 articles.

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Impacto de los «daily huddle» en la seguridad del paciente pediátrico hospitalizado;Journal of Healthcare Quality Research;2023-09

2. Situation awareness and the mitigation of risk associated with patient deterioration: A meta-narrative review of theories and models and their relevance to nursing practice;International Journal of Nursing Studies;2021-12

3. Translating HFE into Action – Lessons from the Frontline;Proceedings of the 21st Congress of the International Ergonomics Association (IEA 2021);2021

4. Software Development and Design of Network Security System Under Big Data Analysis;International Journal of Advanced Information and Communication Technology;2020-09-05

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