Relative frequency that themes, subthemes and underlying dimensions were discussed in the focus groups
Frequency individual dimension was discussed in focus groups | |||||
---|---|---|---|---|---|
Themes | Subthemes | Dimensions | Bedside nurses/RTs (n=3 groups) | Charge nurses (n=3 groups) | Residents (n=1 group) |
Social | |||||
Team-based care | Family empowerment | Family empowerment | +++ | + | + |
Nurse empowerment | Ability/confidence to go ‘up the chain’ | ++ | +++ | − | |
Leadership role during rounds | ++ | + | − | ||
Unit culture that supports teamwork, accountability and safety | Culture that facilitates trusting relationships | ++ | ++ | + | |
Willingness to ask for second opinions | ++ | + | + | ||
Accountability for carrying out mitigation plans | ++ | +++ | + | ||
Explicit sharing of plans across shifts and disciplines | ++ | ++ | + | ||
Technological | |||||
Availability of standardised data | Standardised data elements/scores | Paediatric Early Warning Score | +++ | +++ | − |
Gut feeling | + | ++ | − | ||
Tools for entering, displaying and monitoring data and data trends | Tools for entering, displaying and monitoring data and data trends | ++ | +++ | + | |
Organisational | |||||
Standardised processes and procedures | Shared training and language regarding patient risk | Education/training on SA | ++ | +++ | + |
Shared language of ‘watcher’ | +++ | +++ | + | ||
Experience in deterioration/critical care | +++ | +++ | + | ||
Peer coaching and mentoring | ++ | ++ | + | ||
Debriefs after events | ++ | ++ | + | ||
Structure to proactively identify and plan for risk | Huddles | +++ | +++ | + | |
Proactive assessment and planning | ++ | +++ | + | ||
Clear MRT calling criteria | + | + | − | ||
Structure to support handoffs and continuity of care | Standardised handoff practices | + | ++ | + | |
Knowledge of patient's medical history/baseline | + | +++ | + | ||
Knowledge of family | − | + | − | ||
Documented follow-up plans | − | + | − | ||
Structure that supports adequate workload/staffing | Adequate staffing | ++ | +++ | + | |
Staff knowledgeable of disease/patient population | − | + | + | ||
Extra resources available if needed | ++ | + | − |
−, not mentioned; +, mentioned in one group; ++, mentioned in two groups; +++, mentioned in three groups.
MRT, medical response team; RT, respiratory therapist; SA, situation awareness.