C Owen

Lost in translation: Maximizing handover effectiveness between paramedics and receiving staff in the emergency department

Objective:  The purpose of the present study is to investigate perceptions by paramedics and hospital receiving staff about what enables and constrains handover in the ED.

The role of organisational context in mediating workplace learning and performance

Abstract The success or failure of any workplace training program may not rest with the program itself, but may be influenced by a range of other contextual elements that mediate learning and action in workplace performance. This paper introduces the term “High-3” work, and then discusses the role of formal and informal learning within High-3 workplace contexts. The influence of some aspects of organisational context on work practice is illustrated through a case study and qualitative analysis of a near-miss incident within Australia’s air traffic control airspace. The paper concludes that socio-cultural theories provide a useful framework for understanding performance in High-3 workplace but that these theories need to be further developed to account for a range of features present in workplace contexts. Some recommendations for practitioners interested in better understanding the role of context in developing training programs to support High-3 work are provided.

Role Clarity, Swift Trust and Multi‐Agency Coordination

The purpose of this paper was to further the understanding of swift trust in temporary organizations by examining the role swift trust plays in emergency management coordination and how role clarity acts as an enabler within temporary organizational configurations. A qualitative interview study was conducted with 32 liaison officers working in three strategic-level emergency operations centres in Australia. Role clarity was identified as an important factor in the successful formation of emergency management temporary organizations by emergency services and critical infrastructure liaison officers working in multi-agency arrangements. By providing role clarity, liaison officers may enable collaborative working practices among organizations involved in emergency management and thus facilitate multi-agency coordination. The function of role clarity in the context of swift trust is largely overlooked in emergency management. Therefore, this study has contributed to the knowledge of swift trust by empirically verifying the impact of role clarity by liaison officers working in the research setting.

A theoretical framework for negotiating the path of emergency management multi-agency coordination.

Multi-agency coordination represents a significant challenge in emergency management. The need for liaison officers working in strategic level emergency operations centres to play organizational boundary spanning roles within multi-agency coordination arrangements that are enacted in complex and dynamic emergency response scenarios creates significant research and practical challenges. The aim of the paper is to address a gap in the literature regarding the concept of multi-agency coordination from a human-environment interaction perspective. We present a theoretical framework for facilitating multi-agency coordination in emergency management that is grounded in human factors and ergonomics using the methodology of core-task analysis. As a result we believe the framework will enable liaison officers to cope more efficiently within the work domain. In addition, we provide suggestions for extending the theory of core-task analysis to an alternate high reliability environment.

Developing a research framework for complex multi–team coordination in emergency management

This conceptual paper addresses previous calls for the development of new theoretical frameworks to better account for the multi–agency emergency management coordination required in complex events. It uses, as a departure point, a teamwork model that includes four phases: situation assessment; plan formulation, plan execution and team learning. The thesis put forward here is that we need to move the focus of analysis beyond the team to one of multi–layered multiple team and multiple organisation systems. To further develop this research framework indicators from multi–organisational literature are added to those found in the individual and teamwork literature to develop a more comprehensive account of multi–team multi–organisational coordination. The paper identifies key anchor points for future use in data collection.

Instructor beliefs and their mediation of instructor strategies

Purpose – The overall aim of this research is to investigate how aspects of organizational culture enable or constrain the facilitation of learning in the workplace.Design/methodology/approach – A qualitative design was used involving 100 semi‐structured interviews conducted with air traffic controllers operating in three centers in Australia. The data were analyzed using a phenomenological approach in an attempt to uncover the lived experience of those interviewed.Findings – The study illustrates how elements of organizational culture evidenced in collectively held values and beliefs mediated the approaches used by on‐the‐job‐training instructors. Three collectively held values and beliefs were identified: belief in ability; the value of performance in demonstrating ability; and the need to exude confidence. The degree to which instructors espoused these beliefs influences the type of instructional strategy they used. Three predominant strategies of engagement with the trainee were identified: acting on,...

Spanning Organizational Boundaries in Emergency Management

Multiagency emergency management coordination requires stakeholders to span organizational boundaries and facilitate collaboration among other agencies within temporary supraorganizations. Multiagency coordination is important in emergency management as disasters often require the collaboration of multiple agencies into temporary supraorganizations. However, little is known about the boundary spanning activities that influence this collaboration. Based on 39 semistructured interviews with senior emergency management practitioners spanning organizational boundaries, this paper proposes a typology of boundary spanning activities for emergency management. Embracing these activities may address some of the challenges associated with the collaboration of multiple agencies in a disaster.

Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial.

Purpose Both exercise and self-management are advocated in pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD). The widely used 6-week, group-based Chronic Disease Self-Management Program (CDSMP) increases self-reported exercise, despite supervised exercise not being a program component. This has been little explored in COPD. Whether adding supervised exercise to the CDSMP would add benefit is unknown. We investigated the CDSMP in COPD, with and without a formal supervised exercise component, to address this question. Patients and methods Adult outpatients with COPD were randomized to the CDSMP with or without one hour of weekly supervised exercise over 6 weeks. The primary outcome measure was 6-minute walk test distance (6MWD). Secondary outcomes included self-reported exercise, exercise stage of change, exercise self-efficacy, breathlessness, quality of life, and self-management behaviors. Within- and between-group differences were analyzed on an intention-to-treat basis. Results Of 84 subjects recruited, 15 withdrew. 6MWD increased similarly in both groups: CDSMP-plus-exercise (intervention group) by 18.6±46.2 m; CDSMP-alone (control group) by 20.0±46.2 m. There was no significant difference for any secondary outcome. Conclusion The CDSMP produced à small statistically significant increase in 6MWD. The addition of a single supervised exercise session did not further increase exercise capacity. Our findings confirm the efficacy of a behaviorally based intervention in COPD, but this would seem to be less than expected from conventional exercise-based pulmonary rehabilitation, raising the question of how, if at all, the small gains observed in this study may be augmented.

Organisational features and their effect on the perceived performance of emergency management organisations

Purpose – This study reports on a survey of experienced emergency management personnel in Australia and New Zealand to identify the influence of organisational features in perceived emergency management performance. The purpose of this paper is to analyse the influence of organisational features in emergency response performance and to discuss how this knowledge can be used to enhance the response capacity of emergency services organisations. Design/methodology/approach – Based on a review of the literature, a conceptual theoretical model for organisational performance is first developed based on four organisational features found to be previously important in emergency management organisation. These are, adaptability, leadership, stability (mission and direction) and stakeholder communication. An organisational survey was distributed to all 25 fire and emergency services agencies in Australia and New Zealand which included indicators of these elements. Responses were received from experienced emergency m...

Managing the constraints of boundary spanning in emergency management

Stakeholders tasked with boundary spanning in emergency management are fundamental in facilitating multi-agency coordination. However, there is a scarcity of research investigating the characteristics of emergency management boundary spanners and how they achieve this function in the complex environment of emergency operation centres. An exploratory case study approach was adopted and applied in a strategic-level emergency operations centre. The study used three very different but interrelated qualitative research techniques based upon the Core-Task Analysis framework to categorize the work of stakeholders fulfilling a boundary spanning role in this setting. The data identified that stakeholders performing boundary spanning activities in a strategic-level emergency operations centre face a number of constraints. These can include unfamiliarity with the work domain, its personnel, and structure which can lead to temporal, cultural and information challenges. In order to manage these constraints, boundary spanners working in a strategic-level emergency operations centre need to adopt certain characteristics in order to accomplish their activities. A significant outcome from the data was the necessity to engage in these important undertakings in the pre-response phase in an effort to facilitate successful multi-agency coordination in an actual emergency event.