Johan Berlin

Why is collaboration minimised at the accident scene?: A critical study of a hidden phenomenon

– The purpose of this paper is to study why collaboration among police, fire, and ambulance services is minimised at accident scenes., – Observations and semi‐structured interviews were carried out during 2007‐2008. The data material comprises a total of 248 hours of observations on 20 occasions and 57 interviews with 80 people., – The study identifies the difference between rhetoric and practice in connection with accident work. Collaboration is seen as a rhetorical ideal rather than something that is carried out in normal practice. Asymmetry, uncertainty and lack of incentives are important explanations as to why only limited forms of collaboration are actually implemented., – The paper shows a distinction between collaboration as rhetoric and practical collaboration at accident scenes., – The article proposes a multi‐faceted collaboration concept. In this way, collaboration can be developed and refined., – The results of the study show that police, fire, and ambulance services want to develop excellent forms of collaboration at the accident scene, but avoid this as it leads to uncertainty and asymmetries and because of a lack of incentives. However, simpler forms of collaboration may be realistic in the organisation of everyday work at accident scenes.

The 20-minute team : a critical case study from the emergency room

RATIONALE In this article, the difference between team and group is tested empirically. The research question posed is How are teams formed? Three theoretical concepts that distinguish groups from teams are presented: sequentiality, parallelism and synchronicity. The presumption is that groups cooperate sequentially and teams synchronously, while parallel cooperation is a transition between group and team. METHODS To answer the question, a longitudinal case study has been made of a trauma team at a university hospital. Data have been collected through interviews and direct observations. Altogether the work of the trauma team has been studied for a period of 5 years (2002-2006). RESULTS The results indicate that two factors are of central importance for the creation of a team. The first is related to its management and the other to the forms of cooperation. To allow for a team to act rapidly and to reduce friction between different members, clear leadership is required. CONCLUSIONS The studied team developed cooperation with synchronous elements but never attained a level that corresponds to idealized conceptions of teams. This is used as a basis for challenging ideas that teams are harmonious and free from conflicts and that cooperation takes place without friction.

From artefact to effect : the organising effects of artefacts on teams

PURPOSE Earlier studies have identified artefacts, but have only to a lesser degree looked at their effects. The purpose of this paper is to investigate how artefacts contribute to organisation. DESIGN/METHODOLOGY/APPROACH A trauma team at a university hospital has been observed and its members interviewed. FINDINGS The trauma team showed itself to be rich on artefacts since it had strong internal driving forces, high legitimacy, and tried to live up to high expectations from the outside. Its members were motivated to be in the forefront of trauma care. Through renewal, the team succeeded in maintaining demarcation. It also succeeded in systemising internal work tasks and made for itself a position in relation to the outside. The teams capacity, however, came to be limited by internal conflicts and battles for prestige. PRACTICAL IMPLICATIONS The study shows that informal logic has a strong influence on teams. Teamwork contributed to the development of organisational structure and motivation for the personnel. ORIGINALITY/VALUE Earlier studies advocate the important role of artefacts in order to communicate, collaborate, negotiate or coordinate activities. The conclusion is that artefacts also have an organising and developing effect on teams in a fragmented and differentiated healthcare.

Managing boundaries at the accident scene – a qualitative study of collaboration exercises

Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.Design/methodology/approach Interv ...

Models of teamwork: ideal or not? A critical study of theoretical team models

Purpose. There is a tendency in team research to employ concepts of stepwise models, reaching from the primitive to the excellent, to suggest that a higher level of evolution is better than the bas ...

The dominance of mechanistic behaviour: a critical study of emergency exercises

In this paper, the focus is on emergency exercises between the police, rescue services and ambulance. By practising, it is assumed that the conditions improve for a quick normalisation after an incident. The purpose of this paper is to identify whether the exercises are designed after organic action logic and therefore can be assumed to strengthen the ability to handle emergencies. Data have been collected at two large, regional, full-scale exercises (2008 and 2012). Data collection has been done through observations and document studies. The study shows that mechanistic behaviour is quite prevalent in the two studied exercises. They are time consuming and put little emphasis on practising organic behaviour. Too complex exercise scenarios contribute to a low tempo, long waiting periods and slow implementation. To succeed, the exercises need to have a non-linear time sequence and limited scenarios that invite participants to focus on organisational interfaces.

Synchronous work - myth or reality?: a critical study of teams in health and medical care

RATIONALE, AIMS AND OBJECTIVES In this article, ideal conceptions about teamwork are tested. The research question posed is: How are teams in psychiatry formed? Three theoretical concepts that distinguish groups from teams are presented: sequentiality, parallelism and synchronicity. The presumption is that groups cooperate sequentially and teams synchronously, while the parallel work mode is a transitional form between group and team. METHODS Three psychiatric outpatient teams at a university hospital specialist clinic were studied. Data were collected through 25 personal interviews and 82 hours of observations. The data collection was carried out over 18 months (2008-2009). RESULTS Results show: (1) that the three theoretical distinctions between group and team need to be supplemented with two intermediate forms, semiparallel and semisynchronous teamwork; and (2) that teamwork is not characterized by striving towards a synchronous ideal but instead is marked by an adaptive interaction between sequential, parallel and synchronous working modes. CONCLUSIONS The article points to a new intermediate stage between group and team. This intermediate stage is called semiparallel teamwork. The study shows that practical teamwork is not characterized by a synchronous ideal, but rather is about how to adaptively find acceptable solutions to a series of practical problems. The study emphasizes the importance of the team varying between different working modes, so-called semisystematics.

The Three-Level Collaboration Exercise – Impact of Learning and Usefulness

The aim of the study was to examine the emergency personnels perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi‐experimental and constructed in such a way that employees from different organizations overlapped each others tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of non-quasi experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).

The yellow line: a critical study of the symbolic value of artefacts in health care teams

Artefacts reveal an organisation’s “inner life” and they contribute to its image and reputation. They also play a decisive role for an organisation’s development. In this article, similar artefacts from two different health care teams—a trauma team and a psychiatric team—in the same hospital, are compared. The team members were interviewed and their work observed over the course of several years. It was demonstrated that identical pieces of equipment in a trauma team and a psychiatric team signalled opposite values. The psychiatric team was backward-looking, conservative and contradictory. Modern technology and pieces of equipment were associated with an abandoned and previously criticised activity. The corresponding equipment in the trauma team, on the other hand, signalled a forward looking, developing and unified culture. The trauma team was a relatively new and powerfully idealised phenomenon, which attracted attention. The analysis points out how the symbolic values signal that one activity is attractive and pleasing while another has a low external legitimacy.

Common incentives for teamwork – the unspoken contract's significance

Purpose - The purpose of this article was to identify and study common incentives for teamwork.Design/methodology/approach - The study was designed as a case study. The case consists of teamwork at ...