Sindre Høyland

Exploring varieties of knowledge in safe work practices - an ethnographic study of surgical teams

BackgroundWithin existing research in health and medicine, the nature of knowledge on how teams conduct safe work practices has yet to be properly explored.MethodsWe address this concern by exploring the varieties in which knowledge is expressed during interdisciplinary surgical operations. Specifically, the study was conducted in a surgical section of a Norwegian regional general hospital, between January and April of 2010, by means of an ethnographic design combining detailed non-participant observations, conversations and semi-structured interviews.ResultsBased on an analysis of the gathered data, we identify three particular themes in how knowledge is expressed by operating room personnel: (i) the ability and variety individuals demonstrate in handling multiple sources of information, before reaching a particular decision, (ii) the variety of ways awareness or anticipation of future events is expressed, and (iii) the different ways sudden and unexpected situations are handled by the individual team members.ConclusionsWe conclude that these facets of knowledge bring different insights into how safe work practices are achieved at an individual and team level in surgical operations, thus adding to the existing understanding of the nature of knowledge in safe work practices in surgical operations. Future research should focus on exploring and documenting the relationships between various elements of knowledge and safe work practices, in different surgical settings and countries.

On the need for revising healthcare failure mode and effect analysis for assessing potential for patient harm in healthcare processes

Healthcare Failure Mode and Effect Analysis is a proactive, systematic method adapted from safety-critical industries increasingly used to assess the potential for patient harm in high-risk healthcare processes. In this paper we review and discuss this method. We point to some weaknesses and finally argue for two adjustments. One adjustment is regarding the way in which risk is evaluated, and the other is to adopt a broader evaluation of barrier performance. Examples are given from prehospital critical care and from the operating room environment within hospitals to illustrate these ideas.

Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study.

BACKGROUND Survival rates after out-of-hospital cardiac arrest (OHCA) vary considerably among regions. The chance of survival is increased significantly by lay rescuer cardiopulmonary resuscitation (CPR) before Emergency Medical Services (EMS) arrival. It is well known that for bystanders, reasons for not providing CPR when witnessing an OHCA incident may be fear and the feeling of being exposed to risk. The aim of this study was to gain a better understanding of why barriers to providing CPR are overcome. METHODS Using a semi-structured interview guide, 10 lay rescuers were interviewed after participating in eight OHCA incidents. Qualitative content analysis was used. The lay rescuers were questioned about their CPR-knowledge, expectations, and reactions to the EMS and from others involved in the OHCA incident. They also were questioned about attitudes towards providing CPR in an OHCA incident in different contexts. RESULTS The lay rescuers reported that they were prepared to provide CPR to anybody, anywhere. Comprehending the severity in the OHCA incident, both trained and untrained lay rescuers provided CPR. They considered CPR provision to be the expected behavior of any community citizen and the EMS to act professionally and urgently. However, when asked to imagine an OHCA in an unclear setting, they revealed hesitation about providing CPR because of risk to their own safety. CONCLUSION Mutual trust between community citizens and towards social institutions may be reasons for overcoming barriers in providing CPR by lay rescuers. A normative obligation to act, regardless of CPR training and, importantly, without facing any adverse legal reactions, also seems to be an important factor behind CPR provision. Mathiesen WT , Bjørshol CA , Høyland S , Braut GS , Søreide E . Exploring how lay rescuers overcome barriers to provide cardiopulmonary resuscitation: a qualitative study. Prehosp Disaster Med. 2017;32(1):27-32.

Exploring the benefits of cloud services and accountability tools from a competitiveness and return on investment perspective

There are a number of challenges involved in using cloud services, such as privacy, control of data and compromised networks. The EU-project A4Cloud arose from an interest in mitigating these challenges through the development of tools for holding service providers accountable for handling of data. As part of the A4Cloud project, we applied a case study approach to explore cloud services and accountability tools among enterprise users and authorities in Norway. Our findings suggest that potential competitiveness and return on investment lie in an integrated cloud and accountability tools solution that can improve service dependability and alleviate pressing security concerns, improve competitiveness, and achieve cost reductions while representing a flexible, on-demand, and pay-per-use asset for effectively generating revenues. Therefore, return on investment is found in the synergy between the cloud and accountability tools, where the security mitigation potential of the tools plays an integral part.

Gaining access to a research site and participants in medical and nursing research: a synthesis of accounts.

The literature contains few accounts of how access to a research site and participants in medical and nursing research is gained, and few efforts to synthesise the existing accounts. Therefore, this article has two main goals: (i) to synthesise our own account of access with others in the medical and nursing literature, and (ii) to derive from this synthesis considerations of access and implications for health professions education.

Developing and Applying a Framework for Assessing the Research Quality of Qualitative Project Methods in the EU Project SECUR-ED:

Qualitative research plays a vital role in political development and in the design of statutes and directives. Consequently, ensuring the quality of this research is important. However, the current literature on evaluation of quantitative and qualitative research does not reflect this importance, and we have identified a need to establish guidelines for evaluating qualitative research projects for quality. Therefore, and based on existing research, we have developed a framework for assessing the research quality of large complex projects using qualitative methods. In our study, as presented in this article, we operationalize and apply the framework to evaluate six specific methods in the large European research project, Secured Urban Transportation—A European Demonstration (SECUR-ED); each method is assessed according to the quality criteria of “transferability,” “systematic design/reliability,” and “transactional validity.” Overall, we find that half of the SECUR-ED project methods demonstrate thorough documentation and transferability, and that half of the methods lack consistent usage and therefore score low on both reliability and validity. We also find that one method, the capacity mapping matrix, scores high on all quality parameters. Accordingly, we suggest that future European Union (EU) projects replicate the documentation efforts demonstrated in relation to several of the SECUR-ED methods, and consider the capacity mapping matrix as “best practice” standard. We conclude that the framework represents a novel approach to quality assessments of qualitative project methods across research topics and contexts.