A grounded theory study of interprofessional teamworking in the Operating Room: what makes a “great day” at work?

Scott, Margaret (2021) A grounded theory study of interprofessional teamworking in the Operating Room: what makes a “great day” at work? Doctoral thesis, Northumbria University.

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Abstract

Background:
The operating room (OR) environment is a unique context within the clinical setting, which brings together interprofessional healthcare providers in a confined space where patient care is directed at a concentrated focal point. The notion that a team of experts do not simply merge to form an expert team is reflected through reported failures in teamwork in the OR. Interactions between and among interprofessional healthcare providers within the OR context are critical in optimising the way in which the team works together. There is limited empirical research exploring teamwork in the OR through the perceptions of interprofessional healthcare providers who have experience of teamworking in this unique context.

Aim:
The aim of the research was to address the gap in knowledge and develop a more comprehensive understanding of teamwork in the OR. Specifically, the research aimed to explore interprofessional teamwork in the OR exclusively, through the perceptions of individuals who had personal experiences of working in such teams.

Methodology and Methods:
This research was guided by Strauss and Corbin’s (1990) approach to grounded theory, influenced by the theoretical perspective of symbolic interactionism. The sample population comprised of a group of individuals in an established interprofessional role, who could contribute to understanding ‘teamwork as imagined’ and ‘teamwork as done’ within the OR. Using a theoretical sampling strategy, data were collected via 14 in-depth semi-structured interviews, three observation periods and informal interviews, with accompanying detailed field notes. Data were analysed using open, axial and selective coding techniques, supported by constant comparative analysis until theoretical saturation was achieved.

Findings:
The analysis generated four data categories. Antecedents of Familiarity is the core category that helps to describe the social processes of interactions of interprofessional healthcare providers during OR encounters. The three sub-categories, Shared Understanding, Positive Disposition and Professional Communication, provide further explanation of the micro, meso and macro contexts that facilitate and/or impede interactions during teamwork. To reflect participant perceptions of the complex nature of teamwork in the OR, a grounded theory was constructed and integrated into The Interprofessional Collective Effort (ICE) Model of OR teamwork and the underpinning PerfORm taxonomy. Given the importance of interactions among and between interprofessional healthcare providers in the OR, the new theoretical insight gained from this model provides a more comprehensive understanding to guide educators, leaders/managers and policymakers in planning strategies to support interprofessional teamwork in the OR. Original contributions to the existing knowledge base around OR teamworking are offered, alongside a basis from which to address emerging implications for academic disciplines, research areas, interprofessional education and collaborative team training.

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