Journal article
Leadership structures in emergency care settings: A study of two trauma centers
International journal of medical informatics (Shannon, Ireland), v 80(4)
Apr 2011
PMID: 21306940
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
► We identify five leadership structures in trauma resuscitation and examine the effects of cross-disciplinary leadership on trauma teamwork. ► Leadership structures include: solo decision-making and intervening models within intra-disciplinary leadership category and intervening, parallel and collaborative models within cross-disciplinary leadership category. ► The weakest leadership was observed in cross-disciplinary parallel model, in which both surgical leaders and ED physicians issued independent task orders to other team members.
Trauma resuscitation involves multidisciplinary teams under surgical leadership in most US trauma centers. Because many trauma centers have also incorporated emergency department (ED) physicians, shared and cross-disciplinary leadership structures often occur. Our study identifies leadership structures and examines the effects of cross-disciplinary leadership on trauma teamwork.
We conducted an ethnographic study at two US Level-1 trauma centers, one of which is a dedicated pediatric trauma center. We used observation, videotaping and interviews to contextualize and classify leadership structures in trauma resuscitation. Leadership structures were evaluated based on three dimensions of team performance: defined leadership, likelihood of conflict in decision making, and appropriate care.
We identified five common leadership structures, grouped under two broad leadership categories: solo decision-making and intervening models within intra-disciplinary leadership; intervening, parallel, and collaborative models within cross-disciplinary leadership.
Most important weaknesses of different leadership structures are manifested in inefficient teamwork or inappropriate patient care. These inefficiencies are particularly problematic when leadership is shared between physicians from different disciplines with different levels of experience, which often leads to conflict, reduces teamwork efficiency and lowers the quality of care. We discuss practical implications for technology design.
Metrics
Details
- Title
- Leadership structures in emergency care settings: A study of two trauma centers
- Creators
- Aleksandra Sarcevic - School of Communication and Information, Rutgers University, 4 Huntington Street, New Brunswick, NJ 08901, USAIvan Marsic - Electrical and Computer Engineering Dept., Rutgers University, Piscataway, NJ, USALauren J Waterhouse - Children's National Medical Center, Washington, DC, USADavid C Stockwell - Children's National Medical Center, Washington, DC, USARandall S Burd - Children's National Medical Center, Washington, DC, USA
- Publication Details
- International journal of medical informatics (Shannon, Ireland), v 80(4)
- Publisher
- Elsevier Ireland Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:000288201100001
- Scopus ID
- 2-s2.0-79952533230
- Other Identifier
- 991014877929804721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Computer Science, Information Systems
- Health Care Sciences & Services
- Medical Informatics