Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context

Mohammed Ali Salem Sultan; Amir Khorram-Manesh; Jarle Løwe Sørensen; Johan Berlin; Eric Carlström

doi:10.1007/s13753-023-00484-z

Volume 14 Issue 2

Apr. 2023

Turn off MathJax

Article Contents

Article Navigation > International Journal of Disaster Risk Science > 2023 > 14(2): 183-193

Mohammed Ali Salem Sultan, Amir Khorram-Manesh, Jarle Løwe Sørensen, Johan Berlin, Eric Carlström. Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context[J]. International Journal of Disaster Risk Science, 2023, 14(2): 183-193. doi: 10.1007/s13753-023-00484-z

Citation:

Mohammed Ali Salem Sultan, Amir Khorram-Manesh, Jarle Løwe Sørensen, Johan Berlin, Eric Carlström. Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context[J]. International Journal of Disaster Risk Science, 2023, 14(2): 183-193. doi: 10.1007/s13753-023-00484-z

Citation:

Mohammed Ali Salem Sultan, Amir Khorram-Manesh, Jarle Løwe Sørensen, Johan Berlin, Eric Carlström. Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context[J]. International Journal of Disaster Risk Science, 2023, 14(2): 183-193. doi: 10.1007/s13753-023-00484-z

PDF

Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context

doi: 10.1007/s13753-023-00484-z

1. Model of Care, Healthcare Transformation, Regional Health Directorate, Najran, 66255, Saudi Arabia;
2. Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, 405 30, Gothenburg, Sweden;
3. Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 405 30, Gothenburg, Sweden;
4. Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska Academy, 413 45, Gothenburg, Sweden;
5. USN School of Business, University of South-Eastern Norway, 3199, Borre, Norway;
6. Department of Social and Behavioural Studies, University West, 461 86, Trolhättan, Sweden

Accepted Date: 2023-03-26

Available Online: 2023-04-28

Publish Date: 2023-04-11

Abstract

Abstract

This study aimed to evaluate the development of healthcare teamwork during and after the collaboration tabletop exercises, through observation and interview methods. Integration and maturity theoretical models were employed to explain the collaborative challenges in teams that may suffer from unequally distributed power, hierarchies, and fragmentation. Using three-level collaboration tabletop exercises and the Command and control, Safety, Communication, Assessment, Treatment, Triage, Transport (CSCATTT) instrument, 100 healthcare workers were observed during each step in the implementation of the CSCATTT instrument using two simulated scenarios. The results show a lack of integration and team maturity among participants in the first scenario, leading to the delayed start of the activity, task distribution, and decision making. These shortcomings were improved in the second scenario. In-depth interviews with 20 participants in the second phase of the study revealed improved knowledge and practical skills, self-confidence, and ability in team building within trans-professional groups in the second scenario, which in concordance with the integration theory, was due to the attempts made in the first scenario. Additionally, there was an improvement in the team's maturity, which in concordance with the maturity theory, was due to the knowledge and practical skills during scenario plays. These results indicate the importance of continuous tabletop training, and the use of CSCATTT as a collaborative instrument, to promote the development of collaboration and to test the concept of preparedness.
- Collaboration exercises,
- Disaster education,
- Emergency management,
- Healthcare personnel training,
- Saudi Arabia,
- Teamwork

FullText(HTML)

References(95)

References

[1]	Abu Alsuood, Y., and A. Youde. 2018. An exploration of cultural factors and their influence on Saudi Arabian university deans' leadership perceptions and practices. Education Sciences 8(2):Article 57.
[2]	Alahmadi, H.A. 2010. Assessment of patient safety culture in Saudi Arabian hospitals. Quality and Safety in Health Care 19(5):e17-e17.
[3]	Alamri, A., A.I. Cristea, and M.S. Al-Zaidi. 2014. Saudi Arabian cultural factors and personalized learning. In Proceedings of the 6th International Conference on Education and New Learning Technologies, 7-9 July 2014, Barcelona, Spain, 7114-712.‏
[4]	Alandijany, T.A., A.A. Faizo, and E.I. Azhar. 2020. Coronavirus disease of 2019 (COVID-19) in the Gulf Cooperation Council (GCC) countries:Current status and management practices. Journal of Infection and Public Health 13(6):839-842.
[5]	Aldulaimi, S.H. 2019. Leadership concept and constructs in Arabic philosophy. Journal of Economic Cooperation & Development 40(2):193-210.
[6]	Alenazi, T.H., N.F. BinDhim, M.H. Alenazi, H. Tamim, R.S. Almagrabi, S.M. Aljohani, M.H. Basyouni, and R.A. Almubark et al. 2020. Prevalence and predictors of anxiety among healthcare workers in Saudi Arabia during the COVID-19 pandemic. Journal of Infection and Public Health 13(11):1645-1651.
[7]	Al-Hunaishi, W., V.C. Hoe, and K. Chinna. 2019. Factors associated with healthcare workers' willingness to participate in disasters:A cross-sectional study in Sana'a. Yemen. BMJ Open 9(10):e030547.
[8]	Al Thobaity, A., and F. Alshammari. 2020. Nurses on the frontline against the COVID-19 pandemic:An integrative review. Dubai Medical Journal 3(3):87-92.
[9]	Andersson, A., E. Carlström, and J.M. Berlin. 2013. Organizing a simulated reality:On exercises with public safety organizations (Organisering Av En fingerad Verklighet:Om ovningar mellan blåljusorganisationer). Nordic Organization Studies 15(3):34-64.
[10]	Assbeihat, J.M. 2016. The impact of collaboration among members on team's performance. Management and Administrative Sciences Review 5(5):248-259.
[11]	Berger, P.L., and T. Luckman. 1991. The social construction of reality. London:Penguin Books Ltd.
[12]	Berlin, J.M. 2010. Synchronous work:Myth or reality? A critical study of teams in health and medical care. Journal of Evaluation in Clinical Practice 16(6):1314-1321.
[13]	Berlin, J.M. 2014. Common incentives for teamwork-The unspoken contract's significance. Team Performance Management 20(1):65-80.
[14]	Berlin, J.M., and E.D. Carlström. 2008. The 20-minute team-A critical case study from the emergency room. Journal of Evaluation in Clinical Practice 14(4):569-576.
[15]	Berlin, J.M., and E.D. Carlström. 2015. Collaboration exercises:What do they contribute? A study of learning and usefulness. Journal of Contingencies and Crisis Management 23(1):11-23.
[16]	Berlin, J.M., E.D. Carlström, and H.S. Sandberg. 2012. Models of teamwork:Ideal or not? A critical study of theoretical team models. Team Performance Management 18(5-6):328-340.
[17]	Bistaraki, A., K. Waddington, and P. Galanis. 2011. The effectiveness of a disaster training programme for healthcare workers in Greece. International Nursing Review 58(3):341-346.
[18]	Black, N. 1996. Why we need observational studies to evaluate the effectiveness of health care. BMJ 312(7040):1215-1218.
[19]	Borell, J., and K. Eriksson. 2013. Learning effectiveness of discussion-based crisis management exercises. International Journal of Disaster Risk Reduction 5:28-37.
[20]	Brinkmann, S., and S. Kvale. 2015. Interviews:Learning the craft of qualitative research interviewing, 3rd edn. Thousand Oaks:Sage Publishing.
[21]	Buljac-Samardzic, M., K.D. Doekhie, and J.D. van Wijngaarden. 2020. Interventions to improve team effectiveness within health care:A systematic review of the past decade. Human Resources for Health 18(1):1-42.
[22]	Burnett, A.L., and K. McGuire. 2020. "This is not a drill-Evacuate the building now!" Disaster preparedness at the outpatient surgery department:An experiential lesson. Journal of Pediatric Surgical Nursing 9(2):37-42.
[23]	Calovi, M. 2018. Healthcare and disaster management:A geographical approach. Doctoral thesis. Scuola Universitaria Superiore Sant'anna, Pisa, Italy.
[24]	Cariaso-Sugay, J., M. Hultgren, B.A. Browder, and J.L. Chen. 2021. Nurse leaders' knowledge and confidence in managing disasters in the acute care setting. Nursing Administration Quarterly 45(2):142-151.
[25]	Carpenter, J. 1995. Interprofessional education for medical and nursing students:Evaluation of a programme. Medical Education 29(4):265-272.
[26]	Castañer, X., and N. Oliveira. 2020. Collaboration, coordination, and cooperation among organizations:Establishing the distinctive meanings of these terms through a systematic literature review. Journal of Management 46(6):965-1001.
[27]	Dickinson, T.L., and R.M. McIntyre. 1997. A conceptual framework for teamwork measurement. In Team performance assessment and measurement:Theory, methods, and applications, ed. M.T. Brannick, E. Salas, and C. Prince, 19-43. Hillsdale, NJ:Lawrence Erlbaum Associates Publishers.
[28]	Diefenbach, T., and J.A. Sillince. 2011. Formal and informal hierarchy in different types of organization. Organization Studies 32(11):1515-1537.
[29]	Dirks, K.T., and D.L. Ferrin. 2001. The role of trust in organizational setting. Organizational Sciences 12:450-467.
[30]	Finn, R. 2008. The language of teamwork:Reproducing professional divisions in the operating theatre. Human Relations 61(1):103-130.
[31]	Finn, R., M. Learmonth, and P. Reedy. 2010. Some unintended effects of teamwork in healthcare. Social Science & Medicine 70(8):1148-1154.
[32]	Ghalib, Z.A.Q. 2019. The impact of cross-cultural organizations on teamwork performance:A Yemeni perspective. European Journal of Business and Management. https://doi.org/10.7176/ejbm/11-14-13.
[33]	Glantz, V., P. Phattharapornjaroen, E. Carlström, and A. Khorram-Manesh. 2020. Regional flexible surge capacity-A flexible response system. Sustainability 12(15):Article 5984.
[34]	Gooding, K., M.P. Bertone, G. Loffreda, and S. Witter. 2022. How can we strengthen partnership and coordination for health system emergency preparedness and response? Findings from a synthesis of experience across countries facing shocks. BMC Health Services Research 22(1):1-19.
[35]	Grossman, R., M.S. Campo, J. Feitosa, and E. Salas. 2021. Cross-cultural perspectives on collaboration:Differences between the Middle East and the United States. Journal of Business Research 129:2-13.
[36]	Hall, P., and L. Weaver. 2001. Interdisciplinary education and teamwork:A long and winding road. Medical Education 35(9):867-875.
[37]	Hathaway, J.R., B.A. Tarini, S. Banerjee, C.O. Smolkin, J.A. Koos, and S. Pati. 2022. Healthcare team communication training in the United States:A scoping review. Health Communication 15:1-26.
[38]	Hofstede, G. 1984. Culture's consequences:International differences in work-related values. London:Sage.
[39]	Hofstede, G. 1991. Empirical models of cultural differences. In Contemporary issues in cross-cultural psychology, ed. N. Bleichrodt, and P.J.D. Drenth, 4-20. San Diego:Swets & Zeitlinger Publishers.
[40]	Holloway, I., and K. Galvin. 2017. Qualitative research in nursing and healthcare, 4th edn. London:Wiley-Blackwell.
[41]	Hsieh, H.F., and S.E. Shannon. 2005. Three approaches to qualitative content analysis. Qualitative Health Research 15(9):1277-1288.
[42]	Jamshidi, H., R.K. Jazani, A. Alibabaei, S. Alamdari, and M.N. Kalyani. 2019. Challenges of cooperation between the pre-hospital and in-hospital emergency services in the handover of victims of road traffic accidents:A qualitative study. Investigación y educación en enfermería 37(1):70-79.
[43]	Joseph, S., ed. 2000. Gender and citizenship in the Middle East. Syracuse:Syracuse University Press.
[44]	Kahn, C.A., K.L. Koenig, and C.H. Schultz. 2017. Emergency physician disaster deployment:Issues to consider and a model policy. Prehospital and Disaster Medicine 32(4):462-464.
[45]	Khorram-Manesh, A. 2019. Learning to respect diversity, gender equality, and collaboration:A childhood agenda or the content of a leadership development program. Disaster, Diversity and Emergency Preparation 146:Article 11.
[46]	Khorram-Manesh, A. 2020. Flexible surge capacity-Public health, public education, and disaster management. Health Promotion Perspectives 10(3):175-179.
[47]	Khorram-Manesh, A., J. Berlin, and E. Carlström. 2016. Two validated ways of improving the ability of decision-making in emergencies; Results from a literature review. Bulletin of Emergency & Trauma 4(4):Article 186.
[48]	Khorram-Manesh, A., O. Lupesco, T. Friedl, G. Arnim, K. Kaptan, A.R. Djalali, M. Foletti, and P.L. Ingrasia et al. 2016. Education in disaster management:What do we offer and what do we need? Proposing a new global program. Disaster Medicine and Public Health Preparedness 10(6):854-873.
[49]	Khorram-Manesh, A., H. Lönroth, P. Rotter, M. Wilhelmsson, J. Aremyr, A. Berner, A.N. Andersson, and E. Carlström. 2017. Non-medical aspects of civilian-military collaboration in the management of major incidents. European Journal of Trauma and Emergency Surgery 43(5):595-603.
[50]	Kouzes, J., and B. Posner. 2003. The leadership challenge, 3rd edn. San Francisco:Jossey-Bass.
[51]	Larsson, L.G., S. Bäck-Pettersson, S. Kylén, B. Marklund, and E. Carlström. 2017. Primary care managers' perceptions of their capability in providing care planning to patients with complex needs. Health Policy 121(1):58-65.
[52]	Lozano, R., M. Barreiro-Gen, and A. Zafar. 2021. Collaboration for organizational sustainability limits to growth:Developing a factors, benefits, and challenges framework. Sustainable Development 29(4):728-737.
[53]	Magnussen, L.I., E. Carlstrøm, J.L. Sørensen, G.E. Torgersen, E.F. Hagenes, and E. Kristiansen. 2018. Learning and usefulness stemming from collaboration in a maritime crisis management exercise in northern Norway. Disaster Prevention and Management:An International Journal 27(1):129-140.
[54]	Makaram, S. 1995. Interprofessional cooperation. Medical Education 29:65-69.
[55]	McCormack, R., and G. Coates. 2015. A simulation model to enable the optimization of ambulance fleet allocation and base station location for increased patient survival. European Journal of Operational Research 247(1):294-309.
[56]	Melin Emilsson, U., A.L. Strid, and M. Söderberg. 2020. Lack of coordination between health care and social care in multi-professional teamwork-The obstacle for coherent care of older people suffering from multi-morbidity. Journal of Population Ageing 15(2):319-335.
[57]	Merriam-Webster. 2022. Teamwork. https://www.merriam-webster.com/thesaurus/teamwork. Accessed 18 Nov 2022.
[58]	Miller, C.J., B. Kim, A. Silverman, and M.S. Bauer. 2018. A systematic review of team-building interventions in non-acute healthcare settings. BMC Health Services Research 18(1):1-21.
[59]	Morse, J.M. 2012. Qualitative health research:Creating a new discipline. Walnut Creek:Left Coast Press.
[60]	Mostafa, M.M. 2003. Attitudes towards women who work in Egypt. Women in Management Review 18(5):252-266.
[61]	Moussa, F.L., M. Moussa, H.A. Sofyani, B.H. Alblowi, Y.A. Oqdi, S. Khallaf, H.S. Alharbi, and A. Albarqi. 2022. Attitudes of critical care nurses towards teamwork and patient safety in Saudi Arabia:A descriptive cross-sectional assessment. Healthcare 10(10):Article 1866.
[62]	Noyes, J., A. Booth, K. Flemming, R. Garside, A. Harden, S. Lewin, T. Pantoja, and K. Hannes et al. 2018. Cochrane qualitative and implementation methods group guidance series-Paper 3:Methods for assessing methodological limitations, data extraction, and synthesis, and confidence in synthesized qualitative findings. Journal of Clinical Epidemiology 97:49-58.
[63]	OCHA (United Nations Office for the Coordination of Humanitarian Affairs). 2022. Surge capacity. https://www.unocha.org/our-work/coordination/surge-capacity. Accessed 10 Nov 2022.
[64]	Oktari, R.S., K. Munadi, R. Idroes, and H. Sofyan. 2020. Knowledge management practices in disaster management:Systematic review. International Journal of Disaster Risk Reduction 51:Article 101881.
[65]	Petrie, H.G. 1976. Do you see what I see? The epistemology of interdisciplinary inquiry. Educational Researcher 5(2):9-15.
[66]	Phattharapornjaroen, P., E. Carlström, and A. Khorram-Manesh. 2022. Developing a conceptual framework for flexible surge capacity based on complexity and collaborative theoretical frameworks. Public Health 208:46-51.
[67]	Phattharapornjaroen, P., V. Glantz, E. Carlström, L. Dahlén Holmqvist, and A. Khorram-Manesh. 2020. Alternative leadership in flexible surge capacity-The perceived impact of tabletop simulation exercises on Thai emergency physicians' capability to manage a major incident. Sustainability 12(15):Article 6216.
[68]	Potter, W.J., and D. Levine-Donnerstein. 1999. Rethinking validity and reliability in content analysis. Journal of Applied Communication Research 27:258-284.
[69]	Reiners, R., and S. Jayhooni. 2022. Evolving pattern candidates for setting up educational online seminars:Findings from the COVID-19 pandemic. In Proceedings of the 27th European Conference on Pattern Languages of Programs (EuroPLop '22), 6-10 July 2022, Irsee, Germany, Article 16.
[70]	Robertson, C.J., J.A. Al-Khatib, and M. Al-Habib. 2002. The relationship between Arab values and work beliefs:An exploratory examination. Thunderbird International Business Review 44(5):583-601.
[71]	Rogers, D.L., and C.L. Mulford. 1985. The historical development. In Interorganizational coordination:Theory, research, and implementation, ed. D.L. Roger, and D.A. Whetten. Ames:Iowa State University Press.
[72]	Ronchi, E., D. Nilsson, S. Kojić, J. Eriksson, R. Lovreglio, H. Modig, and A.L. Walter. 2016. A virtual reality experiment on flashing lights at emergency exit portals for road tunnel evacuation. Fire Technology 52(3):623-647.
[73]	Rosen, M.A., D. DiazGranados, A.S. Dietz, L.E. Benishek, D. Thompson, P.J. Pronovost, and S.J. Weaver. 2018. Teamwork in healthcare:Key discoveries enabling safer, high-quality care. American Psychologist 73(4):433-450.
[74]	Ross, W., and J. LaCroix. 1996. Multiple meanings of trust in negotiation theory and research:A literature review and integrative model. International Journal of Conflict Management 7(4):314-360.
[75]	Ruggiano, N., and T.E. Perry. 2019. Conducting secondary analysis of qualitative data:Should we, can we, and how?. Qualitative Social Work 18(1):81-97.
[76]	Sammut, J., D. Cato, and T. Homer. 2001. Major Incident Medical Management and Support (MIMMS):A practical, multiple casualty, disaster-site training course for all Australian health care personnel. Emergency Medicine 13(2):174-180.
[77]	Sandberg, H. 1997. Team development on research foundation (En forskningsbas för teamutveckling). Västerås:Mälardalen University Press (in Swedish).
[78]	Sasangohar, F., J. Moats, R. Mehta, and S.C. Peres. 2020. Disaster ergonomics:Human factors in COVID-19 pandemic emergency management. Human Factors 62(7):1061-1068.
[79]	Schmutz, J.B., L.L. Meier, and T. Manser. 2019. How effective is teamwork really? The relationship between teamwork and performance in healthcare teams:A systematic review and meta-analysis. BMJ Open 9(9):Article e028280.
[80]	Shackleton, V.J., and A.H. Ali. 1990. Work-related values of managers:A test of the Hofstede model. Journal of Cross-Cultural Psychology 21(1):109-118.
[81]	Sherif, V. 2018. Evaluating preexisting qualitative research data for secondary analysis. Forum Qualitative Sozialforschung/Forum:Qualitative Social Research. https://doi.org/10.17169/fqs-19.2.2821.
[82]	Simon, R., A. Morarji, and K. Ganesamurthy. 2021. Disaster management-Hospital perspective. International Journal of Research and Analytical Reviews 8(1):390-394.
[83]	Sørensen, J.L., E.D. Carlström, G.E. Torgersen, A.M. Christiansen, T.E. Kim, S. Wahlstrøm, and L.I. Magnussen. 2019. The organizer dilemma:Outcomes from a collaboration exercise. International Journal of Disaster Risk Science 10(2):261-269.
[84]	Sultan, M.A.S., A. Khorram-Manesh, E. Carlström, J. Berlin, and J.L. Sørensen. 2021. Impact of virtual disaster collaboration exercises on disaster leadership at hospitals in Saudi Arabia. International Journal of Disaster Risk Science 12(6):879-889.
[85]	Sultan, M.A.S., J.L. Sørensen, E. Carlström, L. Mortelmans, and A. Khorram-Manesh. 2020. Emergency healthcare providers' perceptions of preparedness and willingness to work during disasters and public health emergencies. Healthcare 8(4):Article 442.
[86]	Sweis, R.J., A. Al-Mansour, M. Tarawneh, and G. Al-Dweik. 2013. The impact of total quality management practices on employee empowerment in the healthcare sector in Saudi Arabia:A study of King Khalid Hospital. International Journal of Productivity and Quality Management 12(3):271-286.
[87]	Tanco, M., C. Jaca, E. Viles, R. Mateo, and J. Santos. 2011. Healthcare teamwork best practices:Lessons for industry. The TQM Journal 23(6):598-610.
[88]	Tlaiss, H., and S. Kauser. 2020. Women in management in Lebanon. In Women in management worldwide, ed. M.J. Davidson, R.J. Burke, and A.M. Richardsen, 299-315. London:Routledge.
[89]	Weick, K.E. 1990. The vulnerable system:An analysis of the Tenerife air disaster. Journal of Management 16(3):571-593.
[90]	Wennman, I., M. Wittholt, E. Carlström, T. Carlsson, and A. Khorram-Manesh. 2019. Urgent care center in Sweden-The integration of teams and perceived effects. The International Journal of Health Planning and Management 34(4):1205-1216.
[91]	Whetten, D.A. 1985. Objectives and issues:Setting the stage. In Interorganizational coordination:Theory, research, and implementation, ed. D.L. Roger, and D.A. Whetten. Ames:Iowa State University Press.
[92]	WHO (World Health Organization). 2022. East Africa steps up health emergency readiness, response:The East Africa region faces recurrent outbreaks and disasters. Geneva:WHO. https://who-africa.africa-newsroom.com/press/east-africa-steps-up-health-emergency-readiness-response?lang=en. Accessed 18 Oct 2022.
[93]	Xyrichis, A., and E. Ream. 2008. Teamwork:A concept analysis. Journal of Advanced Nursing 61(2):232-241.
[94]	Yaseen, Z. 2010. Leadership styles of men and women in the Arab world. Education, Business and Society:Contemporary Middle Eastern Issues 3(1):63-70.
[95]	Zajac, S., A. Woods, S. Tannenbaum, E. Salas, and C.L. Holladay. 2021. Overcoming challenges to teamwork in healthcare:A team effectiveness framework and evidence-based guidance. Frontiers in Communication 6:Article 606445.