Leadership sharing in maternity emergency teams: a retrospective cohort study in simulation.
leadership
obstetric emergencies
simulation
teamwork
Journal
BMJ simulation & technology enhanced learning
ISSN: 2056-6697
Titre abrégé: BMJ Simul Technol Enhanc Learn
Pays: England
ID NLM: 101684779
Informations de publication
Date de publication:
2020
2020
Historique:
accepted:
10
01
2019
entrez:
6
5
2022
pubmed:
20
4
2020
medline:
20
4
2020
Statut:
epublish
Résumé
Shared leadership is associated with improved team performance in many domains, but little is understood about how leadership is shared spontaneously in maternity emergency teams, and if it is associated with improved team performance. A video analysis study of multidisciplinary teams attending a maternity emergency management course was performed at a simulation centre colocated with a tertiary maternity hospital. Sixteen teams responding to a simulated postpartum haemorrhage were analysed between November 2016 and November 2017. Videos were transcribed, and utterances coded for leadership type using a coding system developed There was a significant sharing of leadership functions across the team despite the traditional recommendation for a singular leader, with the dominant leader only accounting for 58% of leadership utterances. There was no significant difference in Auckland Team Assessment Tool scores between high and low leadership sharing teams (5.02 vs 4.96, p=0.574). Time to critical intervention was shorter in low leadership sharing teams (193 s vs 312 s, p=0.018) but checklist completion did not differ significantly. Teams with better clinical performance had fewer leadership utterances beyond the dominant two leaders compared with poorer performing teams. Leadership is spontaneously shared in maternity emergency teams despite the recommendation for singular leadership. Spontaneous leadership emerging from multiple team members does not appear to be associated with the improvements in team performance seen in other domains.
Sections du résumé
Background
UNASSIGNED
Shared leadership is associated with improved team performance in many domains, but little is understood about how leadership is shared spontaneously in maternity emergency teams, and if it is associated with improved team performance.
Methods
UNASSIGNED
A video analysis study of multidisciplinary teams attending a maternity emergency management course was performed at a simulation centre colocated with a tertiary maternity hospital. Sixteen teams responding to a simulated postpartum haemorrhage were analysed between November 2016 and November 2017. Videos were transcribed, and utterances coded for leadership type using a coding system developed
Results
UNASSIGNED
There was a significant sharing of leadership functions across the team despite the traditional recommendation for a singular leader, with the dominant leader only accounting for 58% of leadership utterances. There was no significant difference in Auckland Team Assessment Tool scores between high and low leadership sharing teams (5.02 vs 4.96, p=0.574). Time to critical intervention was shorter in low leadership sharing teams (193 s vs 312 s, p=0.018) but checklist completion did not differ significantly. Teams with better clinical performance had fewer leadership utterances beyond the dominant two leaders compared with poorer performing teams.
Conclusions
UNASSIGNED
Leadership is spontaneously shared in maternity emergency teams despite the recommendation for singular leadership. Spontaneous leadership emerging from multiple team members does not appear to be associated with the improvements in team performance seen in other domains.
Identifiants
pubmed: 35518378
doi: 10.1136/bmjstel-2018-000409
pii: bmjstel-2018-000409
pmc: PMC8936608
doi:
Types de publication
Journal Article
Langues
eng
Pagination
135-139Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Qual Saf Health Care. 2010 Dec;19(6):e46
pubmed: 20472572
Acad Med. 2015 Oct;90(10):1408-22
pubmed: 26200585
Br J Surg. 2017 Jul;104(8):1028-1036
pubmed: 28376246
Simul Healthc. 2008 Winter;3(4):217-23
pubmed: 19088666
Emerg Nurse. 2009 Dec;17(8):12-7
pubmed: 20043426
J Patient Saf. 2021 Dec 1;17(8):e1441-e1451
pubmed: 29870514
Best Pract Res Clin Obstet Gynaecol. 2013 Aug;27(4):571-81
pubmed: 23647702
J Interprof Care. 2016 Jul;30(4):526-8
pubmed: 27269996
J Appl Psychol. 2014 Mar;99(2):181-98
pubmed: 24188392
BJOG. 2011 Apr;118(5):596-607
pubmed: 21291509
Tutor Quant Methods Psychol. 2012;8(1):23-34
pubmed: 22833776
Acad Med. 2016 Feb;91(2):272-81
pubmed: 26352763
Simul Healthc. 2018 Jun;13(3S Suppl 1):S1-S6
pubmed: 29870522
Leadersh Health Serv (Bradf Engl). 2018 Feb 5;31(1):110-128
pubmed: 29412098
Acta Obstet Gynecol Scand. 2013 Nov;92(11):1239-43
pubmed: 23980798
Simul Healthc. 2017 Jun;12(3):165-176
pubmed: 28009653
Am J Surg. 2013 Jun;205(6):745-51
pubmed: 22867725
J R Army Med Corps. 2011 Sep;157(3 Suppl 1):S310-4
pubmed: 22049813
J Trauma. 1997 Nov;43(5):772-7
pubmed: 9390488
Scand J Trauma Resusc Emerg Med. 2012 Jul 02;20:44
pubmed: 22747848
J Appl Psychol. 2005 Nov;90(6):1288-96
pubmed: 16316282
Resuscitation. 1999 Sep;42(1):27-45
pubmed: 10524729
J Crit Care. 2017 Jun;39:254-258
pubmed: 28082053
BMJ Qual Saf. 2011 Mar;20(3):216-22
pubmed: 21209142