NDLI: Inpatient diabetes care: complexity, resilience and quality of care

Content Provider	Springer Nature Link
Author	Ross, A. J. Anderson, J. E. Kodate, N. Thompson, K. Cox, A. Malik, R.
Copyright Year	2012
Abstract	It is estimated that 10–15 % of UK hospital inpatients have diabetes. Poor glycemic control is a care quality problem that has been linked to organizational factors such as inadequate training, inadequate protocols, problems with communication and teamwork, and difficulty coordinating mealtimes. Interventions using specialist diabetes teams have been effective in addressing some of these problems and have led to increased staff and patient self-efficacy and reduced length of stay. The aim of this study was to investigate how inpatient diabetes care is delivered and how resilience is created and/or breaks down, and to identify the implications for quality improvement. In-depth interviews (n = 32) with diabetes specialist and non-specialist staff were conducted in an acute medical admissions environment in an 850-bed teaching hospital. The Critical Decision Method, a content-orientated knowledge elicitation technique, was adapted to guide interview schedules, which explored key decisions, gaps and discontinuities in care and strategies for work system improvement. Care is delivered through the coordination of a multilayered team of different professionals. Specialists provide expertise and problem solving through case-based reasoning using problem-solving skills acquired through past experience. Ward staff focus on processes and immediate patient needs and are more reliant on decision protocols. Gaps in care can occur and result in delays in referring to specialists and clinical inertia. Specialists are a key source of resilience in the system and bridge gaps by acting reactively to problems, proactively monitoring and anticipating problems, providing staff education, and patient support and education. Opportunities for supporting clinicians to bridge gaps in care were identified.
Starting Page	91
Ending Page	102
Page Count	12
File Format	PDF
ISSN	14355558
Journal	Cognition, Technology & Work
Volume Number	16
Issue Number	1
e-ISSN	14355566
Language	English
Publisher	Springer London
Publisher Date	2012-09-02
Publisher Place	London
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Cognitive systems engineering Resilience engineering Patient safety Organizational complexity Specialist teams Inpatient diabetes care User Interfaces and Human Computer Interaction Industrial, Organisational and Economic Psychology Cognitive Psychology Automotive Engineering Aerospace Technology and Astronautics Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Philosophy Human-Computer Interaction Computer Science Applications

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Exploring gaps in cancer care using a systems safety perspective

Complicated, complex, and compliant: best practice in obstetrics

Standardisation and its discontents

A case study of factor influencing role improvisation in crisis response teams

Risk assessment and resilience of critical communication infrastructure in railways

Assessment of resilience engineering factors based on system properties in a process industry

Widening the scope of human factors safety assessment for decommissioning

Resilience and vulnerability of small flexible crisis response teams: implications for training and preparation

Developing an Organisational Integrity framework for nuclear safety

Inpatient diabetes care: complexity, resilience and quality of care

Similar Documents

Exploring gaps in cancer care using a systems safety perspective

Complicated, complex, and compliant: best practice in obstetrics

Standardisation and its discontents

A case study of factor influencing role improvisation in crisis response teams

Risk assessment and resilience of critical communication infrastructure in railways

Assessment of resilience engineering factors based on system properties in a process industry

Widening the scope of human factors safety assessment for decommissioning

Resilience and vulnerability of small flexible crisis response teams: implications for training and preparation

Developing an Organisational Integrity framework for nuclear safety

Inpatient diabetes care: complexity, resilience and quality of care