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Managing boundaries at the accident scene: a qualitative study of collaboration exercises
University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences. (LINA)ORCID iD: 0000-0002-0871-0475
University West, Department of Nursing, Health and Culture. Sahlgrenska Academy at University of Gothenburg.ORCID iD: 0000-0001-9463-7341
Nordic School of Public Health, Göteborg, Sweden.
University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.ORCID iD: 0000-0002-6358-3528
2014 (English)In: International Journal of Emergency Services, ISSN 2047-0894, Vol. 3, no 1, 77-94 p.Article in journal (Refereed) Published
Abstract [en]

Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.

Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.

Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.

Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.

Place, publisher, year, edition, pages
Emerald Group Publishing Ltd. United Kingdom , 2014. Vol. 3, no 1, 77-94 p.
Keyword [en]
Collaboration, Exercise, Police, Ambulance, Accident, Fire department
National Category
Pedagogical Work Public Administration Studies Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Public health science; SOCIAL SCIENCE, Business administration; SOCIAL SCIENCE, Public administration; SOCIAL SCIENCE, Sociology
Identifiers
URN: urn:nbn:se:hv:diva-6143DOI: 10.1108/IJES-02-2013-0003OAI: oai:DiVA.org:hv-6143DiVA: diva2:710705
Available from: 2014-04-08 Created: 2014-04-08 Last updated: 2016-06-27Bibliographically approved
In thesis
1. In case of emergency: Collaboration exercises at the boundaries between emergency service organizations
Open this publication in new window or tab >>In case of emergency: Collaboration exercises at the boundaries between emergency service organizations
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Due to the emergent and dynamic nature of incidents, the complexity of emergency work is often referred to as a challenge for learning. Another recurrent challenge in emergency work is that of collaboration at and across established organizational boundaries involving actors with specific types of expertise who are operating under different regulations and responsibilities. In addition, training emergency service organizations in collaboration remains a challenge. In light of the difficulties and shortcomings that have been identified in major incident responses, the need for exercises for developing and maintaining collaborative response effectiveness prior to the next incident is often highlighted. The overall aim of this thesis is to understand how full-scale exercises can provide conditions for developing inter-organizational collaboration between the police, ambulance and rescue services at the incident site. Learning activities that carry the potential to support and develop collaborative capacity, and how the alignment of distributed expertise can be trained for, were of particular interest. Interviews with participants in eight full-scale exercises with professionals and interviews and observations of one exercise with senior-level students in Sweden served as the empirical base.Central concepts from Cultural-Historical Activity Theory (CHAT) provided theoretical tools to explore the exercises and understand boundaries between organizations with a wider, systemic approach. The empirical studies show that the participants understood full-scale exercises to be valuable opportunities for becoming involved in response work, making decisions, and acting and interacting in uncertain situations and realistic environments. As in real-life responses, exercises are characterized by the stabilization and confirmation of everyday routines on the one hand, and by improvisation and change on the other hand. The studies also show that exercises tend to focus on specific scenarios,intra-organizational routines, and leadership positions. Infrequent exercises inwhich the participants were only trained in a limited role were perceived to be in adequate for developing preparedness and collaboration. However, the analysis suggested that the way in which exercises were organized and performed had implications for how participants were trained in collaboration.Realizing the potential of boundaries as resources for learning in exercises depends on how boundaries are explicated and approached. Thus, rather than striving to ignore or eliminate boundaries in exercises, the studies illustrated the learning value of explicitly reflecting on the multiple understandings around boundaries. The studies demonstrated that much of the work at an incident site takes place around negotiations. Collaboration at the incident site was not only aquestion about boundary crossing; operational tasks may not always be aligned and have to be prioritized and sequenced. The exercises comprised work situations in which no single motive could explain or determine the collaboration,due to different types of expertise, primary responsibilities and needs forinformation. These factors were understood in terms of the concepts of boundarywork and boundary awareness. These concepts point at a more divergent understanding of collaboration that reaches beyond striving to create mutual understanding between organizations in learning activities. Differences between organizations, such as in terminology, time horizons, priorities, leadership structures, understandings of safety and how intra-organizational decisions and actions could impact the collaborating organizations' work, were central triggers for discussion and negotiation. These differences required explanations in order to make the actions and decisions of one organization understandable and justifiable to another, based on organizational mandates and types of expertise.Giving emergency services the opportunity to work together, to develop an awareness of their expectations of each other in various situations, to use and interpret their own and others' terminologies, and to identify internal hierarchies and motives for prioritizations was essential dimensions of exercises

Place, publisher, year, edition, pages
Trollhättan: University West, 2016. 135 p.
Series
PhD Thesis: University West, 8
Keyword
Exercise, Collaboration, Emergency preparedness, Emergency work, Police, Ambulance, Rescue service, Learning, Boundaries
National Category
Pedagogy
Research subject
Work Integrated Learning; SOCIAL SCIENCE, Pedagogics
Identifiers
urn:nbn:se:hv:diva-9333 (URN)978-91-87531-29-3 (ISBN)978-91-87531-28-6 (ISBN)
Supervisors
Available from: 2016-05-02 Created: 2016-04-29 Last updated: 2016-06-27Bibliographically approved

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Andersson, AnnikaCarlström, Eric D.Berlin, Johan
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Divison for Health, Culture and Educational SciencesDepartment of Nursing, Health and CultureDivision of Social Pedagogy and Sociology
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