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dc.contributor.authorRandell, Rebecca
dc.contributor.authorGreenhalgh, J.
dc.contributor.authorHindmarsh, J.
dc.contributor.authorHoney, S.
dc.contributor.authorPearman, A.
dc.contributor.authorAlvarado, Natasha
dc.contributor.authorDowding, D.
dc.date.accessioned2020-02-21T17:56:58Z
dc.date.accessioned2020-05-01T13:44:28Z
dc.date.available2020-02-21T17:56:58Z
dc.date.available2020-05-01T13:44:28Z
dc.date.issued2021-03-01
dc.identifier.citationRandell R, Greenhalgh J, Hindmarsh J et al (2021) How do team experience and relationships shape new divisions of labour in robot-assisted surgery? A realist investigation. Health (United Kingdom). 25(2): 250-268.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17758
dc.descriptionYesen_US
dc.description.abstractSafe and successful surgery depends on effective teamwork between professional groups, each playing their part in a complex division of labour. This article reports the first empirical examination of how introduction of robot-assisted surgery changes the division of labour within surgical teams and impacts teamwork and patient safety. Data collection and analysis was informed by realist principles. Interviews were conducted with surgical teams across nine UK hospitals and, in a multi-site case study across four hospitals, data were collected using a range of methods, including ethnographic observation, video recording and semi-structured interviews. Our findings reveal that as the robot enables the surgeon to do more, the surgical assistant's role becomes less clearly defined. Robot-assisted surgery also introduces new tasks for the surgical assistant and scrub practitioner, in terms of communicating information to the surgeon. However, the use of robot-assisted surgery does not redistribute work in a uniform way; contextual factors of individual experience and team relationships shape changes to the division of labour. For instance, in some situations, scrub practitioners take on the role of supporting inexperienced surgical assistants. These changes in the division of labour do not persist when team members return to operations that are not robot-assisted. This study contributes to wider literature on divisions of labour in healthcare and how this is impacted by the introduction of new technologies. In particular, we emphasise the need to pay attention to often neglected micro-level contextual factors. This can highlight behaviours that can be promoted to benefit patient care.en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1177/1363459319874115en_US
dc.rights(c) 2021 SAGE Publishing. Full-text reproduced in accordance with the publisher's self-archiving policy.
dc.subjectDivision of labouren_US
dc.subjectEthnographyen_US
dc.subjectInterprofessional workingen_US
dc.subjectNegotiated orderen_US
dc.subjectProfessional boundariesen_US
dc.subjectRealist methodsen_US
dc.subjectRobot-assisted surgeryen_US
dc.titleHow do team experience and relationships shape new divisions of labour in robot-assisted surgery? A realist investigationen_US
dc.status.refereedYesen_US
dc.date.Accepted2019-08-12
dc.date.application2019-09-14
dc.typeArticleen_US
dc.type.versionAccepted manuscripten_US
dc.date.updated2020-02-21T17:57:04Z
refterms.dateFOA2020-05-04T07:04:38Z


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