Aspectos facilitadores e dificultadores do trabalho em equipe em Unidade de Alta Densidade Tecnológica

O trabalho em equipe representa estratégia para superação da frágil articulação entre profissionais, sendo potencializado pela prática colaborativa entre agentes e gestão participativa. Entretanto, os arranjos organizacionais não favorecem a interação entre os profissionais e dificultam o trabalho em equipe. A magnitude dos agravos cardiovasculares por serviços regulados e estruturados, pautados num enfoque multiprofissional em saúde, a carência de publicações científicas sobre trabalho em equipe na atenção hospitalar, a potência do trabalho em equipe para responder às demandas reais de saúde justificam investigações a respeito do trabalho em equipe de saúde em Unidade Coronariana, particularizando a compreensão de aspectos que dificultam e facilitam esse trabalho. Assim, esta pesquisa teve como objetivo analisar o trabalho em equipe, desenvolvido em unidade hospitalar de alta densidade tecnológica, segundo a perspectiva da equipe de saúde. É um estudo descritivo, utilizando dados qualitativos e quantitativos, realizado em Unidade Coronariana de um Hospital público, de ensino, de nível terciário, referência para atendimento de alta densidade tecnológica. A população constituiu-se de profissionais da equipe multiprofissional que atuavam na referida unidade há, pelo menos, um ano, sendo excluídos aqueles que se encontravam afastados do trabalho à época da coleta dos dados e os não localizados após três tentativas para agendamento da entrevista. Utilizou-se a Técnica do Incidente Crítico, e os dados primários foram coletados por meio de entrevista semiestruturada. A análise dos dados fundamentou-se em análise de conteúdo. Participaram do estudo 45 profissionais da equipe de saúde, sendo 20 técnicos/auxiliares de enfermagem; 11 médicos; nove enfermeiros; quatro fisioterapeutas e um psicólogo. Das entrevistas, emergiram 49 situações, das quais 38 (77,6%) receberam referências negativas e 11 (22,4%), positivas; 385 comportamentos, sendo 209 (54,2%) positivos e 176 (45,8%) negativos; além de 182 consequências que receberam 131 (71,9%) referências negativas e 51 (28,1%) positivas. As referências positivas indicam aspectos que facilitam o trabalho em equipe e as negativas, aqueles que dificultam. Foram considerados facilitadores do trabalho em equipe colaborar/relacionar-se com os outros profissionais, desenvolver assistência ao paciente conforme a competência profissional, relacionamento entre agentes pautado na prática colaborativa e comunicação. Aspectos como baixa colaboração entre profissionais, gerenciamento inadequado de agentes, despreparo profissional no atendimento à parada cardiorrespiratória/emergência, divergências nas condutas terapêuticas, limitação de recursos materiais e agir de maneira descomprometida com o trabalho dificultam o trabalho em equipe. Conclui-se que, apesar do predomínio de situações e consequências negativas relativas à dinâmica do trabalho em equipe nessa Unidade Coronariana, a ênfase em comportamentos positivos, favoráveis ao trabalho em equipe, evidencia investimento e esforço para superar dificuldades, na perspectiva da potência do trabalho em equipe para atingir a finalidade do trabalho em saúde. A partir dos resultados, acredita-se que aspectos relativos à formação/capacitação profissional e à organização do serviço precisam favorecer o trabalho em equipe, estando a centralidade do processo de trabalho dessa equipe nas relações entre agentes

Organisational learning - a critical systems thinking discipline

Original Paper European Journal of Information Systems (2001) 10, 135–146; doi:10.1057/palgrave.ejis.3000394 Organisational learning—a critical systems thinking discipline P Panagiotidis1,3 and J S Edwards2,4 1Deloitte and Touche, Athens, Greece 2Aston Business School, Aston University, Aston Triangle, Birmingham, B4 7ET, UK Correspondence: Dr J S Edwards, Aston Business School, Aston University, Aston Triangle, Birmingham, B4 7ET, UK. E-mail: j.s.edwards@aston.ac.uk 3Petros Panagiotidis is Manager responsible for the Process and Systems Integrity Services of Deloitte and Touche in Athens, Greece. He has a BSc in Business Administration and an MSc in Management Information Systems from Western International University, Phoenix, Arizona, USA; an MSc in Business Systems Analysis and Design from City University, London, UK; and a PhD degree from Aston University, Birmingham, UK. His doctorate was in Business Systems Analysis and Design. His principal interests now are in the ERP/DSS field, where he serves as project leader and project risk managment leader in the implementation of SAP and JD Edwards/Cognos in various major clients in the telecommunications and manufacturing sectors. In addition, he is responsible for the development and application of knowledge management systems and activity-based costing systems. 4John S Edwards is Senior Lecturer in Operational Research and Systems at Aston Business School, Birmingham, UK. He holds MA and PhD degrees (in mathematics and operational research respectively) from Cambridge University. His principal research interests are in knowledge management and decision support, especially methods and processes for system development. He has written more than 30 research papers on these topics, and two books, Building Knowledge-based Systems and Decision Making with Computers, both published by Pitman. Current research work includes the effect of scale of operations on knowledge management, interfacing expert systems with simulation models, process modelling in law and legal services, and a study of the use of artifical intelligence techniques in management accounting. Top of pageAbstract This paper deals with the application of critical systems thinking in the domain of organisational learning and knowledge management. Its viewpoint is that deep organisational learning only takes place when the business systems' stakeholders reflect on their actions and thus inquire about their purpose(s) in relation to the business system and the other stakeholders they perceive to exist. This is done by reflecting both on the sources of motivation and/or deception that are contained in their purpose, and also on the sources of collective motivation and/or deception that are contained in the business system's purpose. The development of an organisational information system that captures, manages and institutionalises meaningful information—a knowledge management system—cannot be separated from organisational learning practices, since it should be the result of these very practices. Although Senge's five disciplines provide a useful starting-point in looking at organisational learning, we argue for a critical systems approach, instead of an uncritical Systems Dynamics one that concentrates only on the organisational learning practices. We proceed to outline a methodology called Business Systems Purpose Analysis (BSPA) that offers a participatory structure for team and organisational learning, upon which the stakeholders can take legitimate action that is based on the force of the better argument. In addition, the organisational learning process in BSPA leads to the development of an intrinsically motivated information organisational system that allows for the institutionalisation of the learning process itself in the form of an organisational knowledge management system. This could be a specific application, or something as wide-ranging as an Enterprise Resource Planning (ERP) implementation. Examples of the use of BSPA in two ERP implementations are presented.

A qualitative investigation into leader behavioural flexibility

Purpose – The current research aims to determine to what extent Australian managers are behaviourally flexible and to identify what factors are associated with the development of leader behavioural flexibility (LBF) and its contribution to positive organisational outcomes. Design/methodology/approach – Because of the exploratory nature of the questions to be addressed, a qualitative approach to data collection was selected. In particular, the grounded theory methodology was utilised due to its ability to aid with the theory building process. Semi-structured interviews based on the critical incident interview technique were used as the data source. Findings – The findings illustrate that the Australian managers who participated in this study exhibited significant degrees of LBF. The results also suggest that education level and group size may be antecedents to LBF. In addition, it appears that leader-member exchange may mediate the relationship between LBF and positive organisational outcomes, while social intelligence may moderate this relationship. Research limitations/implications – The current research makes several contributions in terms of theoretical development and reveals a richer insight into the underlying processes associated with the relationship between LBF and positive organisational outcomes. Practical implications – As the current research was conducted in the field with 20 practising organisational managers, the findings also highlight some important practical applications regarding LBF. Originality/value – Although previous studies have been able to establish a relationship between LBF and positive organisational outcomes, they have explained very little about the processes associated with this relationship. The present study attempted to uncover some of these processes.

The development of discourse in a discourse of development:a case study of a group constructing a new discourse.

This thesis is a qualitative case study drawing on discourse analysis and ethnographic traditions. The aim of the study is to provide a description of the discourse consciously constructed by a group of six TESOL professionals in the interests of their own development. Once a week, the group met for one hour and took turns to act as 'Speaker'. The other five individuals acted as Understanders. The extra space given to the Speaker allowed a fuller articulation of a problem or focus than would normally be possible in other professional talk. The Understanders contributed moves to support this articulation. The description covers a two-year period (1998-2000) of this constructed discourse. Data, collected during this period, are drawn from several different sources: recordings, interviews, diaries and critical incident journals. The main recordings are of the actual Group Development Meetings (GDMs). Discussion of six transcribed GDMs demonstrates which discourse choices and decisions were important. In particular, the study looks at the key role played by 'Reflection' in this process. It is argued that Reflection is the key element in supporting the Speaker. The analysis of Reflection, which is considered from four perspectives (values, purpose, form and outcomes) draws on data from the featured cases. Issues relating to the transfer to other groups of this discourse-based approach to professional development are considered.

Are Career Termination Concerns Only for Athletes? A Case Study of the Career Termination of an Elite Female Coach

This paper presents a case study of an elite female coach and her career termination from a 20+ year career following a critical life incident. A novel autobiographical approach was adopted whereby the participant undertook expressive writing to describe her experiences prior to, during, and following coaching an athlete at the 2012 Summer Olympic Games. Thematic analysis indicated seven phases related to the participant’s experiences of the critical incident: Build up to the event, the event, the aftermath, recovery and reflection on the event, sampling of new avenues, enlightenment, and career re-birth. The findings reinforce the high demands placed upon elite coaches, the subsequent threats to physical and mental well-being, and the importance of having robust psychological skills and suitable social support to cope with these demands. Implications for preparing and supporting coaches for successful career transition are discussed.

WorkChoices, ImageChoices and the marketing of new industrial relations legislation

This article takes a critical discourse approach to one aspect of the Australian WorkChoices industrial relations legislation: the government’s major advertisement published in national newspapers in late 2005 and released simultaneously as a 16-page booklet. This strategic move was the initial stage of one of the largest ‘information’ campaigns ever mounted by an Australian government, costing more than $AUD137 million. This article analyse the semiotic (visual and graphic) elements of the advertisement to uncover what these elements contribute to the message, particularly through their construction of both an image of the legislation and a portrayal of the Australian worker. We argue for the need to fuse approaches from critical discourse studies and social semiotics to deepen understanding of industrial relations phenomena such as the ‘hard sell’ to win the hearts and minds of citizens regarding unpopular new legislation.

From 'sympathetic' to 'dialogic' imagination : cultural study in the foreign language classroom

This chapter reports on a critical literacy approach to developing intercultural competence in an EFL/ESL classroom: an approach which uses a form of 'connective analysis' between linguacultures leading to productive exploration of the interstices between cultures.

Valuing the impact of the teacher librarian from an evidence base

Evidence-based practice as it applies to the Library and Information (LIS) sector and in particular teacher librarians is the focus of this research investigation. The context for this research is Australian school libraries and teacher librarians. This is a research in progress and the report here will include some very early findings and lessons learned from the initial pilot study. The contributions of this research will be in developing a framework for the library and information sector with a particular application for teacher librarians. Providing meaningful evidence of work practices that demonstrate contributions to the schools goals and mission statements in conjunction with contributions to student academic, social and cultural achievements are crucial for the future of the teacher librarian.

Ethical dilemmas : a model to understand teacher practice

Over recent decades, the field of ethics has been the focus of increasing attention in teaching. This is not surprising given that teaching is a moral activity that is heavily values-laden. Because of this, teachers face ethical dilemmas in the course of their daily work. This paper presents an ethical decision-making model that helps to explain the decision-making processes that individuals or groups are likely to experience when confronted by an ethical dilemma. In order to make sense of the model, we put forward three short ethical dilemma scenarios facing teachers and apply the model to interpret them. Here we identify the critical incident, the forces at play that help to illuminate the incident, the choices confronting the individual and the implications of these choices for the individual, organization and community. Based on our analysis and the wider literature we identify several strategies that may help to minimize the impact of ethical dilemmas. These include the importance of sharing dilemmas with trusted others; having institutional structures in schools that lessen the emergence of harmful actions occurring; the necessity for individual teachers to articulate their own personal and professional ethics; acknowledging that dilemmas have multiple forces at play; the need to educate colleagues about specific issues; and the necessity of appropriate preparation and support for teachers. Of these strategies, providing support for teachers via professional development is explored more fully.

Inward internationalization of services : Exploring satisfaction and dissatisfaction of overseas students in Australia

Most research has assessed the outward internationalization process of service firms and less is known in the literature about the inward internationalization of services, or companies that provide the service to overseas customers in the domestic market (i.e., tourism, education, healthcare). Specifically, there is scant research looking at the overseas customer perspective. This study attempts to identify the main drivers of satisfaction and dissatisfaction for overseas customers. The critical incident technique (CIT) method was used to collect and analyse the data. A total of 107 critical incidents regarding drivers of satisfaction and dissatisfaction for overseas customers in a higher educational service context were collected. Findings of this study show that drivers of service satisfaction and dissatisfaction for overseas customers derive from elements of the core service and peripheral service. However, the findings show that elements of the peripheral service (living environment, socialization and interaction with others, and personal performance) are more important for international students.

Voices of experience : opportunities to influence creatively the designing of school libraries

Using a critical ethnographic approach this study investigates the potential for multiple voices of experience, of educators, designers/architects, education facility planners and students/learners, to influence creatively the designing of school libraries. School libraries are considered as social and cultural entities within the contexts of school life and of wider society. It is proposed that school library designing is a social interaction of concern to those influenced by its practices and outcomes. School library designing is therefore of significance to educators and students as well as to those with professionally accredited involvement in school library designing, such as designers/architects and education facility planners. The study contends that current approaches to educational space designing, including school libraries, amplify the voices of accredited designers and diminish or silence the voices of the user participants. The study is conceptualised as creative processes of discovery, through which attention is paid to the voices of experience of user and designer participants, and is concerned with their understandings and experiences of school libraries and their understandings and experiences of designing. Grounded theory coding (Charmaz) is used for initial categorising of interview data. Critical discourse analysis (CDA, Fairclough) is used as analytical tool for reflection on the literature and for analysis of the small stories gathered through semi-structured interviews, field observations and documents. The critical interpretive stance taken through CDA, enables discussions of aspects of power associated with the understandings and experiences of participants, and for recognition of creative possibilities and creative influence within and beyond current conditions. Through an emphasis on prospects for educators and students as makers of the spaces and places of learning, in particular in school libraries, the study has the potential to inform education facility designing practices and design participant relationships, and to contribute more broadly to knowledge in the fields of education, design, architecture, and education facility planning.

Contemporary State Terrorism: Theory and Practice

This volume aims to 'bring the state back into terrorism studies' and fill the notable gap that currently exists in our understanding of the ways in which states employ terrorism as a political strategy of internal governance or foreign policy. Within this broader context, the volume has a number of specific aims. First, it aims to make the argument that state terrorism is a valid and analytically useful concept which can do much to illuminate our understanding of state repression and governance, and illustrate the varieties of actors, modalities, aims, forms, and outcomes of this form of contemporary political violence. Secondly, by discussing a rich and diverse set of empirical case studies of contemporary state terrorism this volume explores and tests theoretical notions, generates new questions and provides a resource for further research. Thirdly, it contributes to a critical-normative approach to the study of terrorism more broadly and challenges dominant approaches and perspectives which assume that states, particularly Western states, are primarily victims and not perpetrators of terrorism. Given the scarceness of current and past research on state terrorism, this volume will make a genuine contribution to the wider field, particularly in terms of ongoing efforts to generate more critical approaches to the study of political terrorism. This book will be of much interest to students of critical terrorism studies, critical security studies, terrorism and political violence and political theory in general.

Satisfiers and dissatisfiers for international students of higher education : an exploratory study in Australia

This paper explores the main satisfiers and dissatisfiers for international students in Australia’s higher educational sector. Using a critical incident technique, this study is conducted with international students of higher education in Australia. Four categories of satisfiers and dissatisfiers emerge from the data which are related to individual performance, quality of the educational service, socialisation, and living conditions.

Submission to National Inquiry into Children in Immigration Detention from The Australian Psychological Society

Executive Summary The Australian Psychological Society categorically condemns the practice of detaining child asylum seekers and their families, on the grounds that it is not commensurate with psychological best practice concerning children’s development and mental health and wellbeing. Detention of children in this fashion is also arguably a violation of the UN Convention on the Rights of the Child. A thorough review of relevant psychological theory and available research findings from international research has led the Australian Psychological Society to conclude that: • Detention is a negative socialisation experience. • Detention is accentuates developmental risks. • Detention threatens the bonds between children and significant caregivers. • Detention limits educational opportunities. • Detention has traumatic impacts on children of asylum seekers. • Detention reduces children’s potential to recover from trauma. • Detention exacerbates the impacts of other traumas. • Detention of children from these families in many respects is worse for them than being imprisoned. In the absence of any indication from the Australian Government that it intends in the near future to alter the practice of holding children in immigration detention, the Australian Psychological Society’s intermediate position is that the facilitation of short-term and long-term psychological development and wellbeing of children is the basic tenet upon which detention centres should be audited and judged. Based on that position, the Society has identified a series of questions and concerns that arise directly from the various psychological perspectives that have been brought to bear on estimating the effects of detention on child asylum seekers. The Society argues that, because these questions and concerns relate specifically to improvement and maintenance of child detainees’ educational, social and psychological wellbeing, they are legitimate matters for the Inquiry to consider and investigate. • What steps are currently being taken to monitor the psyc hological welfare of the children in detention? In particular, what steps are being taken to monitor the psychological wellbeing of children arriving from war-torn countries? • What qualifications and training do staff who care for children and their families in detention centres have? What knowledge do they have of psychological issues faced by people who have been subjected to traumatic experiences and are suffering high degrees of anxiety, stress and uncertainty? • What provisions have been made for psycho-educational assessment of children’s specific learning needs prior to their attending formal educational programmes? • who are suffering chronic and/or vicarious trauma as a result of witnessing threatening behaviour whilst in detention? • What provisions have been made for families who have been seriously affected by displacement to participate in family therapy? • What critical incident debriefing procedures are in place for children who have witnessed their parents, other family members, or social acquaintances engaging in acts of self-harm or being harmed while in detention? What psychotherapeutic support is in place for children who themselves have been harmed or have engaged in self- harmful acts while in detention? • What provisions are in place for parenting programmes that provide support for parents of children under extremely difficult psychological and physical circumstances? • What efforts are being made to provide parents with the opportunity to model traditional family roles for children, such as working to earn an income, meal preparation, other household duties, etc.? • What opportunities are in place for the assessment of safety issues such as bullying, and sexual or physical abuse of children or their mothers in detention centres? • How are resources distributed to children and families in detention centres? • What socialization opportunities are available either within detention centres or in the wider community for children to develop skills and independence, engage in social activities, participate in cultural traditions, and communicate and interaction with same-age peers and adults from similar ethnic and religious backgrounds? • What access do children and families have to videos, music and entertainment from their cultures of origin? • What provisions are in place to ensure the maintenance of privacy in a manner commensurate with usual cultural practice? • What is the Government’s rationale for continuing to implement a policy of mandatory detention of child asylum seekers that on the face of it is likely to have a pernicious impact on these children’s mental health? • In view of the evidence on the potential long-term impact of mandatory detention on children, what processes may be followed by Government to avoid such a practice and, more importantly, to develop policies and practices that will have a positive impact on these children’s psychological development and mental health?