30 Nov, 15 | by Kristy Ebanks
By Tierney Kinnison
Veterinary Record has recently published a number of papers that can give the detail; here I draw the strands together. Two papers (the practice effect and the personal effect) used Social Network Analysis (SNA) to map interactions between veterinary practice team members and to identify trends across practices in England. This formed the starting point of the empirical research for my PhD. The SNA produced a vast amount of data, which could be analysed in a number of different ways depending on the focus and questions being asked. This, I think, highlights the usefulness of SNA – relatively unheard of in many fields of work and study – in studying team interactions.
With all these data, we chose to focus the first paper on ‘the practice effect’ and the second on ‘the personal effect’. The practice effect deals with how interactions between staff are affected by the size of a practice and the presence of branches. Small practices were relatively cohesive, with interactions between most individuals, while the density of interactions tended to decrease with increasing team size. However, even in smaller practices, everyone was not connected to everyone else; hence, decisions about whom to interact with were made. In practices that do not rotate staff between branches there tended to be a lack of information/knowledge flow across branch sites, creating sub-teams. These results have implications for practices aiming to grow in size.
The second paper focused on ‘the personal effect’; the concepts of key people, interprofessional interactions and the links between social and work interactions. Key people were identified individuals through whom information/knowledge travels and who tend to link other groups together, as often they were appointed leaders, such as directors, practice managers and head nurses, but they could also be emergent and situational leaders. Analysis of interactions between professions identified a hierarchy with veterinary surgeons at the top. In order to create a well-functioning and informed team, we tentatively suggested that interactions should instead be based primarily on experience and knowledge, as opposed to purely what profession someone is. Social and work interactions were linked, suggesting that we interact at work with those people who we like (rather than on their expertise), or we become friends with those people whose work interactions we value. Crucially, higher order interactions were much more likely between those who socialised than those who did not.
The third paper (errors in veterinary practice) evolved from the second part of my research, case studies, which aimed to explore the trends identified through the SNA in more depth. During the case studies I spent several weeks with two practices and observed the teams as a whole, as well as observing and interviewing selected individuals, who were representatives of each profession. I was looking for good interprofessional working and learning and found many examples of this. However, on occasion, I also saw errors, defined in the most encompassing sense, to mean any behaviour that could lead to any potentially negative consequence for patients, clients, the practice or the team. These errors were primarily, though not exclusively, communication based and involved, for example, mistakes on records, missing information given face-to-face and mistakes in face-to-face communication. Identifying the systems nature of these errors (rather than placing blame on an individual) and using potential solutions may reduce error in veterinary practices, and is likely to be important in large organisations where information flows less easily as a function of their size.
We have had a very positive response from members of the veterinary professions towards these articles, as well as our Veterinary Record letter (VR 2015 177, 345). I hope through this brief piece that the background to the research will be better understood, and that the veterinary community will use this type of research to create a workplace where all professions and occupations are valued for their individual expertise, which when brought together, can form a complementary skills set, best placed to suit the evolving needs of our patients and clients in the 21st century.
Professor Stephen May from the Royal Veterinary College and Professor David Guile from the Institute of Education, University College London are co-authors in these series of articles.