Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Mary-Anne Andrusyszyn

2nd Supervisor

Sandra Regan

Joint Supervisor

Abstract

Interactions between and among first-responders and emergency department (ED) healthcare providers impact the way in which patients are managed during emergency situations. The purpose of this study was to develop a grounded theory to explain the interactions between and among first-responders and ED healthcare providers during emergency situations. Interprofessional collaboration and teamwork has been extensively studied, however little is known about interactions that include first-responders. This study was guided by Strauss and Corbin’s (1990) approach to grounded theory. Data were collected through 256 hours of first-responder and ED observational opportunities and informal interviews with accompanying detailed field notes. As well, in-depth semi-structured interviews were conducted with 15 first-responders and ED healthcare providers. Data were organized using NVivo 10 software. A constant comparative approach consistent with grounded theory was used to analyze the field notes, interview transcripts, and policy documents until theoretical saturation was achieved. The proposed theoretical model, the Interactional Theory of Emergency Response and Care (ITERC), explains the interactions between and among first-responders and ED healthcare providers. Coming together for public safety is the core category that helps to describe the social processes of interactions of first-responders and ED healthcare providers during emergency situations. The four domains or subcategories provide further explanation of the micro, meso, and macro contexts that facilitate and/or impede interactions during emergency response and care. Factors that support first-responders and ED healthcare providers in their coming together for public safety include role clarity, clear communication, IPE, shared policies, and strategies to enhance systems issues such as managing offload delays. Given the importance of interactions between and among first-responders and ED healthcare providers and the effects on public safety, the ITERC may provide a beginning blueprint to guide educators, administrators, and policy makers in planning strategies to enhance the micro, meso, and macro factors influencing emergency response and care.

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