It’s an emergency! Activity theory analysis of team response to paediatric emergencies in General Practice leading to organisational change

Introduction
Provision of emergency care is an essential part of general practice (GP)(1). Paediatric emergencies are challenging, requiring specific knowledge, skills, and equipment. Given their critical nature and benefits timely interventions can confer it is important GP practices are prepared. However, a narrative review of the literature showed that GPs often feel unprepared for paediatric emergencies(1). Simulation is suited to training practitioners to deal with these low frequency, high acuity events, with systematic review evidence linking team training to improved patient outcomes(1).

Aims
In this exploratory study we aim to gain a deeper understanding of organisational change brought about by an in-situ simulation model of emergencies in general practice.

Methods
Guided by the principles of Cultural Historical Activity Theory (CHAT), we facilitated a programme of ISS in which a multidisciplinary team from a GP practice engaged in simulated paediatric emergencies, systemically analysed organisational preparedness, and conceived and implemented new ways of working. The rich data set developed from this programme includes focus group recordings, video footage and participant reflection diaries. We are now at the initial stages of using CHAT as a lens to analyse this data in depth.

Results
Work in progress, data analysis has begun and will be presented at the conference. This research will shed light on the role of ISS bring to the surface many of the nuances and contextualised factors in the complex world of general practice to guide us in the best direction of providing team-based response to managing paediatric emergencies.