Analysing teamwork in health care: What matters when clinicians negotiate the continuity of clinical tasks and care responsibilities?


  • Rick Iedema Monash University School of Public Health and Preventive Medicine
  • Eamon Merrick University of Sydney School of Nursing



clinical handover, continuity of care, discourse analysis, teamwork, video-reflexive ethnography


This paper considers the ways in which clinicians enact ‘being a team’, by analysing how they inform one another about critical patient information. The process where this information exchange happens is known as ‘clinical handover’. The study that informs this paper spanned ten months of data collection in four hospitals, involving 150 clinicians and five patients. The analysis presented here draws on data collected at one of the hospital sites: an emergency department at a regional tertiary teaching hospital. Our analysis reveals how central clinical handover is to ‘being a team’ in health care, and how deficiencies in handover weaken clinical teams’ ability to provide continuous and safe care for their patients. We further discuss how clinical practitioners’ own responses to the footage foregrounded different issues compared to those revealed by formal analysis; namely, issues centring on relationships, and on practical steps to ensure these relationships could be improved. We reflect on the differences between our own formal analysis of the footage, and practitioners’ ‘lived response’ to the footage, and the implications of these differences for how we as analysts conceptualise ‘teamness’ in organisations.

Author Biographies

Rick Iedema, Monash University School of Public Health and Preventive Medicine

Rick Iedema (PhD, FaSSa) is Professor in Healthcare Improvement and Implementation Science at the Monash Centre for Health Research & Implementation (mCHRI), australia. His main research and teaching interest is the connection between health reform policy, frontline care, and the implementation of reform. His most recent publications include Visualising Health Care Improvement (with Jessica mesman and katherine Carroll, 2013, Radcliffe/ Taylor & Francis), and Communicating Quality and Safety in Health Care (edited, with Donella Piper and Marie Manidis, 2015, Cambridge University Press).

Eamon Merrick, University of Sydney School of Nursing

Eamon Merrick (PhD) is a Registered Nurse and a Lecturer at the Sydney Nursing School, University of Sydney. He has a research portfolio that focuses on health services workforce, primary health care, and the quality and safety of care. He has led and managed national research projects which have changed clinical practice and federal policy, and informed national legislation. His work has been recognised and given awards by leading government and industry groups. He has over ten years’ experience of critical care nursing, and has held senior administrative and managerial positions.


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How to Cite

Iedema, R., & Merrick, E. (2017). Analysing teamwork in health care: What matters when clinicians negotiate the continuity of clinical tasks and care responsibilities?. Communication and Medicine, 13(1), 85–97.