Tribalism in the workplace: a survey of perceptions on the causes for IR procedure delays

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

Jordan Bagnall, BS

Medical Student
University of Virginia School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Christine Huynh, BS (she/her/hers)

Medical Student
University of Virginia School of Medicine
DM

Danita Massie, MSN, RN, CNL

IR Clinician III
University of Virginia Health System
JP

James Patrie, MS

Senior Biostatistician
University of Virginia Health System
DS

Daniel Sheeran, MD (he/him/his)

Assistant Professor
University of Virginia Health System
John Fritz Angle, MD

Professor
University of Virginia Health System

Disclosure(s):

Jordan Bagnall, BS: No financial relationships to disclose

Christine Huynh, BS: No financial relationships to disclose

John Fritz Angle, MD: No relevant disclosure to display

Purpose: Many interventional radiology practices suffer procedure-start delays worsened by staff shortages. To assess the relationship between staff role and perceived sources of delay throughout a procedure visit, a multidisciplinary interventional radiology survey and analysis were performed.

Materials and Methods:
A Qualtrics questionnaire was distributed to the interventional radiology and anesthesia department at a single institution. Respondents were asked to indicate their staff position and rank a list of eight sources of pre-procedure delays and five sources of intra-procedure delays as most common and again as most lengthy. The provided sources of delays were chosen by the authors based on observation. Inter-staff comparisons of their ranks for causes of delays were statistically examined by way of the Kendall Tau statistics.

Results:
A total of 47 responses were collected from 5 faculty, 5 advanced practice providers, 9 residents, 13 nurses, 5 technologists, 1 patient care tech, 6 anesthesia faculty, and 11 certified registered nurse anesthetists.

There was a negative correlation between IR faculty and residents compared to all other IR staff for the most common causes of pre-procedure delays (-0.75 [95% CI: -1.0, -0.18]) (p=0.009), with physicians indicating room availability and anesthesia availability and all other IR staff indicating waiting for the attending to see the patient and availability of pre-procedure note and consent. There was a negative correlation between anesthesia and IR team members for the source of the most lengthy pre-procedure delays (-0.75 [95% CI: -1.0, -0.18]) (p=0.009), with anesthesia indicating IR physician availability and IR team members indicating waiting for anesthesia. IR techs and nurses also had diverging views on the most lengthy pre-procedure delays (-0.75 [95% CI: -1.0, -0.18]) (p=0.009).

Conclusion:
There are significant differences of opinion about the most common and lengthy sources of pre-procedure delays when comparing staff groups. It appears that each group has a tendency to ascribe the majority of delays to members of other staff roles, which could lead to tension between groups. These tensions should be investigated as an intervention point to promote greater inter-colleague empathy, communication, and teamwork, and as a result, better efficiency and quality of care.