Are Theatre Practitioners being effectively engaged and utilised to support the agile adaptive capacity of healthcare organisations during major incident response? An inductive qualitative study

Background: Major incidents are increasing globally. A cornerstone of major incident response and recovery in healthcare organisations are Operating Theatres. Theatre Practitioners are healthcare professionals who work in Operating Theatres. The aim of this research project is to identify barriers and enabling factors in the effective utilisation of theatre practitioners’ skills during Major Incident response, and how this impacts organisational adaptive capacity.

Systematic Review: A systematic review of the literature, registered with PROSPERO, identified 17 relevant research papers. Themes identified were; workforce flexibility and adaptability; knowledge and skills; communication; training and experience. From this, the research question and objectives were derived.

Methods: Semi-structured qualitative interviews and inductive thematic analysis were conducted to answer the research objectives with 22 participants from five different hospitals. Two cohorts of staff were interviewed; senior managers with workforce responsibilities; and frontline theatre practitioners. Interviewees were purposively sampled to have experience of either mass casualty incidents, such as the Manchester Arena Bomb, and/or Covid.

Findings: Three findings’ chapters identify themes from the two cohorts. Several barriers to effective utilisation of theatre practitioner skills are identified, including a lack of organisational learning, organisational disconnect, and the influence of major incident response on staff wellbeing. Several enabling factors are also identified, including the potential significant of deploying staff to skill or task-based teams, and the utilisation of debrief as a protective and learning tool.

Conclusions: The role of theatre practitioner utilisation in organisational adaptive capacity is critically analysed in the context of the wider evidence base and findings of the research. The significance of the research findings for are highlighted. Particularly the perceived organisational disconnect and lack of organisational learning post-major incident and potentially negative consequences this may have for organisational recovery and resilience is discussed. Recommendations are made which could improve overall major incident response by supporting better utilisation of staff skills and improved pastoral and wellbeing for healthcare professionals. The most significant and practical of these is the role skills-based teams could have in supporting organisational adaptive capacity.