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This paper reports initial clinical user experiences and views following implementation of these charts in adult general medical-surgical wards.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Across eight trial sites, 44 focus groups were conducted with 218 clinical ward staff, mostly nurses, who received training and had used the charts in routine clinical practice for the preceding 2\u20136\u2005weeks. Transcripts of audio recordings were analysed for emergent themes using an inductive approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>In this exploration of initial user experiences, key emergent themes were: tensions between vital sign \u2018ranges versus precision\u2019 to support decision making; using a standardised \u2018generalist chart in a range of specialist practice\u2019 areas; issues of \u2018clinical credibility\u2019, \u2018professional autonomy\u2019 and \u2018influences of doctors\u2019 when communicating abnormal signs; and \u2018permission and autonomy\u2019 when escalating care according to the protocol. Across themes, participants presented a range of positive, negative or mixed views. Benefits were identified despite charts not always being used up to their optimal design function. Participants reported tensions between chart objectives and clinical practices, revealing mismatches between design characteristics and human staff experiences. Overall, an initial view of \u2018increased activity\/uncertain benefit\u2019 was uncovered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Findings particularly reinforced the significant influences of organisational work-based cultures, disciplinary boundaries and interdisciplinary communication on implementation of this new practice chart. Optimal use of all chart design characteristics will be possible when these broader cultural issues are addressed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjqs-2013-002777","type":"journal-article","created":{"date-parts":[[2014,11,20]],"date-time":"2014-11-20T02:07:04Z","timestamp":1416449224000},"page":"65-75","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Clinical user experiences of observation and response charts: focus group findings of using a new format chart incorporating a track and trigger system"],"prefix":"10.1136","volume":"24","author":[{"given":"Doug","family":"Elliott","sequence":"first","affiliation":[{"name":"Faculty of Health, University of Technology, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Allen","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Technology, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Perry","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Technology, Sydney, New South Wales, Australia"},{"name":"South East Sydney Local Health District, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Fry","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Technology, Sydney, New South Wales, Australia"},{"name":"Northern Sydney Local Health District, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Duffield","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Technology, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre & Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Iedema","sequence":"additional","affiliation":[{"name":"Agency for Clinical Innovation, NSW Health, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"McKinley","sequence":"additional","affiliation":[{"name":"Intensive Care, Royal North Shore Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Roche","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Technology, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,11,19]]},"reference":[{"key":"2025090411135492000_24.1.65.1","unstructured":"Australian Commission on Safety and Quality in Health Care. 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