A CRITICAL REVIEW ON THE IMPACT OF FACILITATING TEAMWORK IN EMERGENCY MANAGEMENT IN PUBLIC HOSPITAL IN MAIDUGIRI

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Globally, the unpredictability of emergencies such as natural disasters, accidents, or health crises like pandemics highlights the need for teamwork to ensure prompt, organized responses. It is no doubt according to Kapucu & Garayev (2021) that teams in emergency situations face challenges such as time pressure, resource limitations, and high-stress environments, making cohesive collaboration crucial for minimizing loss and ensuring successful outcomes. Macrae, 2019) highlighs that teamwork among medical personnel is critical in delivering effective healthcare, particularly in emergency situations where quick and coordinated responses are vital. Medical teams, which often consist of doctors, nurses, paramedics, and support staff, must work collaboratively to ensure that patients receive timely and appropriate care. Effective teamwork in medical settings involves clear communication, shared decision-making, and mutual respect among team members. Each team member's role must be well-defined, and leadership within the team should ensure that everyone works towards a common goal. 

In resource-limited settings like public hospitals, where stress levels are high and resources are often scarce, the importance of effective teamwork is even more pronounced, studies by Salas, Cooke, & Rosen (2008) has shown that teamwork in medical emergencies can reduce errors, improve patient outcomes, and facilitate faster decision-making. Salas et al., (2018) opined that teamwork enhances the ability to solve complex, multifaceted problems, such as coordinating mass evacuations, administering medical aid, and restoring basic services after disasters. For instance, during Hurricane Katrina, the lack of coordination between local and federal agencies delayed rescue operations and led to severe public backlash. This highlighted the importance of pre-established, well-facilitated team structures in emergency management. On the other hand, Boin & McConnell (2017) assert that facilitating teamwork in emergency management involves creating an environment where various stakeholders—such as medical professionals, emergency responders, and government agencies—can communicate and collaborate efficiently, hence when emergency responders work together effectively, it results in better decision-making, reduced response times, and improved overall outcomes

According to Tannenbaum et al. (2022), teamwork in emergencies is grounded in principles such as shared leadership, mutual trust, and clear communication. strong team leadership in emergencies ensures that all team members are aware of their roles and can adapt to changing circumstances, while mutual trust fosters confidence that each member will contribute effectively. Effective communication allows for quick sharing of critical information, helping teams make decisions that are responsive to the situation at hand. The need for structured collaboration was further emphasized during the COVID-19 pandemic and flood where the integration of health professionals, government bodies, and international organizations was essential to managing the crisis (Ducharme, 2020).

While the importance of teamwork in emergency management is well recognized, there are several challenges that impede its facilitation. Issues such as inter-agency rivalry, lack of proper training, and unclear leadership structures can hinder coordination and collaboration during emergency responses (Jenkins et al., 2018). In some cases, organizations may have differing priorities or operational protocols, leading to conflict and delays in critical decision-making. Furthermore, disparities in resource availability, particularly in low- and middle-income countries, exacerbate the difficulties in forming effective emergency teams (Perry & Lindell, 2007). As a result, understanding the factors that contribute to successful teamwork in emergency settings is critical for improving outcomes.

1.2 Statement of the Problem

The need for effective teamwork in emergency management has become increasingly apparent in light of recent global crises. Despite this recognition, many emergency responses remain hindered by poor coordination and communication between key stakeholders. For example, during the Ebola outbreak in West Africa, the COVID-19 pandemic fragmented teamwork and lack of clear leadership structures resulted in delayed containment measures, exacerbating the spread of the virus (Gostin & Friedman, 2020). These failures highlight a persistent gap in understanding the best practices for facilitating teamwork in emergency settings.

Recently, public hospitals in Borno State, Nigeria, have faced numerous challenges in emergency management due to both natural disasters and conflict. The frequent occurrences of floods, disease outbreaks, and the ongoing Boko Haram insurgency have overwhelmed the healthcare system in Maiduguri. Precisly, the recent 2024 floods in Borno State served as a stark reminder of the critical need for effective emergency management, particularly in public hospitals. The hospitals even in the metropolis of Maidugiri, already strained by years of conflict and resource limitations, were unable to adequately manage the influx of patients due to the lack of a structured teamwork approach. Musa (2024) reiterate that the failure to facilitate teamwork among healthcare workers, emergency responders, and support staff resulted in delays in medical interventions, inadequate care for flood victims, and overcrowded facilities. This underscores the pressing need to assess and improve teamwork facilitation in emergency management in these settings.

Existing studies have identified the importance of teamwork in healthcare emergencies. For example, Salas et al. (2018) highlighted that effective teamwork leads to faster decision-making and better patient outcomes. However, most of these studies focus on high-income countries, leaving a gap in research on how teamwork can be facilitated in resource-limited settings such as Maiduguri. The unique challenges faced by public hospitals in the region—including shortages of medical supplies, limited infrastructure, and staff burnout—necessitate a more contextualized understanding of teamwork facilitation in emergency situations. 

In addition, the failure to integrate external stakeholders, such as local emergency management agencies and international NGOs, into the teamwork process during the 2024 floods further complicated the emergency response in Maiduguri. Poor communication between healthcare professionals and external agencies led to confusion over patient triage, resource allocation, and medical evacuations (Comfort, Ko, & Zagorecki, 2024). This lack of coordination points to a broader issue of insufficient collaboration frameworks within the public healthcare system in Borno State. As a result, there is a critical gap in the literature regarding strategies for facilitating teamwork that includes both internal hospital staff and external emergency responders.

1.3 Objectives of the Study

The objective of this study is focused on the impact of facilitating teamwork in emergency management in public hospital in Maiduguri. Specifically, the study seeks to 

To assess the level of teamwork among emergency team in public hospitals during Bornu flooding.

To evaluate the impact of teamwork effectiveness during emergency responses and management in Maiduguri public hospitals.

To examine the challenges faced in coordinating teamwork between healthcare professionals and external emergency response agencies in Maiduguri.

To propose strategies for improving teamwork facilitation in public hospitals during emergency situations in Maiduguri.

Research Questions

What is the level of teamwork among emergency team in public hospitals during Bornu flooding.?

What impact do teamwork effectiveness have on emergency responses and management in Maiduguri public hospitals?

What challenges are faced in coordinating teamwork between healthcare professionals and external emergency response agencies in Maiduguri?

What strategies can be proposed to improve teamwork facilitation in public hospitals during emergency situations in Maiduguri?

1.5  Research Hypotheses

Ho: There is no significant relationship between effective teamwork facilitation and successful emergency management outcomes in public hospitals in Maiduguri.

Hi: There is a significant relationship between effective teamwork facilitation and successful emergency management outcomes in public hospitals in Maiduguri.

1.6 Significance of the Study

Practically, this study provides insights for healthcare practitioners, hospital administrators, and emergency response agencies in Maiduguri on the importance of teamwork in managing emergencies. By identifying the factors that hinder or promote teamwork, this research will offer actionable recommendations for improving response coordination and patient care during crises. The findings will be particularly valuable for public hospitals in resource-limited settings, where teamwork can significantly enhance emergency management outcomes.

Theoretically, the study contributes to the existing body of knowledge on emergency management in healthcare settings by focusing on the unique challenges faced in low-resource environments such as Maiduguri. It will provide a critical review of current theories on teamwork facilitation and leadership in emergency management, offering new insights into how these concepts can be applied in public hospitals in developing regions. The research will also address gaps in the literature concerning teamwork in emergency management in resource-limited settings.

1.7 Scope of the Study

This study focuses on the facilitation of teamwork in emergency management within public hospitals in Maiduguri, with specific attention to leadership, communication, and coordination with external agencies. Geographically, the study is limited to Maiduguri, the capital of Borno State, Nigeria, and will examine emergency responses in public hospitals during the 2024 floods and other similar crises.

1.8 Limitations of the Study

Like ever academic endeavor is faced with constraint, one limitation of this study is its reliance on secondary data, which may not fully capture the real-time dynamics of teamwork during emergencies in public hospitals. Another limitation is that the study focuses primarily on public hospitals in Maiduguri, which may not be representative of private hospitals or healthcare institutions in other regions of Nigeria. Furthermore, the study may be constrained by the availability of reliable data on emergency management practices in Maiduguri.

1.9 Definition of Terms

Teamwork: The coordinated effort of a group of individuals working together to achieve a common goal, particularly in emergency situations.

Emergency Management: The organization and management of resources and responsibilities for dealing with emergencies, particularly in healthcare settings.

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