A Night With Red Eyes Reveals How Teamwork Unfolds in Out-Of-Hours Primary Care.

Abstract

During a night in October 2024, several patients contacted an Out-of-Hours Primary Care (OOH-PC) team reporting "burning eyes." As a pattern emerged, the team was required to manage an uncertain situation without an existing protocol. This case study of an OOH-PC triage team is based on a semi-structured focus group interview with employees who were on duty during the incident. The study explores how a co-located team adapted to an unforeseen clinical situation, with particular attention to team processes and emergent states that supported coordination under uncertainty. A thematic analysis identified three themes: (1) informal communication that demands attention; (2) a new situation without a protocol; and (3) dynamics between physicians and nurses. While planning and coordination were primarily handled by physicians, mutual respect and established communication patterns enabled nurses to remain informed and contribute actively. The findings suggest that pre-existing team characteristics can facilitate adaptive responses during critical events. The case highlights the value of flexible and dynamic teamwork when triage teams manage unexpected situations without relevant protocols.