Lucio Naccarella1, Michelle Raggatt2, Bernice Redley2,3. 1. 1 Health Systems & Workforce Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. 2. 2 Centre for Quality and Patient Safety Research, Monash Health Partnership, Burwood, Victoria, Australia. 3. 3 Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Australia.
Abstract
OBJECTIVE: To identify spatial design factors that influence informal interprofessional team-based communication within hospital emergency departments (EDs). BACKGROUND: Effective team communication in EDs is critical for interprofessional collaborative care and prevention of serious errors due to miscommunication. Limited evidence exists about how informal communication in EDs is shaped by the physical workspace and how workplace design principles can improve the quality of ED team communication. METHOD: Two health services with four hospital sites in Victoria, Australia, participated. A multistage mixed-methods approach used (1) an anonymous online communication network survey ( N = 103) to collect data on patterns and locations of informal interprofessional team communication among ED staff, (2) focus groups ( N = 37) and interviews ( N = 3) using photoelicitation to understand the perspectives of ED staff about how spatial design influences team communication, and (3) validity testing of preliminary findings with executives and ED managers at the participating sites. RESULTS: Informal communication with peers and within discipline groups on nonspecific areas of the ED was most common. Three key factors influenced the extent to which ED workspaces facilitated informal communication: (1) staff perceptions of privacy, (2) staff perceptions of safety, and (3) staff perceptions of connectedness to ED activity. CONCLUSION: Our research supports the proposition that ED physical environments influence informal team communication patterns. To facilitate effective team communication, ED workspace spatial designs need to provide visibility and connectedness, support and capture "case talk," enable privacy for "comfort talk," and optimize proximity to patients without compromising safety.
OBJECTIVE: To identify spatial design factors that influence informal interprofessional team-based communication within hospital emergency departments (EDs). BACKGROUND: Effective team communication in EDs is critical for interprofessional collaborative care and prevention of serious errors due to miscommunication. Limited evidence exists about how informal communication in EDs is shaped by the physical workspace and how workplace design principles can improve the quality of ED team communication. METHOD: Two health services with four hospital sites in Victoria, Australia, participated. A multistage mixed-methods approach used (1) an anonymous online communication network survey ( N = 103) to collect data on patterns and locations of informal interprofessional team communication among ED staff, (2) focus groups ( N = 37) and interviews ( N = 3) using photoelicitation to understand the perspectives of ED staff about how spatial design influences team communication, and (3) validity testing of preliminary findings with executives and ED managers at the participating sites. RESULTS: Informal communication with peers and within discipline groups on nonspecific areas of the ED was most common. Three key factors influenced the extent to which ED workspaces facilitated informal communication: (1) staff perceptions of privacy, (2) staff perceptions of safety, and (3) staff perceptions of connectedness to ED activity. CONCLUSION: Our research supports the proposition that ED physical environments influence informal team communication patterns. To facilitate effective team communication, ED workspace spatial designs need to provide visibility and connectedness, support and capture "case talk," enable privacy for "comfort talk," and optimize proximity to patients without compromising safety.
Entities:
Keywords:
emergency department; hospital design; interprofessional communication; spatial design; team communication
Authors: Chiara Pomare; Kate Churruca; Janet C Long; Louise A Ellis; Brett Gardiner; Jeffrey Braithwaite Journal: BMJ Open Date: 2019-07-09 Impact factor: 2.692