Hospital emergency departments (EDs) are often high-intensity, busy, and complex environments treating especially sensitive patient populations in a time-sensitive manner. The nature of ED environments places added emphasis on the importance of clear communication between staff members and how the overall design of an ED might impact these interactions. The authors note that relatively little research has explored how the physical environment factors into the quality of inter-professional communications within ED environments, and that this matter should be explored to further enhance future ED designs.
To describe the spatial design elements that influence informal, team-based communications between healthcare workers in hospital emergency departments.
An anonymous online survey was distributed to a total of 103 participants who were all registered healthcare workers from two different Australian hospitals. The survey gathered information concerning the locations and social patterns characterizing the informal discussions happening between healthcare professionals within the participants’ respective EDs. Another 40 ED staff members participated in group interviews, which were supplemented with photographs of the physical spaces they discussed. Lastly, seven senior staff members from the two hospital sites attended validation focus groups, providing the researchers with additional data on staff workflows and the impacts of spatial designs.
Results from all participant surveys, interviews, and workshops highlighted the importance of how the spatial designs within EDs directly affect “spatial transparency”, or the degree of visibility (or “visual connections”) which ED staff are subjected to at any given time. Participants working in EDs where the ED’s physical design was made highly visible felt as though they were constantly under pressure to appear busy and remain professional, and thus had no space for important communications in a judgment-free atmosphere. Many ED designs that prioritize workflow and staff efficiency may be detrimental to ED staff needs regarding space for informal communications.
The authors note that this study used multiple sites, which featured different ED designs, staff experiences, and staff workflows. The fact that the data involved in this study were sourced only from volunteers may have influenced the results.