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​Emergency Talks: Designing for Team Communication in Hospital Emergency Departments

Dr Lucio Naccarella, University of Melbourne
Associate Prof Bernice Redley, Deakin University Monash Health Partnership
Michaela Sheahan & Kieren Morgan, HASSELL

Awards RIBA President's Awards for Research 2017
Category Design & Technical

Citrix, Sydney, Australia © Nicole England

The objective of this research was to identify spatial design factors that influence informal inter-professional team-based communication within hospital emergency departments (EDs). Effective team communication in EDs is critical for inter-professional 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. Two health services with four hospital sites in Victoria, Australia participated. A multi-stage mixed methods approach used:

  • An anonymous online communication network survey (n=103) to collect data on patterns and locations of informal inter-professional team communication amongst ED staff;
  • Focus groups (n=37) and interviews (n=3) using photo elicitation to understand the perspectives of ED staff about how spatial design influences team communication.
  • Validity testing of findings with managers and executives at the participating sites.

The data suggests that informal communication with peers and within discipline groups on non-specific areas of the ED were most common. Three key factors influence the extent to which ED workspaces are facilitating informal communication:

  • Staff perceptions of privacy;
  • Staff perceptions of safety, and
  • Staff perceptions of connectedness to ED activity.

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 optimise proximity without compromising safety.

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