Abstract
Introduction
The physical layout of the emergency department affects the way in which patients
and providers move within the space and can cause substantial changes in workflow
and, therefore, affect communication patterns between providers. There is no 1 ED
design that enables the best patient care, and quantitative studies looking at ED
design are limited. The goal of this study was to examine how different ED designs,
centralized and decentralized, are associated with communication patterns among health
care professionals.
Methods
A task performance, direct observation time study was used. By developing a novel
tablet-based digital mapping tool using a cloud-based mapping platform (ArcGIS), data
on provider actions and interactions were collected and mapped to a precise location
within the emergency department throughout an entire nursing shift.
Results
The difference in the duration of nurse-physician interactions between the 2 ED designs
was statistically significant. Within the centralized design, nurse-physician interactions
totaled 14 minutes and 38 seconds compared with 30 minutes and 11 seconds in the decentralized
design (t = 2.31, P = 0.02). More conversations between nurses and physicians occurred inside the patient’s
room in the decentralized design.
Discussion
Our findings suggest that the ED design affects communication patterns among health
care providers and that the design has the potential to affect the quality of patient
care.
Key words
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Biography
Kailey Tindle is a medical student, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Biography
Allison David is a medical student, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Biography
Stephanie Carlisle is a principal architect, Kieran Timberlake, Philadelphia, PA. Twitter: @Steph_Carlisle.
Biography
Billie Faircloth is a partner architect, Kieran Timberlake, Philadelphia, PA.
Biography
J. Matthew Fields, is an associate professor, Department of Emergency Medicine, Thomas Jefferson University Hospitals, Philadelphia, PA. Twitter: @jmatthewfields.
Biography
Geoffrey Hayden is an associate professor, Department of Emergency Medicine, Thomas Jefferson University Hospitals, Philadelphia, PA. Twitter: @geoffhaydenmd.
Biography
Bon Ku is the Assistant Dean for Health and Design, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA. Twitter: @BonKu.
Article info
Publication history
Published online: June 04, 2020
Footnotes
Earn Up to 7.5 Hours. See page 550.
Identification
Copyright
© 2020 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
