The current state of scientific knowledge regarding communication between emergency medicine (EM) providers indicates that communication is critical to safe and effective patient care.
In this study, we identified communication needs of EM nurses and physicians; in particular, what information should be conveyed, when, how, and to whom.
Five semi-structured focus groups and one interview were conducted with nine nurses, eight attending physicians, and four residents. Questions addressed how EM personnel use and share information about patients and clinical work, what information tends to be exchanged, and what additional information would be helpful to share. Sessions were audio recorded. Transcripts were generated and analyzed using a concept mapping approach (a visual qualitative analysis technique to represent and convey synthesized knowledge).
Eleven concept maps were produced summarizing: information physicians needed from nurses and vice versa; methods of communication that could be utilized; barriers or obstacles to effective communication; strategies to enhance or ensure effective communication; and environmental or situational factors that impact communication.
Our main finding of this research is that communication ensures shared awareness of patient health status, the care plan, status of plan steps and orders, and, especially, any critical changes or “surprises” regarding the health of a patient. Additionally, the research identified shared information needs; communication methods, strategies and barriers; and factors affecting successful communication, and has implications for both system and training design. Key implications for emergency nursing practice from this research are distilled in 10 ‘best practice’ strategies for improving EM nurse–physician communication.
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- The human factor: the critical importance of effective teamwork and communication in providing safe care.Qual Saf Health Care. 2004; 13: i85-i90
- The potential for improved teamwork to reduce medical errors in the emergency department.Ann Emerg Med. 1999; 34: 373-383
- Communicating in hospital emergency departments.Springer, Heidelberg, Germany2015
- The social construction of health care teams.in: Nemeth C. Improving healthcare team communication: building on lessons from aviation and aerospace. Ashgate Publishing, Farnham, UK2008
- Cognitive engineering design of an emergency department information system.in: Bisantz A.M. Burns C. Fairbanks R.J. Cognitive systems engineering in health care. 1st edn. CRC/Taylor & Francis, Boca Raton, FL2015
- Importance of verbal communication in the electronic age [Abstract].Ann Emerg Med. 2012; 60: S90-S91
- Variation in communication loads on clinical staff in the emergency department.Ann Emerg Med. 2004; 44: 268-273
- Physician and nurse perceptions of non-urgent communication in the emergency department.Ann Emerg Med. 2011; 58: S189
- Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.Ann Emerg Med. 2010; 56: 614-622
- Identifying and correcting communication failures among health professionals working in the Emergency Department.Int Emerg Nurs. 2013; 21: 168-172
- Tumultuous atmosphere (physical, mental), the main barrier to emergency department inter-professional communication.Glob J Health Sci. 2015; 7: 144-153
- Communicating in the “gray zone”: perceptions about emergency physician-hospitalist handoffs and patient safety.Acad Emerg Med. 2007; 14: 884-894
- We need to talk: an observational study of the impact of electronic medical record implementation on hospital communication.BMJ Qual Saf. 2014; 23: 584-588
- Developing a valid evaluation for interpersonal and communication skills.Acad Emerg Med. 2006; 13: 1056-1061
- Assessment of communication and interpersonal skills competencies.Acad Emerg Med. 2002; 9: 1257-1269
- Physician-patient communication in the emergency department, Part 1.Acad Emerg Med. 1996; 3: 1065-1069
- Physician-patient communication in the emergency department, Part 2: communication strategies for specific situations.Acad Emerg Med. 1996; 3: 1146-1153
- Working minds: a practitioner’s guide to cognitive task analysis.The MIT Press, Cambridge, MA2006
- The discovery of grounded theory: strategies for qualitative research.Routledge, New York, NY1967
Published online: March 05, 2020
Accepted: October 27, 2019
Received in revised form: October 21, 2019
Received: June 18, 2019
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