Design to support staff communication in Emergency Departments

A/Prof. Bernice Redley1, Dr   Lucio  Naccarella2, Ms Michaela  Sheahan3

1Deakin University, Burwood, Australia, 2Centre for Health Policy. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia, 3HASSELL, Melbourne, Australia

Objective: Team communication is critical for effective inter-professional collaborative care in Emergency Departments (EDs), contributing to patient safety, positive staff work experiences and organisational effectiveness. There is a need to better understand how ED design influences this informal communication and effective team-based care.

Method: The research was conducted at four public hospital Emergency Departments in Melbourne, Australia.

A Literature review examining the relationship between teamwork, communication and design was followed by an anonymous social network survey of 103 ED staff to examine patterns of informal team communications. Focus groups and interviews used photo elicitation to understand the experiences and perspectives of ED staff about the influence of spatial design upon team communication.

Results: The literature revealed the fundamental importance of communication for effective team work. The survey indicated that informal communication with peers and within discipline groups (e.g. nurses speaking to nurses) was most common, and staff use all areas of the ED to communicate. Participants’ photographs clustered into five ED workspaces: centralised workstations; dedicated rooms; transit spaces; communal spaces, and patient spaces. The conversations that occurred in these spaces related to both professional issues (case talk) and personal issues (comfort talk).

Focus group discussions revealed three key factors influencing the extent to which ED workspaces are facilitating informal communication: staff perceptions of privacy, safety, and connectedness to ED activity.

Conclusions: ED staff are always on their feet, time poor, and managing competing staff and patient demands. In this context, much communication is unplanned or opportunistic. Our research indicates design elements contribute to several tensions within ED that can hinder effective team communication. ED workspace designs need to: provide visibility and connectedness; support ‘case talk’ and ‘comfort talk’ between staff, and optimise staff proximity without compromising safety. This research supports the need for more effective workplace for emergency department teams.


A Registered Nurse and healthcare researcher, I have over 30 years experience and achievements within clinical settings of emergency and acute care, health services management, academic and policy settings. I have well established research partnerships and collaborations with local and international experts. My research program focuses on four interrelated topics:

  1. Interprofessional clinical communication for patient safety and safe transitions in care, within and between teams, in complex settings;
  2. Interprofessional teamwork and the performance of front line clinical teams to enhance care delivery
  3. Patient and family experiences, engagement and participation to ensure safe high quality healthcare in acute settings
  4. Information technology solutions to support communication and acute care delivery.